The role of Enterococcus faecalis in apical periodontitis

Abstract

Relevance. Apical periodontitis is one of the most common periodontal diseases. Enterococcus faecalis, which naturally inhabits the intestine, relatively rarely colonizes the oral mucosa of healthy individuals – in 1-20% of cases. However, 68% of patients with oral infectious diseases (caries, pulpitis, periodontitis, etc.) demonstrate it, especially patients with comorbidity, e.g., diabetes mellitus (60% of cases). It may change the risk profile of the inflammatory periodontal disease progression caused by the appearance of unusual pathogens in the oral cavity. In the primary apical periodontitis, microorganisms usually spread into the periodontium from necrotized tissues of the tooth pulp, in secondary periodontitis – from the endodontically treated root canals. E faecalis has unique properties, i.e. resistance to physical and chemical factors, nutrient deficiency, which leads to the selection of this microorganism during the development of secondary apical periodontitis. 30-90% of root canals demonstrate this microorganism in this pathology. 33% of secondary apical periodontitis treatment fail due to this microorganism infection. E. faecalis exhibits natural and often acquired resistance to local and systemic antimicrobial drugs.Thus, successful treatment of apical periodontitis requires identifying the microorganism and/or determining the composition of the microbial community that caused its development and determination of sensitivity to antimicrobial drugs due to the high frequency of association of this disease with i nfection of the affected area of E. faecalis.