Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/197529
Title: PLAQUE LIPOPOLYSACCHARIDE INFLUENCES PERIAPICAL HEALING PULPOTOMY IN PREVENTING PULP NECROSIS AND APICAL PERIODONTITIS
Authors: CHEW HUIMIN
Keywords: Persistent lesion
Microbiology
Dental plaque
Cytokines
Root-filled teeth
Issue Date: 4-Feb-2020
Citation: CHEW HUIMIN (2020-02-04). PLAQUE LIPOPOLYSACCHARIDE INFLUENCES PERIAPICAL HEALING PULPOTOMY IN PREVENTING PULP NECROSIS AND APICAL PERIODONTITIS. ScholarBank@NUS Repository.
Abstract: Objectives: The microbial etiology of persistent apical periodontitis (PAP) in well-obturated teeth remains unclear. We hypothesized that increased amounts of lipopolysaccharide (LPS) in the subgingival plaque of teeth could increase the risk of PAP as LPS could potentially enter through gaps and defects in the cementum into the root canal. To test this hypothesis, (i)we compared the concentrations of LPS in plaque of patients with well-obturated teeth and intact coronal restorations, with PAP and without PAP, and (ii)determined if LPS could traverse from the extra-radicular environment into the canal using extracted teeth immersed in LPS. Methods: In total, 103 well-obturated teeth with intact coronal restorations completed ≥1 year earlier, with periodontal probing depths <4mm were included. Fifty teeth had PAP while 53 did not. Age, gender, symptoms, bleeding on probing (BOP) and other clinical variables were recorded. Subgingival plaque samples were collected by inserting paper points into the gingival sulcus and LPS amounts were quantified. Mann-Whitney U test and logistic regression were performed to identify any significant associations. Results: Plaque LPS levels of teeth with PAP were significantly higher than that in teeth without PAP. Other risk factors of PAP included history of trauma, >4 BOP sites per tooth, tenderness to percussion and palpation. Teeth with sinus tracts had higher plaque LPS levels compared to teeth without sinus tract. Ex-vivo experiments demonstrated that LPS could traverse extra-radicularly into the root canal. Conclusions: Findings of this study suggests a potential influence of subgingival plaque LPS on PAP in teeth with adequate root-filling and coronal restoration.
URI: https://scholarbank.nus.edu.sg/handle/10635/197529
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