Endodontic Mycology: A New Perspective of Root Canal Infection

An important consideration in endodontic treatment is the elimination of microorganisms, including fungi, from the complex threedimensional root canal system. Yeasts can be detected in 7-17% of infected root canals. Candida albicans (CA) has a major role in endodontic treatment failure as the most important fungus isolated from the root canal system. C. albicans has been associated with root canal infections resistant to non-surgical therapy and a potent pathogen to infect periapical lesions. They are commonly associated with persistent cases of apical periodontitis, but yeasts can also be isolated in primary apical periodontitis. A variety of virulence factors enable C. albicans to adhere to and penetrate into dentine. Yeasts do not respond favourably to conservative root canal therapy, due to resistance against a commonly used medicament, calcium hydroxide. Thus, alternative therapeutic approaches and other intracanal medicaments are required to treat persistent cases of apical periodontitis.