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YEASTS IN APICAL PERIODONTITIS

¹ Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520 Turku, Finland; ² Department of Restorative Dentistry and Endodontics, Ege University, Izmir, Turkey; ³ Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Finland; ⁴ NIOM, Scandinavian Institute of Dental Materials, Haslum, Norway; ⁵ Department of Endodontics, Dental Faculty, University of Oslo, Norway

*corresponding author, tuomas.waltimo{at}utu.fi

Microbiological reports of apical periodontitis have revealed that yeasts can be isolated from approximately 5-20% of infected root canals. They occur either in pure cultures or together with bacteria. Almost all isolated yeasts belong to the genus Candida, and the predominant species is C. albicans. Pheno- and genotypic profiles of C. albicans isolates show heterogeneity comparable with those of isolates from other oral sites. C. albicans expresses several virulence factors that are capable of infecting the dentin-pulp complex, including dentinal tubules. This causes, consequentially, an inflammatory response around the root apex, which suggests a pathogenic role for this organism in apical periodontitis. Yeasts are particularly associated with persistent root canal infections that do not respond favorably to conservative root canal therapy. This may be due to the resistance of all oral Candida species against a commonly used topical medicament, calcium hydroxide. However, other antimicrobial agents may offer alternative therapeutic approaches and improve the treatment of these persistent cases of apical periodontitis.

Key words. Apical periodontitis, Candida, endodontics, yeast infection

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