Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm Communities

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Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm Communities

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Publication Article, peer reviewed scientific
Title Redefining the Persistent Infection in Root Canals: Possible Role of Biofilm Communities
Author(s) Chávez de Paz, Luis Eduardo
Date 2007
English abstract
Current concepts suggest that persisting infections subsequent to endodontic therapy are caused by one or two bacterial species that are "too robust" to be eliminated by conventional treatment measures. As a consequence, numerous studies are exploring the characteristics of these "most" resistant organisms to define an effective treatment strategy to eradicate them from root canals. By taking an ecological perspective, the main objective of this review is to present evidence that the nature of persisting endodontic infections depends not on the robustness of the organisms in the infected site, but on their capability of adapting their physiology to the new environmental conditions set by the treatment. Changes in the environment, such as an increase in pH by calcium hydroxide or the effect of antimicrobials, are capable of triggering genetic cascades that modify the physiological characteristics of bacterial cells. Surface adherence by bacteria to form biofilms is a good example of bacterial adaptation and one that is pertinent to endodontic infections. Increasing information is now available on the existence of polymicrobial biofilm communities on root canal walls, coupled with new data showing that the adaptive mechanisms of bacteria in these biofilms are significantly augmented for increased survival. This ecological view on the persisting infection problem in endodontics suggests that the action of individual species in persisting endodontic infections is secondary when compared to the adaptive changes of a polymicrobial biofilm community undergoing physiological and genetic changes in response to changes in the root canal environment.
DOI http://dx.doi.org/10.1016/j.joen.2006.11.004 (link to publisher's fulltext)
Host/Issue Journal of Endodontics;6
Volume 33
ISSN 0099-2399
Pages 652-662
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/5386 (link to this page)

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