Endodontik Enfeksiyonların Mikrobiyolojisi ve Tanı Yöntemleri

Endodontic infections are caused by polymicrobial communities that colonize the root canal

system, most commonly in the form of biofilms. Their pathogenesis is influenced not only by

the presence of specific microorganisms but also by ecological interactions among microbial

species, host immune responses, and the complex microanatomy of the root canal system.

Primary, secondary, and persistent endodontic infections differ in their microbial composition

and clinical behavior, although clear distinctions are not always possible. Biofilm organization

plays a critical role in microbial survival by increasing tolerance to antimicrobial agents and

host defense mechanisms. Traditional culture-based methods have historically contributed to

the identification of cultivable microorganisms, whereas targeted molecular approaches such

as PCR, FISH, and DNA–DNA hybridization have improved detection sensitivity. However,

both approaches have limitations in fully characterizing the endodontic microbiota. In this

context, next-generation sequencing (NGS) has expanded current understanding by revealing

a broader and more dynamic microbial diversity than previously recognized. Overall, accurate

diagnosis and interpretation of endodontic infections require an integrated evaluation of

culture-based, molecular, and sequencing-based data to better understand pathogenesis and

support the development of more effective treatment strategies.