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.
Highlights
In daily clinical practice, bacteria are the most common cause of lesions, which lead to pulp necrosis [1]
More than 700 bacterial species were identified in the oral cavity [18], all with the potential to lead to contamination of the dental pulp and root canals [19]
Pulp diseases are the main cause of the invasion of endodontic spaces by oral microbial Pulp main and cause of the of endodontic spaces oral microbial flora
Summary
Bacteria are the most common cause of lesions, which lead to pulp necrosis [1]. The lack of an apical seal [5] leads to the formation of a micro-environment [6] that is favorable to the development and selection of facultative anaerobic bacteria [7] including Enterococcus faecalis [8]. The absence of an apical seal [10], together with the absence of a coronal seal, makes the endodontic system a perfect environment for bacteria to proliferate and form a biofilm [11]. The immune system is unable to counteract the pathogens present in the canals, and the absence of an apical seal allows the bacteria to obtain numerous nutrients via the blood vessels, while the loss of the coronal seal enables new bacteria to enter the tooth [12]
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