Research progress on the dentin adhesion of Enterococcus faecalis and its influencing factors / 口腔疾病防治

ABSTRACT

@#Enterococcus faecalis is the main pathogen causing refractory apical periodontitis (RAP). This bacterium can tolerate harsh environments and trigger periapical immune inflammatory responses that result in persistent infection inside and outside the root canal. Adhesion to the dentin wall of root canals and the subsequent formation of biofilms significantly enhances the drug resistance and anti⁃erosion ability of Enterococcus faecalis, which is the key factor medi⁃ ating its pathogenesis. The adhesion of Enterococcus faecalis to dentin involves non⁃specific adhesion and specific adhe⁃ sion, and the latter is mediated by adhesion⁃related virulence factors, mainly including the adhesin of collagen from en⁃terococci (Ace), extracellular surface protein (Esp), gelatinase (GelE), serine protease (SprE), endocarditis and biofilm associated pilus (Ebp) and aggregation substance (AS), which is regulated by multiple two⁃component systems. The two⁃ component system Fsr can promote the expression of gelE and sprE when the cell population density increases. GelE can further reduce Ace, while the two⁃component system GrvRS directly downregulates ace expression in response to the serum environment. The two⁃component systems CroRS and WalRK may also promote and inhibit the expression of vari⁃ ous virulence factors, including ace and gelE, thus affecting the adhesion of Enterococcus faecalis. In addition, the mech⁃ anochemical preparation and the internal environment of the root canal can also influence the adhesion of Enterococcus faecalis to dentin. Avoiding the introduction of Enterococcus faecalis and using adhesion⁃interfering medications during root canal treatment can effectively prevent the adhesion of Enterococcus faecalis, and a variety of activated irrigation protocols can also be effective at increasing the clearance of Enterococcus faecalis from the root canal. The design of ra⁃ tional drugs targeting key factors involved in and regulators of the adhesion of Enterococcus faecalis to dentin is expected to provide new ideas and strategies for root canal infection control. The present paper reviews the adhesion of Enterococ⁃ cus faecalis to dentin and its influencing factors.