Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms

Author(s)

Machado, Felipe Paiva ^[1] ; Khoury, Rayana Duarte ^[1] ; Toia, Cassia Cestari ^[1] ; Flores Orozco, Esteban Isai ^[1] ; de Oliveira, Felipe Eduardo ^[2] ; de Oliveira, Luciane Dias ^[2] ; da Rosa Cardoso, Flavia Goulart ^[1] ; Valera, Marcia Carneiro ^[1]

Affiliation

^[1] Sao Paulo State Univ Unesp, Endodont Div, Inst Sci & Technol, Dept Restorat Dent, Sao Jose Dos Campos - Brazil

^[2] Sao Paulo State Univ Unesp, Dept Biosci & Oral Diag, Inst Sci & Technol, Sao Jose Dos Campos - Brazil

• Document type: Journal article
• Source: CLINICAL ORAL INVESTIGATIONS; v. 24, n. 9, p. 3169-3179, SEP 2020.
• Web of Science Citations: 0

Abstract

Objectives To compare the microbial load and composition and to determine the lipopolysaccharides (LPS) and lipoteichoic acid (LTA) concentrations found in primary apical periodontitis (PAP) and post-treatment apical periodontitis (PTAP), correlating these findings with clinical/tomographic features. Material and methods Sixty patients with PAP (31) and PTAP (29) were submitted to clinical and tomographic assessment. Samples were collected from each root canal using paper points for microbiological assessment (culture technique and Checkerboard DNA-DNA hybridization) and determination of LPS and LTA levels (limulus amebocyte lysate and enzyme-linked immunosorbent assays, respectively). Data were correlated with clinical/tomographic findings and statistically analyzed using the Mann-Whitney and Pearson correlation tests (alpha = 5%). Results A higher number of cultivable bacteria and LPS were found in PAP (p < 0.05). The median number of species per root canal found in PAP and PTAP was 9 and 22, respectively (p < 0.05). LPS was positively correlated with a larger periapical lesion volume (p < .05). LTA levels were similar in both infections and had no correlation with signs and symptoms. In PAP, gram-positive bacteria were correlated with spontaneous pain (p < .05) and exudate (p < .05). Tenderness to percussion and pain on palpation were correlated to the presence of both gram-positive and negative bacteria. In PTAP, a positive correlation was observed between both gram-positive and gram-negative bacteria with exudate and periapical lesion volume (p < .05). Conclusions PAP had higher contents of microbial load and LPS compared with PTAP. However, PTAP presented a more diverse microbiota compared with PAP. Higher content of LPS was positively correlated with larger periapical bone destruction, whereas signs and symptoms with specific microorganisms. (AU)

• FAPESP's process: 18/01703-9 - Primary versus secondary endodontic infection: inflammatory and lipidic profile, microbial load, endotoxin and lipoteichoic acid levels before and during the root canal therapy and success after 18 months follow-up.
• Grantee: Marcia Carneiro Valera Garakis
• Support type: Regular Research Grants
• FAPESP's process: 15/05397-1 - ENDOTOXINS QUANTIFICATION AND ITS RELATIONSHIP WITH SIGNS AND SYMPTOMS: SINGLE-VISIT VERSUS MULTIPLE-VISIT ENDODONTIC TREATMENT- CONTROL AFTER 1 YEAR CBCT
• Grantee: Cassia Cestari Toia
• Support type: Scholarships in Brazil - Master