Relação da diversidade bacteriana e quantidade de endotoxinas com a sintomatologia dolorosa de pulpite reversível em lesões cariosas profundas
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Data
2016-01-19
Autores
Souza, Letícia Grilo de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A cárie é uma doença infectocontagiosa multifatorial. Em cavidades profundas, as lesões cariosas geralmente estão associadas a quadros de sintomatologia pulpar dolorosa. O objetivo deste estudo foi determinar a diversidade bacteriana e a quantidade de endotoxinas e casos de cáries sintomáticas e assintomáticas. Para este estudo foram selecionados 20 pacientes com lesões cariosas profundas com sensibilidade dolorosa compatível com pulpite reversível (n=10) e sem sintomatologia dolorosa (n=10). As amostras de dentina cariada foram obtidas com o auxílio de colheres de dentina estéreis e apirogénicas e foram coletadas em dois momentos: antes e após a remoção convencional do tecido cariado. Estas amostras foram divididas em duas alíquotas, que foram em seguida submetidas ao teste Checkerboard (alíquotas contendo 150 ul de TE e 100 uL de NaOH a 0,5 M) e teste cinético cromogénico LAL (Alíquotas com 1 ml de soro apirogênico) para determinação do perfil microbiano e quantificação de endotoxina, respectivamente. O teste estatístico Mann Whitney não mostrou diferença entre a camada de dentina superficial e profunda para as bactérias estudadas. Em relação ao fator sensibilidade as bactérias Capnocytophaga sputigena, Leptotrichia buccalis e Lactobacillus species foram as que apresentaram diferenças estatisticas significantes, sendo mais presente em pacientes com sintomatologia. Para as endotoxinas, os dentes sintomáticos resultaram em maiores quantidades de endotoxinas (p = 0,047). Dentes sintomáticos apresentaram 4,13 log 10 EU / mg dentina, enquanto o nível de endotoxinas para os dentes dentes assintomáticos foi de 3,45 log 10 EU / mg dentina. Dentinas coletadas em diferentes áreas apresentaram quantidades similares de endotoxinas (p = 0,139). A quantidade de bactérias não parece estar relacionada com a sintomatologia de lesões cariosas profunda, enquanto a quantidade de endotoxinas é maior em cáries sintomáticas.
Caries is a multifactorial infectious disease. In deep cavities, carious lesions are usually associated with scenarios of pulp painful symptoms. The objective is to determine bacterial diversity and endotoxin levels in cases of sintomatic and assintomatic caries. Twenty patients with deep carious lesions with soreness compatible with reversible pulpitis (n = 10) and without pain symptoms (n = 10). Carious dentine samples were obtained with the aid of sterile dentine and apyrogenic spoons and harvested in two steps: before and after conventional caries removal. These samples were divided into two aliquots, which were then subjected to the checkerboard(aliquots contained in 150µl of TE and 100µl of 0.5 M NaOH) and kinetic chromogenic LAL test(aliquots with 1 ml of apirogenic serum) for determination of microbial profile and quantitation of endotoxin, respectively. By Mann Whitney test showed no difference between the superficial and deep dentin layer for the studied bacteria. In relation to factor sensitivity bacteria Capnocytophaga sputigena, Leptotrichia buccalis e Lactobacillus species were the ones that showed statistically significant differences, being more present in patients with symptoms. For the endotoxins, symptomatic teeth resulted in greater quantity of endotoxins (p=0.047). Symptomatic teeth presented 4.13 log10 EU/mg dentin, while endotoxin level for no symptomatic teeth was 3.45 log10 EU/mg dentin. Dentin collected in different areas presented similar amount of endotoxins (p=0.139). The amount of bacteria does not seem to be related to symptomatology of deep carious lesions, while endotoxins quantity is greater in symptomatic scenarios.
Caries is a multifactorial infectious disease. In deep cavities, carious lesions are usually associated with scenarios of pulp painful symptoms. The objective is to determine bacterial diversity and endotoxin levels in cases of sintomatic and assintomatic caries. Twenty patients with deep carious lesions with soreness compatible with reversible pulpitis (n = 10) and without pain symptoms (n = 10). Carious dentine samples were obtained with the aid of sterile dentine and apyrogenic spoons and harvested in two steps: before and after conventional caries removal. These samples were divided into two aliquots, which were then subjected to the checkerboard(aliquots contained in 150µl of TE and 100µl of 0.5 M NaOH) and kinetic chromogenic LAL test(aliquots with 1 ml of apirogenic serum) for determination of microbial profile and quantitation of endotoxin, respectively. By Mann Whitney test showed no difference between the superficial and deep dentin layer for the studied bacteria. In relation to factor sensitivity bacteria Capnocytophaga sputigena, Leptotrichia buccalis e Lactobacillus species were the ones that showed statistically significant differences, being more present in patients with symptoms. For the endotoxins, symptomatic teeth resulted in greater quantity of endotoxins (p=0.047). Symptomatic teeth presented 4.13 log10 EU/mg dentin, while endotoxin level for no symptomatic teeth was 3.45 log10 EU/mg dentin. Dentin collected in different areas presented similar amount of endotoxins (p=0.139). The amount of bacteria does not seem to be related to symptomatology of deep carious lesions, while endotoxins quantity is greater in symptomatic scenarios.
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Palavras-chave
Cárie dentária, Endotoxinas, Bactérias, Pulpite, Dor, Dental caries, Endotoxins, Pain, Pulpits