Influence of acute renal failure on the severity of apical periodontitis

Author(s)

Carolina de Barros Morais Cardoso

• Document type: Master's Dissertation
• Press: Araçatuba. 2019-07-25.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Odontologia. Araçatuba
• Defense date: 2019-06-14
• Advisor: Luciano Tavares Angelo Cintra

Abstract

Objective: This study aimed to verify the influence of Acute Renal Failure (ARF) on the severity of apical periodontitis (AP) in Wistar rats. Methods: Sixty-four rats divided into 4 groups and 2 periods of analysis (n = 8) were used: Control (C), ARF, AP and ARF+AP. IRA was induced by daily application of Gentamicin (100 mg/kg/day) for 8 days,intraperitoneal route. AP was induced by the pulp exposure of the upper and lower right and first and second molars. After 15 and 30 days of AP induction, the animals were anesthetized, the urine was collected for urinalysis and sedimentation, and the blood was collected for hemogram, creatinine, serum protein and urea analysis. Afterwards, the animals were euthanized, the kidneys collected for histological analysis and the jaws and jaws removed and processed for histomorphometric and immunohistochemical analysis for IL-6, IL-17, IL-23 and TNF-α. Results: For urinalysis, the amount of protein was higher in the AP, ARF and ARF+AP groups when compared to the control, in both experimental periods (p <0.05). In the sedimentation, granular cylinders, amorphous phosphate and calcium carbonate were found in the ARF and ARF+AP groups. In the hemogram, the number of red blood cells, hemoglobin and globular volume were lower in the ARF and ARF+AP groups at 15 and 30 days compared to the C and AP groups (p <0.05); mean corpuscular volume was lower in the ARF+AP group in the 15-day period, compared to the other groups (p <0.05). Regarding the leukogram, the number of leukocytes was higher in the ARF and ARF+AP groups in the first experimental period with significant statistical differences (p <0.05), in the second experimental period, the groups PA, IRA and ARF+AP did not present significant statistical differences among themselves (p> 0.05). In the analysis of serum biochemical parameters, urea and creatinine levels were higher in the ARF and ARF+AP groups (p <0.05), compared to the other experimental groups in both periods. Protein levels were reduced in the AP, ARF and ARF+AP groups, however, without statistical differences (p> 0.05). The kidneys were histologically analyzed and renal damage was demonstrated in all induced animals. Regarding the inflammatory infiltrate, in the first experimental period the AP group presented four specimens with discrete infiltrate and four specimens with moderate infiltration, while the ARF+AP group showed discrete infiltrate in all the specimens; in the second experimental period, the AP group presented a more intense inflammatory infiltrate when compared to the ARF+AP group, thus presenting a statistically significant difference between the groups in both experimental periods (p <0.05). In the histometric analysis, the AP group presented greater bone loss at 15 days when compared to the ARF+AP group (p <0.05). In the second experimental period, both groups with AP did not present statistical differences (p> 0.05), although the bone resorption of the AP group was higher. In the immunohistochemical analysis, TNF-α presented immunostaining pattern ranging from high to extremely high in the AP group and predominantly low to moderate in ARF + AP in both experimental periods (p <0.05). Already IL-23 presented an extremely high immunostaining pattern predominantly in the AP group and high in the ARF+AP group at 15 days (p <0.05). For IL-6 and IL-17, there were no statistical differences between the AP and ARF+AP groups in both experimental periods (p> 0.05). Conclusion: It was observed that the association of apical periodontitis with acute renal failure leads to alterations in the blood parameters of the hemogram, serum biochemical parameters, inflammatory, bone loss and the pattern of periapical lesion immunostaining. (AU)

• FAPESP's process: 16/23365-2 - Influence of Acute kidney injury on the development and progression of Apical Periodontitis
• Grantee: Carolina de Barros Morais Cardoso
• Support Opportunities: Scholarships in Brazil - Master