Role of Enterococcus faecalis in Failed Root Canal Treatment. A Review

Abstract

Failure in endodontic treatment is always attributed to persistent communities of bacteria, with Enterococcus faecalis being the most commonly implicated bacterium due to its resistance to antimicrobial disinfection and survival mechanisms. This study aimed to review the recent literature to assess the prevalence of E. faecalis in persistent endodontic infections and to understand its role in failure. An electronic search was conducted using PubMed and Google Scholar databases for studies published between 2010 and 2026. After applying inclusion and exclusion criteria, a total of 19 studies were included. Detection techniques and reported prevalence were analysed. The prevalence of E. faecalis varied widely across studies. It ranged from being detected in some studies to being the most prevalent microorganism in others. Higher detection rates were reported for molecular techniques compared to culture-based methods. The findings suggest that persistent infections are polymicrobial, with E. faecalis often present in low abundance along with other species within the endodontic microbial community.