ABSTRACT
Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms' formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.
ABSTRACT
BACKGROUND: The most common cause of failure of endodontic therapy is inadequate apical and coronal seal. Proper coronal seal reduces the risk of endodontic failure. Hence, the present study was done to test the role of self-etching primers in reducing microleakage through coronal seal. MATERIALS AND METHODS: Following root canal preparation and obturation, 46 specimen teeth were subjected to one of the test methods as follows: Group I - deproteinization with 3% sodium hypochlorite and etching with 37% phosphoric acid; Group II - deproteinization with 3% sodium hypochlorite and chelation with 15% ethylenediaminetetraacetic acid (EDTA) (Glyde) without etching. Group I and Group II were further divided into two subgroups with 10 specimens in each: In subgroup A, Clearfil Liner Bond 2V was used and in subgroup B, Excite was used. Group III (obturated without access restorative material) had six specimens. RESULTS: Spectrophotometric analysis was done to quantitatively analyze the amount of dye leakage. Microleakage values obtained in Group I and Group II were comparable. In Group I, marginally better values were obtained with the Clearfil Liner Bond 2V in comparison with Excite. In Group II, microleakage values obtained with Clearfil Liner Bond 2V and Excite were similar and statistically not significant. In Group III (control) where no access restoratives were placed, maximum leakage was observed. CONCLUSIONS: Maximum leakage values were observed in Group III, when obturated without access restorative and when exposed to artificial saliva. Clearfil Liner Bond 2V as a self-etching primer showed better values in preventing microleakage. Deproteinization may be important to reduce microleakage when using the fifth-generation bonding system (Excite) and sixth-generation bonding system (Clearfil Liner Bond 2V).
