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Clinical studies using culture and molecular microbiology methods to identify the microbial taxa present exclusively in the apical root canal segment of infected teeth with apical periodontitis were included. Studies were critically assessed using the Joanna Briggs Institute Critical Prevalence Assessment Checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 2277 articles initially detected, 52 were selected for full reading and 21 were eventually included in this review. Of these, molecular methods were used in 19 and culture in 2 studies. Ten studies evaluated primary infections, 8 evaluated posttreatment infections, and 3 included both. Cryopulverization of the apical root specimens was conducted in 11 studies. All studies evaluated the prevalence and diversity of bacteria, and only one also reported on fungi. Overall, the most frequent\/abundant bacterial taxa found in the apical canal of primary infections were\n                      <jats:italic>Pseudoramibacter alactolyticus, Olsenella uli<\/jats:italic>\n                      ,\n                      <jats:italic>Fusobacterium<\/jats:italic>\n                      species,\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      species,\n                      <jats:italic>Porphyromonas endodontalis<\/jats:italic>\n                      ,\n                      <jats:italic>Prevotella<\/jats:italic>\n                      species,\n                      <jats:italic>Actinomyces<\/jats:italic>\n                      species,\n                      <jats:italic>Parvimonas micra, Treponema denticola<\/jats:italic>\n                      , Synergistetes species, and an as\u2010yet uncharacterized taxon. In posttreatment infections, the most prevalent\/abundant bacterial taxa included species of\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Fusobacterium<\/jats:italic>\n                      ,\n                      <jats:italic>Actinomyces<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudoramibacter, Pseudomonas,<\/jats:italic>\n                      and\n                      <jats:italic>Propionibacterium<\/jats:italic>\n                      . At the phylum level,\n                      <jats:italic>Firmicutes<\/jats:italic>\n                      was the most represented. The average apical bacterial load ranged from 10\n                      <jats:sup>5<\/jats:sup>\n                      to 10\n                      <jats:sup>6<\/jats:sup>\n                      in primary infections and from 10\n                      <jats:sup>3<\/jats:sup>\n                      to 10\n                      <jats:sup>4<\/jats:sup>\n                      in posttreatment infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Microbial diversity in the apical part of the root canal system was examined encompassing data from both primary and posttreatment infections. Heterogeneity amongst the studies, especially in sample collection and microbial identification methods, is an important limitation that prevented a meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a pronounced bacterial diversity in the infected apical canal, with a high interindividual variability. Different microbiome compositions at the species\/genus level are observed according to the infection type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42021275886.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iej.14071","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T10:19:07Z","timestamp":1713435547000},"page":"1043-1058","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Apical root canal microbiome associated with primary and posttreatment apical periodontitis: A systematic review"],"prefix":"10.1111","volume":"57","author":[{"suffix":"Jr","given":"Jos\u00e9 F.","family":"Siqueira","sequence":"first","affiliation":[{"name":"Postgraduate Program in Dentistry University of Grande Rio (UNIGRANRIO)  Rio de Janeiro RJ Brazil"},{"name":"Department of Endodontics, Faculty of Dentistry Igua\u00e7u University (UNIG)  Nova Igua\u00e7u RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2326-2367","authenticated-orcid":false,"given":"Warley O.","family":"Silva","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Dentistry University of Grande Rio (UNIGRANRIO)  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaline","family":"Romeiro","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Dentistry University of Grande Rio (UNIGRANRIO)  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana F.","family":"Gominho","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa PB Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9922-8202","authenticated-orcid":false,"given":"Fl\u00e1vio R. 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