The dentine-pulp complex is normally protected from the microbial invasion by the intact enamel and cementum. The ingress of invading bacteria occurs when there is a break in the integrity of the overlying enamel and dentine by caries, trauma, and contamination of the pulp during dental treatment (including root canal treatment), seepage of saliva through cracks or inadequate coronal restorations. The bacteria of the carious process advances ahead when the infecting pathogen enters through caries. When there is trauma without pulp exposure, the access of the bacteria is through the dentinal tubules. With the establishment of infection, the microbial flora changes from an initially predominant facultative Gram positive flora to a completely anaerobic Gram negative bacteria when the canals have been infected for 3 months or more
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