Infecções endodônticas primária x secundária: perfil microbiano, níveis de endotoxinas e ácido lipoteicóico, sinais e sintomas
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Data
2018-12-14
Autores
Machado, Felipe Paiva
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Esta pesquisa clínica teve como objetivo comparar a carga e composição microbiana bem como as concentrações de LPS e LTA encontradas na infecção endodôntica primária (IEP) e na infecção endodôntica secundária (IES). Além disso, a correlação desses achados com características clínicas e tomográficas também foram investigadas. Sessenta dentes de pacientes com IEP (31) e IES (29) foram submetidos à avaliação clínica e tomográfica, seguido do tratamento endodôntico ou retratamento. Amostras foram coletadas de cada canal radicular utilizando cones de papel. Logo após a abertura coronária (IEP) ou após a desobturação dos canais (IES) o conteúdo coletado foi submetido à técnica de cultura microbiológica para determinar a carga microbiana de bactérias anaeróbias e ao método Checkerboard DNA-DNA hybridization para investigação de espécies bacterianas presentes. O teste de Lisado de Amebócito de Limulus e o Ensaio de Imunoabsorção Enzimática foram utilizados para quantificar os níveis de LPS e LTA. Os dados obtidos foram correlacionados com os achados clínicos e tomográficos. Maiores quantidades de bactérias cultiváveis e de LPS foram encontradas na IEP (p < 0,05). Não houve diferença nos níveis de LTA entre IEP e IES (p > 0,05). A mediana de espécies por canal radicular encontrada na IEP foi de 9 espécies e na IES foi de 22 (p < 0,05). As espécies bacterianas mais prevalentes detectadas na IEP foram P. gingivalis (14/31) e S. intermedius (14/31). Na IES, as espécies mais prevalentes foram P. gingivalis (21/29) e C. rectus (20/29). LPS foi correlacionado positivamente com um maior volume da lesão periapical (p < 0,05). Níveis de LTA não foram relacionados a sinais e sintomas ou ao volume da lesão periapical (p > 0,05). Concluiu-se que dentes com IEP tiveram maiores quantidades de carga microbiana e de LPS do que os dentes com IES. Uma maior quantidade de LPS foi correlacionada positivamente com um maior volume de destruição óssea periapical. Uma ampla interação de espécies bacterianas específicas resultou em diferentes características clínicas.
This clinical research aimed to compare the microbial load and composition as well as the LPS and LTA concentrations found in Primary Endodontic Infection (PEI) and Secondary Endodontic Infection (SEI). In addition, the correlation of these findings with clinical and tomographic features was also investigated. Sixty patients’ teeth with PEI (31) and SEI (29) were submitted to clinical and tomographic assessment, followed by endodontic treatment or retreatment. Samples were taken from each root canal using paper points. After the coronary opening (PEI) or after the removal of root filling material (SEI), the collected samples were submitted to the microbiological culture technique to determine the microbial load of anaerobic bacteria and to the Checkerboard DNA-DNA hybridization method for investigation of present bacterial species. The Limulus amebocyte lysate assay and enzyme-linked immunosorbent assay were used to quantify LPS and LTA levels. The data obtained were correlated with clinical and tomographic findings. A higher number of cultivable bacteria and LPS was found in PEI (p < 0.05). There was no difference in LTA levels between PEI and SEI (p> 0.05).The median number of species per root canal found in PEI was 9 and 22 in SEI (p < 0.05). The most prevalent bacterial species detected in PEI were P. gingivalis (14/31) and S. intermedius (14/31). In SEI, the most prevalent species were P. gingivalis (21/29) and C. rectus (20/29). LPS was positively correlated with a larger periapical lesion volume (P < 0.05). LTA levels were not related to signs and symptoms or periapical lesion volume (p> 0.05). It was concluded teeth with PEI had higher contents of microbial load and LPS than teeth with SEI. However, a more diverse microbiota was found in SEI than that of PEI. Higher content of LPS was positively correlated with larger periapical bone destruction. A widely interaction of specific microbial species resulted in different clinical features.
This clinical research aimed to compare the microbial load and composition as well as the LPS and LTA concentrations found in Primary Endodontic Infection (PEI) and Secondary Endodontic Infection (SEI). In addition, the correlation of these findings with clinical and tomographic features was also investigated. Sixty patients’ teeth with PEI (31) and SEI (29) were submitted to clinical and tomographic assessment, followed by endodontic treatment or retreatment. Samples were taken from each root canal using paper points. After the coronary opening (PEI) or after the removal of root filling material (SEI), the collected samples were submitted to the microbiological culture technique to determine the microbial load of anaerobic bacteria and to the Checkerboard DNA-DNA hybridization method for investigation of present bacterial species. The Limulus amebocyte lysate assay and enzyme-linked immunosorbent assay were used to quantify LPS and LTA levels. The data obtained were correlated with clinical and tomographic findings. A higher number of cultivable bacteria and LPS was found in PEI (p < 0.05). There was no difference in LTA levels between PEI and SEI (p> 0.05).The median number of species per root canal found in PEI was 9 and 22 in SEI (p < 0.05). The most prevalent bacterial species detected in PEI were P. gingivalis (14/31) and S. intermedius (14/31). In SEI, the most prevalent species were P. gingivalis (21/29) and C. rectus (20/29). LPS was positively correlated with a larger periapical lesion volume (P < 0.05). LTA levels were not related to signs and symptoms or periapical lesion volume (p> 0.05). It was concluded teeth with PEI had higher contents of microbial load and LPS than teeth with SEI. However, a more diverse microbiota was found in SEI than that of PEI. Higher content of LPS was positively correlated with larger periapical bone destruction. A widely interaction of specific microbial species resulted in different clinical features.
Descrição
Palavras-chave
Periodontite apical, Microbiota, Endotoxinas, Ensaio de imunoadsorção enzimática, Hibridização de ácido nucleico, Periapical periodontitis, Endotoxins, Enzyme-linked Immunosorbent assay, Nucleic acid hybridization