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Critical Reviews in Oral Biology & Medicine
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15(5):308-320 (2004)     Crit Rev Oral Biol Med
© 2004 International and American Associations for Dental Research

VIRULENCE FACTORS OF ENTEROCOCCUS FAECALIS: RELATIONSHIP TO ENDODONTIC DISEASE

Güven Kayaoglu* and Dag Ørstavik

1 Gazi University, Faculty of Dentistry, Department of Endodontics and Conservative Treatment, 82. Sokak 06510 Emek, Ankara, Turkey;
2 NIOM, Scandinavian Institute of Dental Materials, Haslum, Norway

Correspondence: * corresponding author, guvenk{at}gazi.edu.tr

Enterococcus faecalis is a micro-organism that can survive extreme challenges. Its pathogenicity ranges from life-threatening diseases in compromised individuals to less severe conditions, such as infection of obturated root canals with chronic apical periodontitis. In the latter situation, the infecting organisms are partly shielded from the defense mechanisms of the body. In this article, we review the virulence factors of E. faecalis that may be related to endodontic infection and the periradicular inflammatory response. The most-cited virulence factors are aggregation substance, surface adhesins, sex pheromones, lipoteichoic acid, extracellular superoxide production, the lytic enzymes gelatinase and hyaluronidase, and the toxin cytolysin. Each of them may be associated with various stages of an endodontic infection as well as with periapical inflammation. While some products of the bacterium may be directly linked to damage of the periradicular tissues, a large part of the tissue damage is probably mediated by the host response to the bacterium and its products.

Key Words: Enterococcus faecalis • virulence factors • endodontic infection • apical periodontitis

Critical Reviews in Oral Biology & Medicine, Vol. 15, No. 5, 308-320 (2004)
DOI: 10.1177/154411130401500506
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