Aim: The study aimed to evaluate the association of root canal microorganisms red complex and E. facealis with endodontic clinical signs and symptoms using polymerase chain reaction. Materials and Methods: Bacterial samples were obtained using sterile paper points from the teeth of 100 subjects divided into two groups; Group I: 50 individuals with primary tooth infections and Group II: 50 individuals with failed endodontic treatment having the secondary infection. DNA extracted from samples was analyzed for endodontic pathogens by using species-specific primers. Results: The pain was noticed in 66%, (33 of 50 subjects) in primary infection and 60% (30 of 50) in a secondary infection. A statistically significant association between pain and E. faecalis bacteria observed both in primary infection and secondary infection ( P < 0.05). Tenderness on percussion was associated with 40% cases in Group I and 70% cases in Group II. The red complex accounted for 94% of cases associated with tenderness on percussion in primary infection while 86% of cases associated with secondary infection with a statistically significant association ( P < 0.05). Conclusion: Prevalence of red complex bacteria and E. faecalis suggested the association of studied bacteria with symptomatic infected pulp and periradicular diseases.
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