Influence of genetic polymorphisms on oral health-related quality of life after root canal treatment

Abstract To evaluate the impact of genetic polymorphisms in interleukins (IL1A rs17561, rs1304037; IL10 rs1800871; IL1RN rs9005), nitric oxide (NOS2 rs2779249, rs2897518) and suppressor of cytokine signaling (SOCS1 rs243327, rs33977706) on oral health-related quality of life (OHRQoL) of patients under-going root canal treatment (RCT). Methods: The sample consisted of 108 participants, presenting single-rooted teeth with asymptomatic periapical periodontitis. The impact of the OHRQoL was recorded using the Oral Health Impact Profile (OHIP-14) before, seven, and 30 days after RCT. Saliva samples were collected as a source of genomic DNA. Genetic polymorphisms were genotyped by Real-Time PCR using the Taqman method. Univariate and Multivariate analyses were used (p<0.05). Results: A significant difference was observed for the polymorphism rs2297518 in the NOS2 gene in functional limitation in the codominant (p=0.037) and recessive (p=0.001) models; in the physical pain (p<0.001 in both models); in psychological discomfort (p<0.001 in both models); in physical disability (p<0.001 in both models) and in psychological disability (p<0.001 in both models). Polymorphisms in the SOCS1 gene, in the recessive model, rs33977706 (p=0.045) and rs243327 (p=0.019), influenced the OHRQoL in the psychological discomfort domain. Conclusions: Polymorphisms in NOS2 and SOCS1 genes influenced the OHRQoL of patients undergoing RCT.

Resumo Avaliar o impacto de polimorfismos genéticos em interleucinas (IL1A rs17561, rs1304037; IL10 rs1800871; IL1RN rs9005), óxido nítrico (NOS2 rs2779249, rs2897518) e supressor da sinalização de citocinas (SOCS1 rs243327, rs33977706) na qualidade de vida relacionada à saúde bucal (QVRSB) de pacientes submetidos a tratamento endodôntico (TE). Métodos: A amostra foi composta por 108 participantes, que apresentavam dentes unirradiculares com lesão periapical assintomática. O impacto da QVRSB foi registrado usando o Oral Health Impact Profile (OHIP-14) antes, sete e 30 dias após o TE. Amostras de saliva foram coletadas como fonte de DNA genômico. Os polimorfismos genéticos foram genotipados por PCR em tempo real usando o método Taqman. Análises univariadas e multivariadas foram utilizadas (p<0,05). Resultados: Observou-se diferença significativa para o polimorfismo rs2297518 no gene NOS2 na limitação funcional nos modelos codominante (p=0,037) e recessivo (p=0,001); na dor física (p<0,001 em ambos os modelos); no desconforto psicológico (p<0,001 em ambos os modelos); na deficiência física (p<0,001 em ambos os modelos) e na deficiência psicológica (p<0,001 em ambos os modelos). Polimorfismos no gene SOCS1, no modelo recessivo, rs33977706 (p=0,045) e rs243327 (p=0,019), influenciaram a QVRSB no domínio desconforto psicológico. Conclusões: Polimorfismos nos genes NOS2 e SOCS1 influenciaram a QVRSB de pacientes submetidos a TE.

Factors associated with postoperative signs and symptoms in teeth with periapical lesion: a longitudinal study

Abstract This study aimed to evaluate the association of the variables age, gender, arch position, tooth length, root canal amplitude, and periapical lesion size with the occurrence of postoperative signs and symptoms (pain, tenderness, and edema) and the use of postoperative analgesics following root canal treatment with foraminal enlargement in single-rooted teeth with apical periodontitis. This prospective longitudinal study included 105 patients requiring root canal treatment of maxillary or mandibular single-rooted teeth with periapical lesion. After root canal treatment in a single session, pain intensity and tenderness were recorded daily for 7 days and on days 14 and 30. Edema was evaluated by two independent evaluators within 48 h, 72 h, and 7 days after treatment. Ordinal and logistic regressions were performed (p < 0.05). Female gender (beta = 1.02; p < 0.01), mandibular teeth (beta = 25.50; p < 0.01), medium root canal amplitude (beta = 0.93; p = 0.03), and edema (beta = 1.88; p < 0.01) were associated with increased postoperative pain and tenderness, while the use of analgesics (beta = -1.82; p < 0.01) and time in days (beta = -0.23; p < 0.01) were associated with a decrease in these signs and symptoms. Edema was considered a risk factor for analgesic requirement (Odds Ratio [OR] = 61.46; p < 0.01). Factors such as gender, arch position, and root canal amplitude were associated with postoperative signs and symptoms. The use of analgesics was more required in edema and was associated with decreased pain.

