Clinical, microbiological and immunological monitoring of patients undertaken to endodontic therapy with diagnosis of irreversible Pulpitis

• Grant number: 17/25242-8
• Support type: Scholarships in Brazil - Doctorate
• Effective date (Start): October 01, 2018
• Effective date (End): January 31, 2021
• Field of knowledge: Health Sciences - Dentistry - Endodontics
• Principal researcher: Brenda Paula Figueiredo de Almeida Gomes
• Grantee: Rodrigo Arruda Vasconcelos
• Home Institution: Faculdade de Odontologia de Piracicaba (FOP). Universidade Estadual de Campinas (UNICAMP). Piracicaba , SP, Brazil
• Associated research grant: 15/23479-5 - Microbiomes and immunobiological aspects in endodontic infections, AP.TEM
• Associated scholarship(s): 19/10755-5 - Clinical investigation of epigenetic modulations in dental pulp tissues with diagnosis of irreversible pulpitis, BE.EP.DR

Abstract

The Acute Irreversible Pulpitis (AIP) is a pathological condition of the dental pulp that has as main etiological factor the presence of bacterial biofilm and different Chemical Mediators of Inflammation (CMI), capable of generating exacerbated responses to the host. The present study aims to: 1) investigate the presence, establish the structure of the microbial community and quantify microorganisms (MO) in the different phases of the endodontic therapy by molecular and culture-dependent methods; 2) to monitor the effect of the chemical-mechanical preparation (CMP) and Intracanal Medication (ICM) on the levels of endotoxins (LPS), lipoteichoic acid (LTA) and levels of CMI and related to neurogenic pain of pulp origin; 3) correlate the clinical/radiographic characteristics of the patients with the MO found and with the levels of the CMI and pain; 4) analyze, where possible, the presence of Streptococcus mutans and Enterococcus faecalis through culture technique with specific media and genetic sequencing. The sample will consist of 20 teeth with diagnosis of AIP, randomly assigned into two groups according to the Auxiliary Chemical Substance (ACS) used - 2% chlorhexidine (CHX) gel (n = 10) or 6% sodium hypochlorite (NaOCl) (n = 10) - during the CMP. In addition, samples of teeth with normal pulp (control group) will be collected, which CMP will be performed using 2% CHX (n = 5) or 6% NaOCl (n = 5). The samples will be collected before CMP using Reciproc® file (S1); after CMP (S2); and after ICM (S3) based on calcium hydroxide. MO will be identified and quantified exclusively by molecular method (Nested-PCR and Checkerboard DNA-DNA hybridization) through specific probes; microbial culture (CFU/mL) and by molecular methods derived from samples obtained from the microbial culture (Gene Sequencing of the 16S rRNA gene [BigDye® Terminator v3.1 Cycle Sequencing] and Next Generation Sequencing [NGS]). The levels of CMI and related neurogenic pain, as well as the virulence factors of OM (IL-1±, IL-1², TNF-± and substance P, LTA) will be measured by the enzyme-linked immunosorbent assay Assay - ELISA) and LPS evaluated by the LAL Pyrogent 5000 turbidimetric method. Patient pain levels will be further measured qualitatively by visual scale and quantitatively by means of the electrical test. After the samples are processed, the data will be tabulated and analyzed statistically by SPSS for Windows. (AU)

Scientific publications

(8)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

ALVES-SILVA, ESDRAS GABRIEL; ARRUDA-VASCONCELOS, RODRIGO; LOUZADA, LIDIANE MENDES; DE-JESUS-SOARES, ADRIANA; FERRAZ, CAIO CEZAR RANDI; ALMEIDA, JOSE FLAVIO AFFONSO; MARCIANO, MARINA ANGELICA; STEINER-OLIVEIRA, CAROLINA; BELLO-SILVA, MARINA STELLA; SHEMESH, HAGAY; GOMES, BRENDA PAULA FIGUEIREDO DE ALMEIDA. The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection. Photodiagnosis and Photodynamic Therapy, v. 37, MAR 2022. Web of Science Citations: 0.

