Inspection of the Microbiota in Endodontic Lesions

Abstract

The primary objective of endodontic therapy is to create a biologically acceptable environment within the root canal system that allows for the healing and maintenance of the health of the peri-radicular tissue. Bacteria are one of the main causes of pulp problems, and they have different methods of penetrating and invading the endodontic space such as through carious lesions, traumatic pulp exposures, and fractures. The types of bacteria found range from facultative anaerobes to aerobes, up to the most resistant species able to survive in nutrient-free environments; the bacterial species Enterococcus faecalis belongs to this last group. Enterococcus faecalis is considered one of the main causes of recurring apical periodontal lesions following endodontic treatment, with persistent lesions occurring even after re-treatment. The review presented in this paper was performed in accordance with the PRISMA protocol and covers articles from the related scientific literature that were sourced from PubMed, Scopus, and Google Scholar using the following terms as keywords: “endodontic treatment”, “endodontic bacteria”, “microbial endodontic”, and “endodontic failure”. Only the articles considered most relevant for the purposes of this paper were read in full and taken into consideration for the following review. The results show that Enterococcus faecalis, Actinomycetes, and Propionibacterium propionicum are the species most frequently involved in persistent radicular and extra-radicular infections.

Comparative Analysis of the Smear Layer Removal Capability between EndoVac and Endoactivator Endodontic Irrigation Systems at the Root Canal System and Isthmus: A Micro-Computed Tomography Analysis

“…[18]. It has been reported that 130 µm of NaOCl can be introduced into the dentinal tubules [19], while Enterococcus faecalis can penetrate up to a depth of 151 µm and attach to collagen fibers present [20], leaving bacteria harbored in deeper layers, isthmus, accessory canals, anastomoses, and fins [21,22]. Furthermore, endodontic smear layer formation during RCS surgery can cause blockage of dentinal tubules and isthmus, avoiding the effect of NaOCl inside the RCS [23].…”

Antimicrobial peptide GH12 as root canal irrigant inhibits biofilm and virulence of Enterococcus faecalis

“…Enterococcus faecalis ( E. faecalis ) has been isolated from primary endodontic infections, but is more likely to be recovered from cases of with post‐treatment endodontic disease or secondary endodontic infections (Bouillaguet et al 2018), with a prevalence of 24–80% (Stuart et al 2006, Keskin et al 2017), which corresponds to 9.0–99.8% of the total bacterial counts (Antunes et al 2015). The inherent ability of E. faecalis to invade dentinal tubules and form biofilms makes it difficult to completely eliminate it from the complicated root canal system (Ran et al 2015, Dioguardi et al 2019). The persistence of this bacteria in root canals and its resistance to endodontic medicaments may contribute to tissue damage and periapical disease, which is considered to be a possible cause of post‐treatment apical periodontitis (Yang et al 2016, Nishio Ayre et al 2018, Dioguardi et al 2019).…”

Potencial antimicrobiano de diferentes retentores intrarradiculares frente a Enterococcus faecalis: uma avaliação in vitro

“…A presença de microrganismos no interior do canal radicular está fundamentada na literatura pela existência de mais de 400 espécies diferentes de bactérias, as quais estão relacionadas a diversos tipos de infecções endodônticas, uma vez que estas são classificadas de acordo com sua localização: intrarradicular ou extrarradicular 1,2 . Por sua vez, o canal radicular é considerado uma via, a qual se caracteriza por ser suscetível a infecções bacterianas.…”

“…Entretanto, falhas no tratamento endodôntico ou na confecção dos pinos intracanais transcorrem devido à ruptura nos princípios biológicos, uma vez que microrganismos usualmente penetram no sistema de canais radiculares no período entre as consultas ou até mesmo após a finalização do tratamento endodôntico 1,5,6 . Para além disso, após o tratamento de canais radiculares, a quantidade de microrganismos diminui significativamente.…”

“…Para além disso, após o tratamento de canais radiculares, a quantidade de microrganismos diminui significativamente. Porém, o retorno de características de esterilidade dos tecidos infectados é impossível, devido ao fato de que não há eliminação de 100% dos agentes microbianos 1,11 . Neste contexto, vale ressaltar que há a possibilidade de manutenção do crescimento microbiano no interior do sistema de canais radiculares mesmo após o tratamento endodôntico.…”