NS-23 Apical Periodontitis and Bacterial Biofilms: A Strict Interrelationship

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CE Hours: 1.5

Program Overview:

Recent histomorphological studies have demonstrated that bacteria are often observed to form complex structures adhering to the root canal walls in teeth with necrotic pulps and periapical radiolucencies. These structures, known as "biofilms," have also been associated with apical periodontitis. This presentation will describe the various periapical responses to the apical progression of pulp degeneration. In addition, the patterns of bacterial colonization of anatomical complexities such as isthmuses, lateral canals and apical ramifications will be explained. The mechanisms by which bacteria invade the periapical tissue and become established extraradicularly, depending on various time factors, will also be analyzed. Finally discussed will be the role of the lesion type and the importance of bacterial biofilm localization on the nonhealing of periapical pathosis following contemporary root canal treatment.  

At the conclusion, participants should be able to:

  • Describe the important aspects of bacterial colonization of the root canal system and periapical lesion formation.
  • List the current limitations of contemporary root canal instrumentation and obturation on obtaining a bacteria-free endodontic environment.
  • Discuss the impact of a periradicular infection on the outcome of conventional endodontic treatment.


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7 Questions
CE Test
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass
1.50 CE credits  |  Certificate available
1.50 CE credits  |  Certificate available

Domenico Ricucci, D.D.S., M.D.

Dr. Domenico Ricucci received his degree in General Medicine from “La Sapienza” University of Rome in 1982, and his DDS from the same University in 1985. Since then on he has maintained private dental practices limited to endodontics. In addition to his private practice, Dr. Ricucci was Professor of Cariology at “Magna Graecia” University of Catanzaro, Italy in 2002 -2003. He served in the Research Committee of the European Society of Endodontology from 1999 to 2005. Dr. Ricucci’s primary research interest relates to pulpal and periapical tissue reactions to caries and treatment procedures, biofilms in endodontic infections, etiology of RTC treatment failure, pulp regeneration/revascularization. Since 1998 he has run his own histology laboratory and has developed considerable skills in hard tissue preparations for light microscopy. Dr Ricucci has published 110 papers and has lectured both nationally and internationally. He has authored the Textbook and Atlas “Patologia e Clinica Endodontica”, the textbook and atlas “Endodontology. An integrated biological and clinical view”. He has also authored or co-authored eighteen book chapters.

I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.