Resumo Este estudo teve como objetivo avaliar a associação das variáveis idade, sexo, posição no arco, comprimento do dente, amplitude do canal radicular e tamanho da lesão periapical com a ocorrência de sinais e sintomas pós-operatórios (dor, dor ao toque e edema) e o uso de analgésicos após o tratamento endodôntico com alargamento foraminal em dentes uniradiculares com lesão periapical. Este estudo longitudinal prospectivo incluiu 105 pacientes que necessitavam de tratamento endodôntico em dentes uniradiculares superiores ou inferiores com lesão periapical. Após o tratamento do canal radicular em uma sessão, a intensidade da dor e a dor ao toque foram registradas diariamente por 7 dias e nos dias 14 e 30. O edema foi avaliado por dois avaliadores independentes dentro de 48 h, 72 h e 7 dias após o tratamento. Foram realizadas regressões ordinal e logística, e a significância estatística foi fixada em um valor de p < 0,05. Gênero feminino (beta = 1,02; p < 0.01), dentes inferiores (beta = 25,50; p < 0.01), amplitude média do canal radicular (beta = 0,93; p = 0,03) e edema (beta = 1,88; p < 0.01) foram associados ao aumento da dor e dor ao toque pós-operatória, enquanto o uso de analgésicos (beta = -1,82; p < 0.01) e o tempo em dias (beta = -0,23; p < 0.01) foram associados à diminuição desses sinais e sintomas. O edema foi considerado fator de risco para necessidade de analgésico (Odds Ratio [OR] = 61,46; p < 0.01). Fatores como sexo, posição do arco e amplitude do canal radicular foram associados aos sinais e sintomas pós-operatórios. O uso de analgésicos foi mais necessário no edema e foi associado à diminuição da dor.

Aspergillus in endodontic infection near the maxillary sinus / Aspergillus em infecções endodônticas próximas ao seio maxilar

ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%):Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus(1.6%). CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

RESUMO Introdução: Doenças do seio maxilar têm sido associadas à raízes com tratamento endodôntico próximas ao seio maxilar. Objetivo: Investigar a presença de fungos filamentosos em raízes com tratamento endodôntico e lesão periapical, próximas ao seio maxilar, alertando para uma possível contaminação do seio maxilar por via odontogênica. Método: Estudo transversal em sessenta raízes palatinas de primeiros molares superiores próximas ao seio maxilar, com tratamento endodôntico e lesão periapical. Após remoção do material obturador, raspas de dentina foram coletadas e inseridas em tubos de ensaio contendo Agar Sabouraud Dextrose e Clorafenicol. O fenótipo foi determinado pela análise macroscópica e microscópica das colônias. Para o PCR utilizou-se iniciadores ITS-5 e ITS-4. As sequencias obtidas foram comparadas as disponíveis no GenBank utilizando Basic Local Alignment Search Tool. Resultados: Fungos filamentosos foram isolados de 6 dos 60 canais (10%):Aspergillus niger (6,7%), Aspergillus versicolor (1,6%) e Aspergillus fumigatus(1,6%). Conclusão: Raízes próximas ao seio maxilar com tratamento endodôntico e lesão periapical, podem apresentar cultura positiva para fungos filamentosos. Profissionais afins devem estar alerta, pois este micro-organismo possuem características de patogenicidade podendo causar doenças no seio maxilar de origem odontogênica.

Increased overjet is a risk factor for dental trauma in preschool children.

Context: Traumatic dental injury and malocclusion constitute a public health problem due to their high prevalence. Preventing or detecting such conditions, in any population, is of paramount importance. Aim: Assessing the association of anterior occlusal characteristics and dental trauma in preschool children. Settings and Design: A cross‑sectional study was carried out with 2–6‑year‑old randomly selected by a sample calculation, resulting in 606 subjects. Materials and Methods: A questionnaire to collect information about the sample (age, gender, and race) was sent to the children’s parents. Two trained and calibrated examiners (Kappa 0.80) evaluated dental trauma according to criteria established by the World Health Organization. The following anterior occlusal characteristics were evaluated: Normal occlusion, anterior open bite, anterior crossbite, increased overjet (categorized as ≥3 mm), and increased overbite (categorized as ≥3 mm). Statistical Analysis Used: The variables associations were assessed (odds ratio, Chi‑square test, and logistic regression, P < 0.05) using statistical software (SPSS, version 16.0). Results: Dental trauma was observed in 20.8% and malocclusion in 48.6% of the children. There is an association between malocclusion and dental trauma (P = 0.01). Children with malocclusion have a 64% higher chance of suffering dental trauma. Increased overjet was the type of malocclusion related to a higher rate of tooth fracture (P < 0.01). Subjects with this type of malocclusion suffered tooth fractures three times more often than subjects with other malocclusion types. Conclusions: There was association of dental trauma and malocclusion. Increased overjet was the most common malocclusion related to dental trauma. Preventive strategies are needed to reduce the rate of anterior malocclusion and, consequently, dental trauma in preschool children.