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These are bacterial cells embedded within a self-constructed extracellular polymeric substance (EPS), which provides a significant survival advantage, as the physical and chemical barrier it presents restricts access to antibiotics ( Other than biofilm-associated tolerance, MDR periodontal pathogens also utilize active efflux mechanisms, such as efflux pumps, to export antibiotics from their intracellular environments (Soto, 2013)

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The cell receives protection at multiple points in the death pathway, from the initial decision to the final execution