Reconsideration of treatment protocol on the reduction of Enterococcus faecalis associated with failed root canal treatment

Woo Cheol Lee; Seong-Tae Hong; WonJun Shon

doi:10.5395/JKACD.2008.33.6.560

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Lee, Hong, and Shon: Reconsideration of treatment protocol on the reduction of Enterococcus faecalis associated with failed root canal treatment

Original Article

Journal of Korean Academy of Conservative Dentistry

Journal of Korean Academy of Conservative Dentistry 2008; 33(6): 560-569.

Published online: 30 November 2008

DOI: https://doi.org/10.5395/JKACD.2008.33.6.560

Reconsideration of treatment protocol on the reduction of Enterococcus faecalis associated with failed root canal treatment

Woo Cheol Lee, Seong-Tae Hong, WonJun Shon

Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.

Corresponding Author: Woo Cheol Lee. Department of Conservative Dentistry, School of Dentistry, Seoul National University & Dental Research Institute, 28 YunGun-Dong, JongNo-Gu, Seoul, Korea. 110-749, Tel: 82-2-2072-1634, Fax: 82-2-2072-3859, jimin525@snu.ac.kr

Received 23 September 2008 Revised 21 October 2008 Accepted 23 October 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Microorganism survived in the root canal after root canal cleaning and shaping procedure is a main cause of root canal treatment failure. There are several mechanisms for the bacteria to survive in the root canal after chemomechanical preparation and root canal irrigation. Bacteria organized as biofilm has been suggested as an etiology of persistent periapical lesion. Recent studies were focus on removal of Enterococcus faecalis biofilm due to the report that the persistence of this bacteria after root canal treatment may be associated with its ability to form biofilm. Several investigations demonstrated that current root canal treatment protocol including use of NaOCl, EDTA and Chlorhexidine as irrigants is quite effective in eliminating E. faecalis biofilm. However, this microorganism still can survive in inaccessible areas of root canal system and evade host immune response, suppress immune activity and produce biofilm. Up to date, there is no possible clinical method to completely get rid of bacteria from the root canal. Once the root canal treatment failure occurred, and conventional treatment incorporating current therapeutic protocol has failed, periapical surgery or extraction should be considered rather than prolong the ineffected retreatment procedure.

Keywords: Enterococcus faecalis, Treatment protocol, Biofilm, Persistent periapical lesion

Figures and Tables

Table 1

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