Ashraf F. Fouad, BDS, DDS, MS
Professor and Chair
Department of Endodontics, Prosthodontics and Operative Dentistry
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 primary and persistent endodontic infections using contemporary molecular techniques. We are also interested in whether host factors such as chronic systemic disease play a role in controlling the microbial composition, and thus in modulating the presentation and healing of endodontic infections. We are also interested in whether endodontic infections may contribute to the pathogenesis of certain system chronic conditions in which microbial factors participate in the pathogenesis. Finally, we are investigating how more effective antimicrobial therapy may enhance and accelerate healing following endodontic therapy.
Endodontic treatment outcomes:
With the advent of newer technologies in endodontic treatment, there is a great need to undertake 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 novel imaging technologies, and accurate documentation of host and microbial factors at the time of treatment are important parameters in evaluating treatment outcome. Furthermore, the effects of chronic systemic disease such as diabetes mellitus on the treatment outcome is essential in understand the various factors of clinical importance both in diabetics and non-diabetics.
Dental Pulp Regeneration:
Over the past decade, there has been a growing interest in whether regenerative procedures could promote vital tissue growth with the root canal of immature teeth that developed endodontic infections due to trauma, caries or congenital abnormalities. Our group is interested in identifying optimal antimicrobial methods to disinfect the pulp space without interfering with the viability of stem cells of the apical papilla, that are thought to pioneer vital tissue regrowth into the pulp. We are also interested in developing animal models to show the efficacy of tissue engineered constructs that would promote dental pulp regeneration in these immature teeth, in order to resume normal formation of the root structure.
- 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
- Nandakumar R, Whiting J, Fouad AF. Identification of selected respiratory pathogens in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106:145-51.
- Kakoli P., Nandakumar R., Romberg E., Arola D., Fouad A.F. The effect of age on bacterial penetration of radicular dentin. J Endod 2009:35(1):78-81
- Nandakumar R, Madayiputhia N, Fouad AF. Proteomic Analysis of Endodontic Infections by Liquid Chromatography -Tandem Mass Spectrometry. Oral Microbiol Immunol 2009 (in press)
- Li L, Hsiao WWL, Nandakumar R, Barbuto SM, Mongodin EF, Paster BJ, Fraser-Liggett CM, and Fouad AF. Analyzing Endodontic Infections by Deep Coverage Pyrosequencing. J Dent Res:2010; 89 (9); 980-4
- Alongi DJ, Yamaza T, Song Y, Fouad AF, Romberg EE, Shi S, Tuan RS, Huang GT. Stem/progenitor cells from inflamed human dental pulp retain tissue regeneration potential. Regen Med 2010 Jul; 5(4):617-31.
- Fouad, AF. The Microbial Challenge to Pulp Regeneration. Adv Dent Res 2011; 23 (3) July: 285-9.
- G.B. Jungermann, K. Burns, R. Nandakumar, M. Tolba, R.A. Venezia, A.F. Fouad. Antibiotic resistance in primary and persistent endodontic infections. J Endod 2011; 37(10):1337-44.
- Hsiao WWL, Li KL, Liu Z, Jones C, Fraser-Liggett CM, and Fouad AF. Microbial transformation from normal oral microbiota to acute endodontic infections. BMC Genomics 2012; 13:345; 1-15.
- Fouad, AF and Nosrat A. Dental pulp regeneration in previously infected root canal space. Endod Topics 2013; 28: 24-37.
- Hong BY, Lee TK, Lim SM, You YJ, JH Park, Han SH, Zhu Q, Safavi KE, Fouad AF, Kum KY. Microbial analysis in primary and persistent endodontic infections using pyrosequencing. J Endod; 39: (9) 1136-40.
- Nosrat A, Li K, Vir K, Hicks ML, Fouad AF. Is pulp regeneration necessary for root maturation? J Endod; 2013 (10):1291-5.
- Gomes MS; Blattner TC, Filho MS, Grecca FS, Hugo FN, Fouad AF, Reynolds MA. Can apical periodontitis modify systemic levels of inflammatory markers? A systematic review and meta-analysis. J Endod; 2013 (10):1205-17
- Li F, Weir MD, Fouad AF, Xu HHK. Time-kill behavior against eight bacterial species and cytotoxicity of antibacterial monomers, J Dent, 2013; 41:881-91.