Relationship Apical Periodontitis and the Main Bacterial Species in the Oral Microbiota
Condition: Periapical Periodontitis; MMP-9
MeSH terms: Periodontitis; Periapical Periodontitis
Study type: Interventional

Summary: 
      Aim: Apical periodontitis(AP) caused by root canal infection is the most frequent
      pathological lesion in the jaws. Bacterial products, host immune cells and biologically
      active factors called locally produced cytokines(such as IL-1, TNF-α) have been reported to
      play an important role in the pathogenesis of AP. Metalloproteinases(MMP), is a measurable
      biomarker that plays an important role in the degradation and regeneration of collagen and is
      an indicator of collagen. This study aimed to determine the main bacterial species in the
      microbiota as Gr(+) and Gr(-) and to compare the relationship between MMP-9 and TNF-α with
      controlled patient groups. Methodology:60 patients with AP and extraction indication were
      included in the study. 30 systemically and orally healthy volunteers were selected as the
      control group. After access cavity preparation, an initial microbiologic sample(S1) was taken
      from the root canal. After atraumatic extraction of the tooth, second microbial sample(S2)
      was taken from the external root surface. After bacterial DNA extraction, 16S rRNA gene
      primer was designed for sequence analysis. Bacterial community profiling was made by Sanger
      sequencing of the PCR products. Besides, blood samples were collected from all of the
      patients. Enzyme-linked immunosorbent assay was used to measure levels of MMP-9 and TNF-α.
    

Detailed description: 
      60 patients with AP and extraction indication were included in the study. 30 systemically and
      orally healthy volunteers were selected as the control group. After access cavity
      preparation, an initial microbiologic sample(S1) was taken from the root canal. After
      atraumatic extraction of the tooth, second microbial sample(S2) was taken from the external
      root surface. After bacterial DNA extraction, 16S rRNA gene primer was designed for sequence
      analysis. Bacterial community profiling was made by Sanger sequencing of the PCR products.
      Besides, blood samples were collected from all of the patients. Enzyme-linked immunosorbent
      assay was used to measure levels of MMP-9 and TNF-α Approximately 450 patients who applied to
      xxxx University, Faculty of Dentistry, Endodontics Department for routine examination due to
      apical periodontitis complaints were examined and their demographic characteristics were
      recorded. Patients who had any acute or chronic inflammatory disease, known infection status,
      history of trauma or surgical operation within 6 months that may affect MMP-9 levels,
      pregnant and/or lactating, malignity, morbid obesity, arthritis, immunologic diseases,
      cardiovascular diseases or use of vitamins with high biotin were not included in the study.
      Additionally, patients who used antibiotics or anti-inflammatory drugs within the last 6
      months, and patients with periodontal disease were excluded from the study. Of these
      patients, 60 patients with AP and extraction indication (due to restorative causes and lesion
      size) were included in the study. A total of 30 volunteers who were determined to be
      systemically and orally healthy (not having AP indication), were included in the study as the
      control group. The study was conducted between March 2022 and February 2023.

      Demographic Characteristics & Clinical and Radiographic Evaluation Laboratory Analysis ELISA
      measurement procedure of MMP-9 and TNF-α levels Bacteriological Sampling from the Root Canal
      System and Outer Root Surface Genomic DNA Isolation and Measurement of DNA Concentration PCR
      (16S Universal primer) Purification and sequencing of the 16S rRNA gene Power Analysis and
      Sample Size Calculations
    

Intervention name(s): apical periodontitis
Intervention type(s): Other
Intervention description(s): Of these patients, 60 patients with AP and extraction indication (due to restorative causes and lesion size) were included in the study
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment