employee
Yaroslavl, Yaroslavl, Russian Federation
UDC 616.31
Subject. The microbial composition of the root canal contents in patients with chronic apical periodontitis was investigated, differentiated by the clinical course of the disease. Objectives. To identify and compare the microbial species composition in root canals of patients with asymptomatic and symptomatic chronic apical periodontitis, using highly sensitive molecular genetic analysis methods. Methodology. The study was conducted based on Yaroslavl State Medical University and Sodruzhestvo LLC. It was a single-center, prospective, case-control study that randomly divided patients with chronic apical periodontitis into two groups: asymptomatic (n=170) and symptomatic (n=130). Before endodontic treatment, the contents of the root canals were collected under sterile conditions using a cofferdam, an apex locator, and endocanal paper pins. DNA was isolated at an automated station and then analyzed for microorganisms using real-time polymerase chain reaction with specific reagent kits. To identify key pathogens, the detection rate of microorganisms was compared between the two groups using the Yates-adjusted χ² criterion and the exact Fisher criterion with a significance level of p < 0.05 for statistical analysis. Results. The polymerase chain reaction (PCR) method was used to detect microorganisms, allowing for the identification of even small species. Statistical analysis confirmed the significance of the differences between groups. The results showed that symptomatic patients have a higher detection rate of highly virulent pathogens, such as E. faecalis and F. nucleatum, and their synergistic association contributes to the formation of resistant biofilms. Asymptomatic patients, on the other hand, are dominated by streptococci and form a more balanced community. Conclusion. These findings open up new possibilities for personalized endodontic treatment based on a patient's microbiological profile.
periodontitis, microflora, PCR, symptoms, diagnosis, root canal
1. Siqueira J.F. Jr., Silva W.O., Romeiro K., Gominho L.F., Alves F.R.F., Rôças I.N. Apical root canal microbiome associated with primary and posttreatment apical periodontitis: A systematic review. International endodontic journal. 2024;57(8):1043-1058. https://doi.org/10.1111/iej.14071
2. Tiburcio-Machado C.S., Michelon C., Zanatta F.B., Gomes M.S., Marin J.A., Bier C.A. The global prevalence of apical periodontitis: a systematic review and meta-analysis. International endodontic journal. 2021;54(5):712-735. https://doi.org/10.1111/iej.13467
3. Dem'yanenko S.A., Morozova M.N., Pavlova N.V., Marchenko N.V., Shabliy D.N., Kazinina E.N. i dr. Mikrobiota sistemy kornevogo kanala u pacientov s destruktivnymi formami hronicheskogo apikal'nogo periodontita do i posle standartnogo endodonticheskogo lecheniya i sovremennye vozmozhnosti vozdeystviya na nee. Vestnik sovremennoy klinicheskoy mediciny. 2022;15(3):15-20. [Demyanenko S.A., Morozova M.N., Pavlova N.V., Marchenko N.V., Shabliy D.N., Kazinina E.N. et al. Microbiota of the root canal system in patients with destructive forms of chronic apical periodontitis before and after standard endodontic treatment and modern possibilities of influencing it. The Bulletin of Contemporary Clinical Medicine. 2022;15(3):15-20. (In Russ.)]. https://www.elibrary.ru/item.asp?id=49026609
4. Perez-Carrasco V., Uroz-Torres D., Soriano M., Crielaard W., Krom B.P., Zaura E. et al. Microbiome in paired root apices and periapical lesions and its association with clinical signs in persistent apical periodontitis using next-generation sequencing. International endodontic journal. 2023;56(5):622-636. https://doi.org/10.1111/iej.13893
5. Bouillaguet S., Manoil D., Girard M., Louis J., Gaïa N., Leo S. et al. Root microbiota in primary and secondary apical periodontitis. Frontiers in microbiology. 2018;9:2374. https://doi.org/10.3389/fmicb.2018.02374
6. Chervinec V.M., Chervinec Yu.V., Leont'eva A.V., Kozlova E.A., Stulov N.M., Belyaev V.S. i dr. Mikrobiom polosti rta u bol'nyh parodontitom, adgezivnye i bioplenkoobrazuyuschie svoystva. Klinicheskaya laboratornaya diagnostika. 2021;66(1):45-51. [Chervinets V.M., Chervinets Yu.V., Leont'eva A.V., Kozlova E.A., Stulov N.M., Belyaev V.S. et al. The microbiome of oral cavity patients with periodontitis, adhesive and biofilm forming properties. Klinicheskaya laboratornaya diagnostika (Russian Clinical Laboratory Diagnostics). 2021;66(1):45-51. (In Russ.)]. https://doi.org/10.18821/0869-2084-2021-66-1-45-51
