Impact of root canal preparation using two single-file systems on the intra-radicular microbiome of teeth with primary apical periodontitis

Rodrigues Amaral, Rodrigo, Love, Robert M., Braga, Tiago, Souza Côrtes, Maria I., Rachid, Caio T.C.C., N. Rôças, Isabela, and Siqueira, José F. (2024) Impact of root canal preparation using two single-file systems on the intra-radicular microbiome of teeth with primary apical periodontitis. Clinical Oral Investigations, 28. 139.

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Objectives: This study aimed to describe the effects of two single-file systems on the diversity of the endodontic microbiome of teeth with primary asymptomatic apical periodontitis.

Materials and methods: The root canals from single-rooted teeth with apical periodontitis were prepared using either the Reciproc Blue (RB) or the XP-endo Shaper (XPS) instrument system. The latter was followed by a supplementary step with the XP-endo Finisher (XPF) instrument. For irrigation, 5.25% sodium hypochlorite was used. Root canal samples were taken at the baseline (S1), after preparation (S2), and after the supplementary step (S3). DNA was extracted and subjected to high-throughput sequencing using the MiSeq Illumina platform.

Results: Samples from 10 teeth from the RB and 7 from the XPS group were subjected to DNA sequencing. Initial samples differed significantly from post-preparation samples in bacterial diversity, with no significant difference when comparing the two instrument systems. The most dominant phyla in S2 were Bacteroidetes, Proteobacteria, Firmicutes, Fusobacteria, and Actinobacteria. The same phyla were found to dominate baseline samples and samples taken after using XPF, but with differences in the ranking of the most dominant ones. At the genus level, the most dominant genera identified after RB instrumentation were Bacteroidaceae [G-1], Fusobacterium, and Staphylococcus, while the most dominant genera after XPS instrumentation were Fusobacterium and Porphyromonas. These genera were also dominant in the initial samples.

Conclusions: Both treatment protocols had measurable effects on the root canal microbial diversity, with no significant differences between them. Most of the dominant taxa involved in the primary infection and probably in the aetiology of apical periodontitis were eliminated or substantially reduced.

Clinical relevance: The most dominant taxa that persisted after instrumentation were Fusobacterium, Porphyromonas, Staphylococcus, and Bacteroidaceae [G-1].

Item ID: 81784
Item Type: Article (Research - C1)
ISSN: 1436-3771
Keywords: 16S ribosomal RNA sequencing; Apical periodontitis; Endodontic infection; High-throughput sequencing; Root canal preparation
Copyright Information: © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Date Deposited: 09 Apr 2024 06:40
FoR Codes: 31 BIOLOGICAL SCIENCES > 3107 Microbiology > 310703 Microbial ecology @ 70%
42 HEALTH SCIENCES > 4203 Health services and systems > 420315 One health @ 30%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100%
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