Abstract
Endodontic infections are often interkingdom biofilms, though current clinical management rarely considers this phenomenon. This study aimed to evaluate new and standard endodontic antimicrobial regimens against simple and complex Candida albicans and Enterococcus faecalis mono- and dual-species biofilms. C. albicans and E. faecalis mono- and dual-species biofilms were grown upon Thermanox™ coverslips and treated for 5 min with 3% NaOCl, 3% NaOCl followed by 17% EDTA, or 9% HEDP dissolved in 3% NaOCl. The number of cells remaining immediately after treatment at 0 h and after 72 h of regrowth were assessed using real-time quantitative PCR. All three treatment arms showed a similar positive antimicrobial effect on C. albicans and E. faecalis in both mono- and dual-species biofilms following initial treatment, resulting in ≥98% reduction in colony forming equivalent (CFE). Regardless of species or biofilm type (mono- or dual- species), the antimicrobial effect of NaOCl:HEDP mixture was comparable to that of NaOCl alone, with both showing significant regrowth after 72 h, whereas sequential treatment with NaOCl and EDTA consistently prevented significant regrowth. Our data suggest that sequential irrigation with NaOCl and EDTA remains the antimicrobial strategy of choice as it significantly reduces biofilm persistence and regrowth in our experimental dual-species biofilm conditions.
Highlights
Apical periodontitis arises from micro-organisms mainly organized as microbial biofilm in the intricate anatomy of the root canal system [1,2]
The effect of treatment regimens on planktonic mono-species and dual-species microorganisms was established through planktonic minimum inhibitory concentration (PMIC)
C. albicans is significantly more susceptible to NaOCl and NaOCl:HEDP treatment when co-cultured with E. faecalis, suggesting some level of interkingdom antagonism
Summary
Apical periodontitis arises from micro-organisms mainly organized as microbial biofilm in the intricate anatomy of the root canal system [1,2]. It is widely accepted that biofilms rarely exist as single species entities. They exist as complex, diverse and heterogeneous cellular communities of organisms spanning different phylogenetic kingdoms [3]. Enterococcus faecalis has been classically associated with endodontic infections, and whilst occasionally detected in primary infections, it is more frequently associated with post-treatment disease [5]. Less well recognised with post-treatment disease, but arguably as important is the yeast Candida albicans. Its prevalence in canals of failing root filled teeth varies from one study to another [6,7], though it has been reported to be as high as 36.7% [8]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