7. Qian W., Ma T., Ye M., Li Z., Liu Y., Hao P. Microbiota in the apical root canal system of tooth with apical periodontitis. BMC Genomics. 2019;20(Suppl 2):189. https://doi.org/10.1186/s12864-019-5474-y
8. Blinova A.V., Rumyancev V.A. Destruktivnye porazheniya apikal'nogo periodonta: dostizheniya fundamental'noy i prikladnoy nauki v sovremennyh podhodah k resheniyu problemy. Nauka molodyh (Eruditio Juvenium). 2021;9(3):471-480. [Blinova A.V., Rumyantsev V.A. Destructive lesions of apical periodontitis: achievements of fundamental and applied science in modern approaches to solving the problem. Science of the young (Eruditio Juvenium). 2021;9(3):471-480. (In Russ.)]. https://doi.org/10.23888/HMJ202193471-480
9. Siqueira J.F. Jr., Rôças I.N. Present status and future directions: microbiology of endodontic infections. International endodontic journal. 2022;55(Suppl 3):512-530. https://doi.org/10.1111/iej.13677
10. Francisco P.A., Delboni M.G., Lima A.R., Xiao Y., Siqueira W.L., Gomes B. Proteomic profile of root canal contents in teeth with post-treatment endodontic disease. International endodontic journal. 2019;52(4):451-460. https://doi.org/10.1111/iej.13021
11. Korchagina M.S., Postnikov M.A., Burda G.K., Simanovskaya O.E., Rozhkova E.N., Ratnikova A.S. Analiz sovremennyh metodov endodonticheskogo lecheniya oslozhnennogo kariesa po dannym literatury. Vestnik volgogradskogo gosudarstvennogo medicinskogo universiteta. 2024;21(3):15-24. [Korchagina M.S., Postnikov M.A., Burda G.K., Simanovskaya O.E., Rozhkova E.N., Ratnikova A.S. Analysis of modern methods of endodontic treatment of complicated caries according to the literature. Journal of Volgograd State Medical University. 2024;21(3):15-24. (In Russ.)]. https://doi.org/10.19163/1994-9480-2024-21-3-15-24
12. Varoni E.M., Bavarian R., Robledo-Sierra J., Porat Ben-Amy D., Wade W.G., Paster B. et al. World Workshop on Oral Medicine VII: Targeting the microbiome for oral medicine specialists – Part 1. A methodological guide. Oral Diseases. 2019;25(Suppl 1):12-27. https://doi.org/10.1111/odi.13063
13. Brito L.C.N., Doolittle-Hall J., Lee C.-T., Moss K., Bambirra Júnior W., Tavares W.L.F. et al. The apical root canal system microbial communities determined by next-generation sequencing. Scientific reports. 2020;10(1):10932. https://doi.org/10.1038/s41598-020-67828-3
14. Strel'nikova N.V., Carev V.N., Antonova A.A., Shapovalenko E.S., Skorobogatova V.E. Fenomen simul'tannoy vegetacii uslovno-patogennyh mikroorganizmov polosti rta pri hronicheskih parodontitah s recidiviruyuschim techeniem. Tihookeanskiy medicinskiy zhurnal. 2023;(1):64-69. [Strelnikova N.V., Tsarev V.N., Antonova A.A., Shapovalenko E.S., Skorobogatova V.E. Simultaneous vegetation of opportunistic oral microorganisms in chronic periodontitis with recurrent course. Pacific Medical Journal. 2023;(1):64-69. (In Russ.)]. https://doi.org/10.34215/1609-1175-2023-1-64-69
15. Konjhodzic A, Hasic Brankovic L, Tahmiscija I, Dzankovic A, Korac S, Pasic M. et al. Molecular genetic identification methods of microorganisms in root canals. Stomatološki vjesnik. 2023;12(2):60-67. https://stomatoloskivjesnik.ba/bs/wp-content/uploads/2024/01/8.Konjhodzic.pdf
16. Cavalla F., Araujo M.G., Trindade A.C., Johnson N., Gottlieb P.D. Determinants of periodontal/periapical lesion stability and progression. Journal of dental research. 2021;100(1):29-36. https://doi.org/10.1177/0022034520952341
17. Siqueira J.F. Jr., Rôças I.N. A critical analysis of research methods and experimental models to study the root canal microbiome. International endodontic journal. 2022;55(Suppl 1):46-71. https://doi.org/10.1111/iej.13656
18. Xiang D., Dong P.T., Cen L., Bor B., Lux R., Shi W. et al. Antagonistic interaction between two key endodontic pathogens Enterococcus faecalis and Fusobacterium nucleatum. Journal of oral microbiology. 2022;15(1):2149448. https://doi.org/10.1080/20002297.2022.2149448
19. Wong J., Manoil D., Näsman P., Belibasakis G.N., Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. Frontiers in oral health. 2021;2:672887. https://doi.org/10.3389/froh.2021.672887
20. Amaral R.R., Braga T., Siqueira J.F. Jr., Rôças I.N., Rachid C.T.C.C., Oliveira A.G.G. et al. Root Canal Microbiome Associated With Asymptomatic Apical Periodontitis as Determined by High-Throughput Sequencing. Journal of endodontics. 2022;48(4):487-495. https://doi.org/10.1016/j.joen.2022.01.012
