Penetration of E. faecalis into Root Cementum Cause for Reinfection

Enterococcus faecalis possesses the unique properties such as production of serine protease and specific gene Ace, which aid in binding to extra cellular matrix protein like collagen, aggregation substances that help E. faecalis adhesion to recipient bacteria; helps to form biofilms through surface adhesion, which in turn resist alkalinity of calcium hydroxide in the medicated canal. The production of lipoteichoic acid by E. faecalis enables binding to PNM cell, erythrocytes, and platelets, and lysis of cell in vitro and in vivo. It can resist the high temperature of 60ºC for 30 minutes and can grow at 10–45ºC in a pH of 9.6, and is the most frequently isolated micro-organism from root-filled teeth. E. faecalis can penetrate up to 140 to 160 µm deep into root dentin and root cementum beyond minor constriction in root-filled teeth. The aim of this article is to understand the role of E. faecalis beyond minor constriction and its role in causing persisting infection. It was found that the virulent factors and ability of E. faecalis to penetrate deep into root dentin and root cementum beyond minor constriction and ability to adapt to environment in adverse conditions are the possible causes for persisting infection in root-filled teeth.