Microbial Biofilms in Endodontics

Abstract

Microorganisms colonizing different sites in humans have been found to grow predominantly in complex structures known as biofilms. Biofilms are dynamic systems with attributes of both primordial multicellular organisms and represent a protected mode of growth that allows cells to survive. The initial stage of biofilm formation includes the attachment of bacteria to the substratum. Bacterial growth and division then leads to the colonization of the surrounding area and the maturation of the biofilm. The environment in a biofilm is not homogeneous; the bacteria in multispecies biofilms are not randomly distributed, but rather are organized to best meet their requirements. The implications of this mode of microbial growth in the context of endodontic infections are discussed in this chapter. Although there is an initial understanding on the mechanisms of biofilm formation in root canals and its associated resistance to clinical antimicrobial regimens, this topic is still under investigation. A greater understanding of biofilm processes should lead to novel, effective control strategies for endodontic biofilm control and a resulting improvement in patient management.