Evaluation of Presence of Enterococcus faecalis in Root Canals of Deciduous Molars with Necrotic Pulp by Agar Culture and Polymerase Chain Reaction

Successful endodontic therapy of teeth with necrotic pulp depends upon reduction or elimination of infecting bacteria. 1Necrotic pulp tissue harbors an array of microbiota, with anaerobes like Porphyromonas gingivalis, Prevotella intermedia, Porphyromonas endodontalis, and Enterococcus faecalis, to name a few. [2][3]][4][5] Enterococcus faecalis, most commonly recovered from teeth with failed endodontic therapy, [6][7][8] was recently also found in primarily infected teeth. 9,10nterococcus faecalis is a gram-positive facultative anaerobe occurring solitary, in pairs or short chains, and can thrive in extreme conditions like alkaline pH of 9.6 and temperature of 60°C for as long as 30 minutes.It is a virulent bacteria due to the presence of lytic enzymes like cytolysin, pheromones, and lipoteichoic acid, suppressing the action of lymphocytes, hence, potentially contributing to endodontic failure. 11,12Enterococcus faecalis, being small in size, invades dentinal tubules and can endure prolonged periods of starvation. 13It can also utilize serum originating from alveolar bone and periodontal ligament as a source of nutrition and synthesize an array of stress proteins when exposed to adverse environmental conditions. 14Such a microorganism situated in inaccessible parts of root canals of deciduous tooth with necrotic pulp may be difficult to eradicate due to the complex root canal morphology and anatomical irregularities.