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Microbiology and Immunology of endodontic infections

Chapter in book
Authors Gunnar Dahlén
Luis Chávez de Paz
Published in Endodontic prognosis. Chugal N., Lin L. (eds)
Pages 13-27
ISBN 978-3-319-42412-5
Publisher Springer
Place of publication Cham
Publication year 2017
Published at Institute of Odontology, Section 3
Pages 13-27
Language en
Keywords Endodontic infections, Infected root canals, Biofilms, Oral microbiology, Chronic infection, Apical periodontitis
Subject categories Oral microbiology


Endodontic infections are complex diseases associated with apical tissue inflammation that is determined by microbial, immunological, and environmental factors. During the past years, the integration of research tools, including molecular techniques for identification, sophisticated in vitro modeling, and human microbiome analysis, has provided additional insight in the understanding of endodontic infections. Recent studies suggest that the basis for infections associated to root canals of teeth is polymicrobial in nature and includes the emergence of microbial colonization in form of biofilms. Biofilms deep seated in areas that are difficult to reach by mechanical treatment will enhance microbial virulence, antibiotic resistance, colonization potential, and resistance. Furthermore, with the advent of the human oral microbiome project, insights on the differences among oral microfloras in different individuals appear to have an important role in progressing endodontic infections. This chapter discusses the current data regarding the role that microbial biofilms play in endodontic infections, as well as its place in the current knowledge of endodontic microbiology. The complex relations between the root canal microflora and the inflammatory response in apical periodontitis are also highlighted in this chapter, as well as their implications in regard to the diagnosis and clinical management of endodontic infections.

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