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Endodontic Topics 2012, 22, 1
All rights reserved
Editorial
Endodontic biofilm: Where are we now and where are
we going?
ANIL KISHEN & MARKUS HAAPASALO, GUEST EDITORS
The enhanced antimicrobial resistance of bacterial bio-
films has been attributed to the restricted penetration
of antimicrobials, decreased growth rate, expression of
biofilm-specific antimicrobial resistance, or antimicro-
bial tolerant physiologies in bacterial biofilm. There-
fore, the treatment of bacterial biofilms has been a
major challenge, especially when it involves a complex
in vivo situation such as the root canal system. The
treatment of bacterial biofilms may lead to killing of
the susceptible population, but disrupting the biofilm
structure and eliminating all of the resident bacteria,
including the fraction of persister cells, is still a daunt-
ing task in endodontic disinfection. The surviving bac-
teria will be able to reconstitute the biofilm following
discontinuation of the antimicrobials. Thus, multi-
faceted approaches are required to disinfect biofilm
bacteria.
This volume of Endodontic Topics focuses on mul-
tiple issues that deal with biofilm-mediated infection.
It includes the development and structural consider-
ations of biofilms in general, and organization of
endodontic biofilms and therapeutic options in the
management of biofilm-mediated infections. More
specifically, the first article by Dufour, Leung &
Lévesque discusses general considerations of bacterial
biofilms, and the role of biofilms in infectious diseases.
Newer strategies to counteract biofilm infection are
also reviewed in this chapter. The second article by
Lang, Zhu & Kreth reviews the host immune cell–
biofilm interaction. The biofilm and bacterial compo-
nents that participate in immune modulation are also
discussed in this chapter.
2012 © John Wiley & Sons A/S
ENDODONTIC TOPICS 2012
1601-1538
The third article by Siqueira, Rôças & Ricucci
describes the relevance of bacterial biofilms in apical
periodontitis. The structure and organization of
biofilm in treated and untreated root canals, besides
the microbial diversity in primary, secondary and per-
sistent endodontic infections, are discussed. The
fourth chapter by Love reviews the biofilm bacteria–
substrate interaction. The factors influencing bacterial
adhesion to the tooth surface are also explained in this
chapter. The fifth article by Kishen & Haapasalo dis-
cusses contemporary biofilm models and assays used to
assess antimicrobial efficacy in Endodontics, while the
sixth article by Haapasalo & Shen details current
therapeutic options available to manage biofilms in
root canals. The seventh article by Kishen describes the
challenging factors in root canal disinfection and
advanced therapeutic options in the management of
bacterial biofilms.
Currently, a comprehensive understanding of the
molecular dynamics of biofilm bacteria in response to
transitions in the endodontic environment is sparse;
hence, this issue of Endodontic Topics is aimed at pre-
senting the best evidence available. The fact that a
cross-section of recognized clinicians, academicians,
and scientists have contributed to this topic lends great
authenticity to the information discussed. We are
extremely grateful to the authors for their contribu-
tions to this issue of Endodontic Topics. We are con-
vinced that the material presented here will provide
the readership with an up-to-date and comprehensive
appraisal of one of the most challenging aspects of
Endodontics today.