ArticleJournal of conservative dentistry and endodontics2026
Microbial dynamics in primary and refractory apical periodontitis: Next-generation 16S rRNA sequencing reveals selective shifts and reduced diversity.
Article in Journal of conservative dentistry and endodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Context: Apical periodontitis (AP) is an inflammatory condition caused by root canal infection. Primary AP (PAP) arises from untreated necrotic pulp and is typically polymicrobial, whereas persistent or refractory AP (RAP) occurs after root canal treatment (RCT) and may reflect selective microbial survival. Aim: The study aimed to compare the root canal microbiomes in PAP and persistent AP using 16S rRNA gene sequencing in a standardized mandibular molar cohort. Settings and Design: Comparative, observational, cross-sectional study conducted at a tertiary care dental institution. Materials and Methods: Intracanal samples were collected from 45 systemically healthy adults (30 RAP, 15 PAP) with chronic asymptomatic mandibular molars (Periapical Index 2-4). Samples were processed using Illumina MiSeq sequencing targeting the V3-V4 region. Bioinformatics analysis was performed using QIIME 2 and DADA2 pipelines. Statistical Analysis Used: Alpha diversity was analyzed using the Mann-Whitney Results: RAP exhibited significantly reduced alpha diversity ( Conclusions: Persistent AP is associated with reduced microbial diversity and enrichment of Gram-positive organisms, particularly
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