Abstract

BackgroundApical Periodontitis (AP) is an inflammatory disease that affects the tissues surrounding the root end of a tooth. The disease which is caused by endodontic infections presents in different clinical ways including development of an acute abscess. Recent studies have provided information suggesting role of a multitude of factors in pathogenesis of acute apical abscess (AAA). In this case-control study, our goal was to evaluate the frequency and potential role of two common polymorphisms of toll like receptor-4 (TLR-4) gene; Thr399Ile (1196 C>T) and Asp299Gly (+896 A>G), in 50 patients with AAA as cases and 50 patients with asymptomatic apical periodontitis (AAP) as controls.Material and MethodsSaliva sample containing mucosal epithelial cells was used for DNA extraction. Polymorphisms were detected by Tetra-ARMS (Amplification Refractory Mutation System) PCR method. Statistical analyses were carried out in SPSS 21 software.ResultsHomozygous wild type (CC) and heterozygous (CT) genotypes of Thr399Ile polymorphism were detected in 84% and 16% of AAA patients respectively. In controls, respective ratios were 94% (CC) and 6% (CT). Observed difference was not statistically significant (P>0.05) for distribution of these genotypes. The mutant homozygous (TT) genotype of this polymorphism was identified in neither of the participants. Overall, T allele frequency was obtained 8% in AAA and 3% in AAP (OR=2.6, 95% CI; 0. 6-10.6, p>0.05). For Asp299Gly polymorphism, no individual was detected with the mutant allele in case or control groups.ConclusionsOur results indicated a possible role for Thr399Ile polymorphism in acute presentations of abscess in AAA. However, the impact of this polymorphism needs to be more assessed in future studies. Key words:Genetic polymorphism, periapical abscess, periapical periodontitis, toll-like receptor 4.

Highlights

  • Apical abscess is an inflammatory process in the periradicular tissues caused by biofilms in the necrotic root canal systems [1]

  • In present study, we assessed a potential relationship between two well-known toll like receptor-4 (TLR-4) polymorphisms; Thr399Ile and Asp299Gly with two clinical forms of periapical disease; apical abscess (AAA) and apical periodontitis (AAP)

  • We found that distribution of Thr399Ile and Asp299Gly polymorphisms was not significantly different between AAA and AAP individuals

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Summary

Introduction

Apical abscess is an inflammatory process in the periradicular tissues caused by biofilms in the necrotic root canal systems [1]. Recent studies in the fields of microbiology and immunology have provided information regarding pathogenesis of symptomatic apical periodontitis, including its most severe form, the acute apical abscess (AAA) [1,2]. Recent studies have provided information suggesting role of a multitude of factors in pathogenesis of acute apical abscess (AAA). In this case-control study, our goal was to evaluate the frequency and potential role of two common polymorphisms of toll like receptor-4 (TLR-4) gene; Thr399Ile (1196 C>T) and Asp299Gly (+896 A>G), in 50 patients with AAA as cases and 50 patients with asymptomatic apical periodontitis (AAP) as controls. Results: Homozygous wild type (CC) and heterozygous (CT) genotypes of Thr399Ile polymorphism were detected in 84% and 16% of AAA patients respectively. The impact of this polymorphism needs to be more assessed in future studies

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