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Ashraf F. Fouad, BDS, DDS, MS
Professor, Chairman, Director of Postgraduate Endodontics
Department of Endodontics, Prosthodontics and Operative Dentistry
Endodontics

Research Interests:

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.

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 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 system disease such as diabetes mellitus on the treatment outcome is essential in understand the various factors of clinical importants both in diabetics and non-diabetics.

Identification of effective endodontic antimicrobial agents:
Pulpal and periradicular disease is caused by 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.


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 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 ;37(10):1337-44.
  • Arola D., Ivancik J., Majd H., Fouad A.F., Bajaj D., Zhang X., and Eidelman N. On the Microstructure and Mechanical Behavior of Radicular and Coronal Dentin. Endod Topics, 2011 (in press).