To evaluate the presence of bacteria in permanent teeth with intact crowns (without caries, periodontal disease, or dental trauma) in sickle cell anaemia patients (HbSS genotype) by analyzing their clinical, imaging, and microbiological parameters.
This is a case series study nested in a cohort. In the first follow-up of this cohort study (Costa et al. 2013), ten HbSS patients with at least one tooth with intact crown and clinically diagnosed with pulp necrosis, by pulse oximetry adapted for dentistry and a cold sensitivity test (n = 27 teeth), were selected. Changes in the pulp chamber, root, and periodontal ligament were identified in the tomographic analysis. Bacterial culture, staining for live and dead bacteria, and real-time polymerase chain reaction with 16S rRNA primers were used to identify the presence of bacteria. Culture sample collection was performed immediately after access to the pulp chamber. The microbiome was analyzed with a MiSeq sequencer (Illumina, San Diego, CA).
The diagnosis of pulp necrosis was clinically confirmed in 82% (22/27) of the teeth. The amount of bacterial load identified was less than 100 copies/μL in 23% (5/22) of the teeth with intact crowns and pulp necrosis. Thirteen bacterial species were identified that are commonly found in urinary tract infection, septicemia, and infective endocarditis. Only one of these species, Granulicatella adjacens, has also be found in primary endodontic infections.
Prospective clinical, imaging and microbiological analyses suggest that pulp necrosis of teeth with intact crowns from HbSS patients is not caused by the presence of bacteria.

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