Abstract
Bacteria and its by-products are found to be the main cause of pulpal and periapical infection of tooth. Infected root canals of tooth harbours a wide variation of microbial flora that includes both Gram-positive and Gram-negative microorganisms. Bacterial components such as Lipopolysaccharide (LPS) of gram negative bacteria and Lipoteichoic Acid (LTA) of gram positive bacteria have the potential to enter the peri-apical tissue of tooth and initiate the inflammatory process. After microbial death that occurs either due to body’s defence cells or by antibiotic action, bacterial cell wall components such as LTA are released which can persist inside macrophages for prolonged periods causing chronic inflammation. Once these cell-wall components are recognized by the body immune surveillance cells, numerous inflammatory mediators are released leading to inflammation and subsequent pathological consequences. The purpose of this review is intend to summarize the role of gram positive bacterial component LTA in causing endodontic infection and use of potential therapeutic agents against LTA.
Highlights
Evidence based treatment is the new paradigm in global health care
Bacterial components such as Lipopolysaccharide (LPS) of gram negative bacteria and Lipoteichoic Acid (LTA) of gram positive bacteria have the potential to enter the peri-apical tissue of tooth and initiate the inflammatory process
LPS is the commonly investigated bacterial virulence factor but taking into account that endodontic infections are polymicrobial in nature studies can be focused on influence of other bacterial virulence factors
Summary
A wide variation of microbial flora is normally present in infected root canals of tooth. A thorough understanding of the microbiota associated with pulp pathology is the basis for the success of endodontic treatment. The microbiota involved in endodontic treatment failure are facultative anaerobes such as Enterococcus, Actinomyces species and Candida. Gram positive Enterococcus faecalis (E.faecalis) is commonly found in high percentage in sites exhibiting root canal failures and it survives as a single organism or as a major component of the flora in the root canals of tooth. Bacterial virulence factors which are primarily involved in various stages of endodontic as well as peri-apical infections promotes bacterial colonization and activation of host defence mechanisms. Among various virulence factors of gram positive bacteria, Lipoteichoic acid (LTA) which has pathogenic potential similar to that of gram-negative bacteria virulence factor Lipopolysaccharide,plays a key role in serious inflammatory responses[1,2]
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