Cardoso Flávia G R, Ferreira Nádia S, Martinho Frederico C, Nascimento Gustavo G, Manhães Luiz R C, Rocco Marco A, Carvalho Cláudio A T, Valera Marcia C
Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil.
Department of Semiology, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil.
J Endod. 2015 Jul;41(7):1015-9. doi: 10.1016/j.joen.2015.02.005. Epub 2015 Apr 30.
This clinical study was conducted to correlate the levels of endotoxins and bacterial counts found in primary endodontic infection with the volume of periapical bone destruction determined by cone-beam computed tomography (CBCT) analysis. Moreover, the levels of bacteria and endotoxins were correlated with the development of clinical features.
Twenty-four root canals with primary endodontic disease and apical periodontitis were selected. Clinical features such as pain on palpation, pain on percussion, and previous episode of pain were recorded. The volume (cubic millimeters) of periapical bone destruction was determined by CBCT analysis. Endotoxins and bacterial samplings were collected by using sterile/apyrogenic paper points. Endotoxins were quantified by using limulus amebocyte lysate assay (KQCL test), and bacterial count (colony-forming units [CFU]/mL) was determined by using anaerobic culture techniques. Data were analyzed by Pearson correlation and multiple logistic regression (P < .05).
Endotoxins and bacteria were detected in 100% of the root canal samples (24 of 24), with median values of 10.92 endotoxin units (EU)/mL (1.75-128 EU/mL) and 7.5 × 10(5) CFU/mL (3.20 × 10(5)-8.16 × 10(6) CFU/mL), respectively. The median volume of bone destruction determined by CBCT analysis was 100 mm(3) (10-450 mm(3)). The multiple regression analysis revealed a positive correlation between higher levels of endotoxins present in root canal infection and larger volume of bone destruction (P < .05). Moreover, higher levels of endotoxins were also correlated with the presence of previous pain (P < .05).
Our findings revealed that the levels of endotoxins found in root canal infection are related to the volume of periapical bone destruction determined by CBCT analysis. Moreover, the levels of endotoxin are related to the presence of previous pain.
本临床研究旨在将原发性牙髓感染中内毒素水平和细菌计数与通过锥形束计算机断层扫描（CBCT）分析确定的根尖周骨破坏体积相关联。此外，细菌和内毒素水平还与临床特征的发展相关。
选取24个患有原发性牙髓疾病和根尖周炎的根管。记录诸如触诊疼痛、叩诊疼痛及既往疼痛发作等临床特征。通过CBCT分析确定根尖周骨破坏的体积（立方毫米）。使用无菌/无热原纸尖收集内毒素和细菌样本。采用鲎试剂法（KQCL试验）对内毒素进行定量，使用厌氧培养技术确定细菌计数（菌落形成单位[CFU]/mL）。数据采用Pearson相关性分析和多元逻辑回归分析（P <.05）。
在100%的根管样本（24/24）中检测到内毒素和细菌，中位数分别为10.92内毒素单位（EU）/mL（1.75 - 128 EU/mL）和7.5×10⁵ CFU/mL（3.20×10⁵ - 8.16×10⁶ CFU/mL）。通过CBCT分析确定的骨破坏中位数体积为100 mm³（10 - 450 mm³）。多元回归分析显示，根管感染中内毒素水平升高与更大的骨破坏体积之间存在正相关（P <.05）。此外，较高的内毒素水平还与既往疼痛的存在相关（P <.05）。
我们的研究结果表明，根管感染中发现的内毒素水平与通过CBCT分析确定的根尖周骨破坏体积相关。此外，内毒素水平与既往疼痛的存在相关。
