Microbiota of the Root Canal System in Patients With Destructive Forms of Chronic Apical Periodontitis Before and After Standard Endodontic Treatment and Modern Possibilities of Influencing It

The study involved 32 patients with destructive forms of chronic apical periodontitis and examined microbiological changes before and after standard endodontic treatment. Results showed that by the 10th day of treatment, small associations of microorganisms, including gram-positive and gram-negative bacteria and Candida albicans, were present at the root apex. In vitro tests revealed that hydroxyapatite gel had a strong bactericidal effect on Staphylococcus aureus and Candida albicans, while platelet-enriched blood autoplasm had a weak effect. The combined use of these substances showed no antibacterial effect. The study suggested that incorporating these substances sequentially in endodontic treatment could optimize the standard protocol for treating destructive forms of chronic apical periodontitis.