ARRUDA-VASCONCELOS, RODRIGO; BARBOSA-RIBEIRO, MARLOS; LOUZADA, LIDIANE M.; LEMOS, BEATRIZ I. N.; DE-JESUS-SOARES, ADRIANA; FERRAZ, CAIO C. R.; ALMEIDA, JOSE F. A.; MARCIANO, MARINA A.; GOMES, BRENDA P. F. A. fficacy of 6% Sodium Hypochlorite on Infectious Content of Teeth with Symptomatic Irreversible Pulpiti. JOURNAL OF ENDODONTICS, v. 48, n. 2, p. 179-189, FEB 2022. Web of Science Citations: 1.

GOMES, BRENDA P. F. A.; BERBER, VANESSA B.; MARINHO, ARIANE C. S.; LOUZADA, LIDIANE M.; ARRUDA-VASCONCELOS, RODRIGO; PASSINI, MAICON R. Z.; LOPES, ERICA M.; PECORARI, VANESSA G. A.; CHEN, TSUTE; PASTER, BRUCE J. Chemomechanical preparation influences the microbial community and the levels of LPS, LTA and cytokines in combined endodontic-periodontal lesions: A clinical study. JOURNAL OF PERIODONTAL RESEARCH, DEC 2021. Web of Science Citations: 0.

MARTINHO, FREDERICO C.; LEITE, FABIO R. M.; ARRUDA-VASCONCELOS, RODRIGO; DARVEAU, RICHARD P.; GOMES, BRENDA P. F. A. Influence of Bacterial Profiles in Cytokine and Clinical Features of Endodontic Disease. JOURNAL OF ENDODONTICS, v. 47, n. 8, p. 1265-1271, AUG 2021. Web of Science Citations: 0.

ARRUDA-VASCONCELOS, R.; LOUZADA, L. M.; FERES, M.; TOMSON, P. L.; COOPER, P. R.; GOMES, B. P. F. A. Investigation of microbial profile, levels of endotoxin and lipoteichoic acid in teeth with symptomatic irreversible pulpitis: a clinical study. International Endodontic Journal, v. 54, n. 1, p. 46-60, JAN 2021. Web of Science Citations: 0.

GOMES, BRENDA P. F. A.; LOUZADA, LIDIANE M.; ALMEIDA-GOMES, REBECCA F.; PINHEIRO, ERICKA T.; SOUSA, EZILMARA L. R.; JACINTO, ROGERIO C.; ARRUDA-VASCONCELOS, RODRIGO. Investigation of Filifactor alocis in primary and in secondary endodontic infections: A molecular study. ARCHIVES OF ORAL BIOLOGY, v. 118, OCT 2020. Web of Science Citations: 0.

BARBOSA-RIBEIRO, MARLOS; ARRUDA-VASCONCELOS, RODRIGO; LOUZADA, LIDIANE M.; DOS SANTOS, DANIELLE G.; ANDREOTE, FERNANDO D.; GOMES, BRENDA P. F. A. Microbiological analysis of endodontically treated teeth with apical periodontitis before and after endodontic retreatment. CLINICAL ORAL INVESTIGATIONS, v. 25, n. 4 AUG 2020. Web of Science Citations: 1.

BARBOSA-RIBEIRO, MARLOS; ARRUDA-VASCONCELOS, RODRIGO; LOUZADA, LIDIANE M.; LIMA, AUGUSTO R.; MARCIANO, MARINA A.; ALMEIDA, JOSE FLAVIO A.; DE-JESUS-SOARES, ADRIANA; ZAIA, ALEXANDRE A.; FERRAZ, CAIO CEZAR R.; GOMES, BRENDA P. F. A. Microbiological Investigation in Teeth with Persistent/Secondary Endodontic Infection in Different Stages of Root Canal Retreatment. EUROPEAN ENDODONTIC JOURNAL, v. 5, n. 3, p. 219-225, 2020. Web of Science Citations: 0.