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Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms.
Clin Oral Investig. 2020 Jan 13 [Online ahead of print]CO

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 (α = 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.

CLINICAL RELEVANCE

It was verified that PAP and PTAP are polymicrobial infections with predominance of gram-negative bacteria and a more diverse bacterial population found in PTAP. A wide interaction of specific microbial species resulted in different clinical features in both infections.

Authors+Show Affiliations

Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil. marcia@fosjc.unesp.br.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31933111

Citation

Machado, Felipe Paiva, et al. "Primary Versus Post-treatment Apical Periodontitis: Microbial Composition, Lipopolysaccharides and Lipoteichoic Acid Levels, Signs and Symptoms." Clinical Oral Investigations, 2020.
Machado FP, Khoury RD, Toia CC, et al. Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. Clin Oral Investig. 2020.
Machado, F. P., Khoury, R. D., Toia, C. C., Flores Orozco, E. I., de Oliveira, F. E., de Oliveira, L. D., da Rosa Cardoso, F. G., & Valera, M. C. (2020). Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. Clinical Oral Investigations. https://doi.org/10.1007/s00784-019-03191-6
Machado FP, et al. Primary Versus Post-treatment Apical Periodontitis: Microbial Composition, Lipopolysaccharides and Lipoteichoic Acid Levels, Signs and Symptoms. Clin Oral Investig. 2020 Jan 13; PubMed PMID: 31933111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. AU - Machado,Felipe Paiva, AU - Khoury,Rayana Duarte, AU - Toia,Cassia Cestari, AU - Flores Orozco,Esteban Isai, AU - de Oliveira,Felipe Eduardo, AU - de Oliveira,Luciane Dias, AU - da Rosa Cardoso,Flávia Goulart, AU - Valera,Marcia Carneiro, Y1 - 2020/01/13/ PY - 2019/06/06/received PY - 2019/12/27/accepted PY - 2020/1/15/entrez KW - Apical periodontitis KW - Endotoxins KW - Enzyme-linked immunosorbent assay KW - Lipoteichoic acid KW - Microbiota KW - Nucleic acid hybridization JF - Clinical oral investigations JO - Clin Oral Investig N2 - 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 (α = 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. CLINICAL RELEVANCE: It was verified that PAP and PTAP are polymicrobial infections with predominance of gram-negative bacteria and a more diverse bacterial population found in PTAP. A wide interaction of specific microbial species resulted in different clinical features in both infections. SN - 1436-3771 UR - https://www.unboundmedicine.com/medline/citation/31933111/Primary_versus_post-treatment_apical_periodontitis:_microbial_composition,_lipopolysaccharides_and_lipoteichoic_acid_levels,_signs_and_symptoms L2 - https://dx.doi.org/10.1007/s00784-019-03191-6 DB - PRIME DP - Unbound Medicine ER -
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