Abstract
Fungi are chemoorganotroph eukaryotic microorganisms that can take part in endodontic
infections and thereby may participate in the etiology of periradicular diseases.
They possess virulence attributes—including adaptability to a variety of environmental
conditions, adhesion to a variety of surfaces, the production of hydrolytic enzymes,
morphologic transition, biofilm formation, and evasion and immunomodulation of the
host defense—that may play a role in the pathogenesis of periradicular diseases. Fungi
have occasionally been found in primary root canal infections, but they seem to occur
more often in the root canals of obturated teeth in which treatment has failed. Candida albicans is by far the fungal species most commonly isolated from infected root canals, and
this species has been considered a dentinophilic microorganism because of its invasive
affinity to dentin. C albicans has also been discovered to be resistant to some intracanal medicaments, such as
calcium hydroxide. Its ability to invade dentinal tubules and resistance to commonly
used intracanal medicaments may help to explain why C albicans has been associated with cases of persistent root canal infections. Some medicaments,
such as chlorhexidine digluconate, calcium hydroxide combinations (with camphorated
paramonochlorophenol or chlorhexidine), and EDTA, have the potential to be used as
effective intracanal medications for patients in whom fungal infection is suspected.
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References
- Fundamentals of fungi.4th ed. Prentice Hall, Upper Saddle River (NJ)1996
- Brock biology of microorganisms.9th ed. Prentice Hall, Upper Saddle River (NJ)2000
- Candida commensalism and virulence: the evolution of phenotypic plasticity.Acta Trop. 2002; 81: 101-110
- Oral microbiology.4th ed. Wright, Oxford (England)1999
- Association of psychotropic drugs, prevalence of denture-related stomatitis and oral candidosis.Community Dent Oral Epidemiol. 1993; 21: 313-316
- The prevalence and intra-oral distribution of Candida albicans in man.Arch Oral Biol. 1980; 25: 1-10
- Fungal infections in AIDS patients.J Med Vet Mycol. 1992; 30: 19-28
- Role of dentinal carious lesions in the pathogenesis of oral candidiasis in HIV infection.J Am Dent Assoc. 1998; 129: 187-194
- The incidence of Candida albicans in the plaques of teeth of children.Dent Pract Dent Rec. 1972; 22: 296-301
- A comparison of primary root caries lesions classified according to colour.Caries Res. 1994; 28: 233-239
- Yeasts, enteric rods and pseudomonads in the subgingival flora of severe adult periodontitis.Oral Microbiol Immunol. 1988; 3: 47-52
- Studies of the subgingival microflora in patients with acquired immunodeficiency syndrome.J Periodontol. 1990; 61: 699-704
- Genotyping and antifungal susceptibility of human subgingival Candida albicans isolates.Arch Oral Biol. 2002; 47: 189-196
- Yeasts in periodontal pockets.J Clin Periodontol. 2001; 28: 860-864
- Basic mycology.in: Slots J. Taubman M.A. Contemporary oral microbiology and immunology. Mosby, St Louis1992: 59-62
- Cell wall and secreted proteins of Candida albicans: identification, function, and expression.Microbiol Mol Biol Rev. 1998; 62: 130-180
- Molecular organization of the cell wall of Candida albicans.Med Mycol. 2001; 39: 1-8
- Virulence factors of Candida albicans.Trends Microbiol. 2001; 9: 327-335
- Adherence and receptor relationships of Candida albicans.Microbiol Rev. 1991; 55: 1-20
- Candida adherence phenomena, from commensalism to pathogenicity.Int Microbiol. 1998; 1: 117-122
- Adhesins and ligands involved in the interaction of Candida spp. with epithelial and endothelial surfaces.Clin Microbiol Rev. 1994; 7: 29-42
- Coagglutination reactions between Candida albicans and oral bacteria.J Med Microbiol. 1986; 22: 165-169
- Plaque formation by mixed cultures of nonprimary plaque-forming microorganisms.J Dent Res. 1974; 53: 825-831
- Coaggregation of Candida dubliniensis with Fusobacterium nucleatum.J Clin Microbiol. 1999; 37: 1464-1468
- Adherence of Candida albicans to a cell surface polysaccharide receptor on Streptococcus gordonii.Infect Immun. 1995; 63: 1827-1834
- Coaggregation of Candida albicans with oral Actinomyces species.Oral Microbiol Immunol. 1996; 11: 59-61
- Coaggregation of Candida albicans with oral Fusobacterium species.Oral Microbiol Immunol. 1997; 12: 168-173
- Coaggregation of Streptococcus sanguis and other streptococci with Candida albicans.Infect Immun. 1990; 58: 1429-1436
- Effect of microbial interactions on in vitro plaque formation by Streptococcus mutans.J Dent Res. 1974; 53: 427-434
- Virulence in Candida species.Trends Microbiol. 2001; 9: 591-596
- Candida and oral candidosis: a review.Crit Rev Oral Biol Med. 1994; 5: 125-157
- Degradation of human dentine collagen by an enzyme produced by the yeast Candida albicans.Arch Oral Biol. 1988; 33: 617-619
- Potential role of phospholipases in virulence and fungal pathogenesis.Clin Microbiol Rev. 2000; 13: 122-143
- Colonization of Candida albicans on cleaned human dental hard tissues.Arch Oral Biol. 1997; 42: 513-520
- Growth patterns of Candida albicans in relation to radicular dentin.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 84: 68-73
- Fungal morphogenesis and virulence.Med Mycol. 2000; 38: 79-86
- Role of hyphal formation in interactions of Candida albicans with endothelial cells.Infect Immun. 2000; 68: 3485-3490
- Adherence mechanisms of Candida albicans.Br J Biomed Sci. 2000; 57: 241-249
- Candida albicans: adherence, signaling and virulence.Med Mycol. 2000; 38: 125-137
- Biofilms: survival mechanisms of clinically relevant microorganisms.Clin Microbiol Rev. 2002; 15: 167-193
- Candida biofilms.Curr Opin Microbiol. 2002; 5: 608-611
- Production and function of cytokines in natural and acquired immunity to Candida albicans infection.Microbiol Rev. 1995; 59: 646-672
- Rapid killing of monocytes in vitro by Candida albicans yeast cells.Infect Immun. 1986; 51: 307-313
- Yeast extracellular proteases.Crit Rev Biotechnol. 1993; 13: 1-55
- Secretion of TNF-alpha by alveolar macrophages in response to Candida albicans mannan.J Leukoc Biol. 1994; 55: 161-168
- Candida albicans triggers interleukin-6 and interleukin-8 responses by oral fibroblasts in vitro.Oral Microbiol Immunol. 1999; 14: 364-370
- Activation of the complement system by pathogenic fungi.Clin Microbiol Rev. 1996; 9: 34-46
- Taxonomy, ecology, and pathogenicity of the root canal flora.Oral Surg Oral Med Oral Pathol. 1994; 78: 522-530
- Microbiological examination of root canals and periapical tissues of human teeth. Methodological studies.Odontol Tidskr. 1966; 74: 1-380
- Observation of Saccharomyces cerevisiae in blood of patient undergoing root canal treatment.Int Endod J. 1997; 30: 313-317
- Microorganisms isolated from root canals presenting necrotic pulp and their drug susceptibility in vitro.Oral Microbiol Immunol. 2001; 16: 100-105
- Occurrence of Candida albicans in infections of endodontic origin.J Endod. 2000; 26: 695-698
- Direct amplification of rRNA gene sequences for identification of selected oral pathogens in root canal infections.Int Endod J. 2002; 35: 345-351
- Observation of bacteria and fungi in infected root canals and dentinal tubules by SEM.Endod Dent Traumatol. 1995; 11: 6-9
- Patterns of microbial colonization in primary root canal infections.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 174-178
- Scanning electron microscopic observations of apical root surfaces of teeth with apical periodontitis.Endod Dent Traumatol. 1996; 12: 70-76
- Dental sepsis due to Candida albicans causing urticaria: case report.Ann Allergy. 1978; 41: 179-181
- Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study.J Endod. 1990; 16: 580-588
- Fungi in therapy-resistant apical periodontitis.Int Endod J. 1997; 30: 96-101
- Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 86-93
- Microbiological status of root-filled teeth with apical periodontitis.Int Endod J. 1998; 31: 1-7
- Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis.Int Endod J. 2001; 34: 429-434
- Bacteria isolated after unsuccessful endodontic treatment in a North American population.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 579-586
- Microbial flora of root canal-treated teeth associated with asymptomatic periapical radiolucent lesions.Oral Microbiol Immunol. 2001; 16: 332-337
- Microorganisms from canals of root-filled teeth with periapical lesions.Int Endod J. 2003; 36: 1-11
- Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 85-94
- Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation.Int Endod J. 1997; 30: 91-95
- Yeasts in apical periodontitis.Crit Rev Oral Biol Med. 2003; 14: 128-137
- Development of Candida albicans hyphae in different growth media—variations in growth rates, cell dimensions and timing of morphogenetic events.J Gen Microbiol. 1986; 132: 3083-3088
- Candida glabrata: review of epidemiology, pathogenesis, and clinical disease with comparison to C. albicans.Clin Microbiol Rev. 1999; 12: 80-96
- A new method for studying the adhesion of Candida albicans to dentin in the presence or absence of smear layer.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 201-206
- In vitro yeast infection of human dentin.J Endod. 2000; 26: 207-209
- Candidal invasion of dentine complicating hypodontia.Br Dent J. 1983; 154: 400-401
- Dentinal candidiasis in cancer patients.Oral Surg Oral Med Oral Pathol. 1988; 65: 56-60
- Fungal infection of the radicular dentin.J Endod. 2002; 28: 770-773
- Evaluation of antifungal agents for endodontic use.J Dent Res. 1967; 46: 215-217
- An evaluation of the antimicrobial effectiveness of citric acid as root canal irrigant.J Endod. 1986; 12: 54-58
- Antifungal effects of sodium hypochlorite and chlorhexidine in root canals.J Endod. 1999; 25: 235-238
- The effect of ethylenediamine-tetraacetic acid on Candida albicans.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90: 651-655
Ates M, Sen BH, Akdeniz BG. Antifungal effects of calcium sequestering agents (manuscript in preparation).
- Inactivation of local root canal medicaments by dentine: an in vitro study.Int Endod J. 2000; 33: 126-131
- Susceptibility of oral Candida species to calcium hydroxide in vitro.Int Endod J. 1999; 32: 94-98
- In vitro susceptibility of Candida albicans to four disinfectants and their combinations.Int Endod J. 1999; 32: 421-429
- Aetiology of root canal treatment failure: why well-treated teeth can fail.Int Endod J. 2001; 34: 1-10
- Adherence of Candida albicans to immobilized extracellular matrix proteins is mediated by calcium-dependent surface glycoproteins.Microb Pathog. 1993; 14: 133-147
- Effect of calcium uptake on Candida morphology.FEMS Microbiol Lett. 1991; 61: 187-193
- Strategies to treat infected root canals.J Calif Dent Assoc. 2001; 29: 825-837
- Antifungal effects of endodontic medicaments.Aust Endod J. 2001; 27: 112-114
- Effectiveness of intracanal irrigants and medications against the yeast Candida albicans.J Endod. 2002; 28: 68-71
- Effect of sodium hypochlorite and five intracanal medications on Candida albicans in root canals.J Endod. 2001; 27: 401-403
- Elimination of Candida albicans infection of the radicular dentin by intracanal medications.J Endod. 2003; 29: 501-504
Article info
Publication history
Accepted:
December 16,
2003
Received:
November 4,
2003
Rio de Janeiro, Brazil, and Izmir, Turkey ESTÁCIO DE SÁ UNIVERSITY AND EGE UNIVERSITYIdentification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.