Ashraf F. Fouad, B.D.S., D.D.S., M.S.

Research Interests:

1) Microbial analysis of endodontic infections:
 
 Novel molecular techniques offer high specificity and sensitivity in detecting cultivable as well as not-yet-cultured endodontic pathogens. Over the past few years we have sought to characterize the microbial irritants in endodontic infections and relate them to a history of diabetes mellitus. We are also interested in describing a clonal analysis of microbial associations with clinical symptoms and resistance to healing.

2) Endodontic treatment outcomes:
 With the advent of newer technologies in endodontic treatment, there is a great need to run randomized clinical trials to determine the most effective clinical protocols. Central to these studies are clinical information systems that allow the tracking of data on patient care, and the use of novel diagnostic and imaging systems. The objective determination of healing of periradicular lesions is critical in these studies. Thus the use of algorithms to document radiographic changes with time is an important component of evaluating treatment outcome. Furthermore, the effects of system disease and residual microbial phylotypes on the treatment outcome is essential in obtaining a comprehensive determination of the treatment outcome.

3) Identification of effective endodontic antimicrobial agents:
Pulpal and periradicular disease is caused by microorganisms and microbial irritants, and can cause significant morbidity, and on rare occasions mortality. The prognosis of endodontic therapy in cases with pre-operative infections (pulp necrosis with periradicular disease) is lower than that of cases with vital pulp, and frequently these teeth are lost. However, the healing of extraction sockets following extraction of a tooth with a periradicular lesion appears to be faster and more predictable than healing following endodontic therapy. Therefore, more effective antimicrobial therapy may enhance and accelerate healing following endodontic therapy.

 Selected Recent Publications

• Fouad AF, Acosta AW. The effect of LPS hyporesponsiveness on periapical lesion progression and cytokine expression in a murine model. Int Endod J 2001; 34: 506-13.
• Fouad AF, Barry J, Russo J, Radolf J, Zhu Q. Periapical lesion progression with controlled microbial inoculation in a type 1 diabetic mouse model. J Endod 2002; 28(1):8-16.
• Fouad AF, Barry J, Caimano M, Clawson M, Zhu Q, Carver R, Hazlett K, Radolf JD. PCR-based identification of bacteria in endodontic infections. J Clin Microbiol 2002; 40(9):1491-01.
• Fouad AF, Burleson J. The Effect of Diabetes Mellitus on Endodontic Treatment Outcome: Data from an Electronic Patient Record. JADA 2003; 134(1): 43-51
• Fouad AF. Are antibiotics effective for endodontic pain? - An evidence-based review. Endod Topics 2002 (3-1): 52-66.
• Fouad AF. Diabetes mellitus as a modulating factor of endodontic infections. J Dent Educ 2003; (4): 459-67.
• Fouad AF, Kum K-Y, Clawson ML, Barry J, Abenoja C, Zhu Q, Caimano M, Radolf JD. Molecular characterization of the presence of Eubacterium spp. and Streptococcus spp. in endodontic infections. Oral Micobiol Immunol 2003(18) 249-255.
• Fouad AF, Zerella J, Barry J, Spangberg LS. Molecular detection of Enterococcus spp. in root canals of therapy-resistant endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99(1): 112-118.
• Fouad AF, Barry J. The Effect of Antibiotics and Endodontic Antimicrobials on the Polymerase Chain Reaction. J Endod 2005; 31(7): 510-13.
• Kaufman B, Spangberg LS, Barry J, Fouad AF. Enterococcus spp. in endodontically treated teeth with and without periradicular lesions. J Endod 2005; 31(12): 851-6.
• Zerella JA, Fouad AF, Spångberg LSW. The effectiveness of a mixture of Calcium Hydroxide and Chlorhexidine Digluconate as a disinfectant during retreatment of failed endodontic cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100(6): 756-61.
• Nandakumar R, Mirchandani R, Fouad AF. Primer Sensitivity: Can it influence the results in Enterococcus faecalis prevalence studies? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103(3): 429-32.
• Cook J, Nandakumar R, Fouad AF. Molecular- and culture-based comparison of the effects of antimicrobial agents on bacterial survival in infected dentinal tubules. J Endod 2007; 33(6):690-2
• Warren CA, Mok L, Gordon S, Fouad AF, Gold MS. Quantification of Neural Protein in Extirpated Tooth Pulp. J Endod 2008 Jan; 34(1):7-10.
• Nandakumar R, Whiting J, Fouad AF. Identification of selected respiratory pathogens in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod (in press).