Virus in Endodontics Viruses in Endodontics Scarlette Hernández Vigueras *; Luis Salazar Navarrete **; Ricardo Perez Tomas ***; Juan José Segura Egea ****; Miguel Viñas ***** \x26amp; José López-López ****** * Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile. PhD Dental Sciences, Campus Universitario de Bellvitge, University of Barcelona, Spain. ** Laboratory of Molecular Biology and Pharmacogenetics, Department of Basic Sciences, Faculty of Medicine, University of La Frontera, Temuco, Chile. *** Full Professor. Department of Basic Sciences. Campus Universitario de Bellvitge. University of Barcelona, Spain. **** Full Professor. Department of Stomatology. University of Sevilla, Sevilla, Spain.
***** Laboratory of Molecular Microbiology and Antimicrobials. Department of Pathology and Experimental Therapeutics, University of Barcelona, Spain. ****** Professor of Oral Medicine. Odontoestomatología Department, Campus Universitario de Bellvitge, University of Barcelona, Spain. Mailing Address: SUMMARY: The endodontic infection is the infection of the root canal system and undoubtedly is the main etiological agent of apical periodontitis. Further, endodontic pathogenic bacteria, has been sought in recent years to associate the presence of viruses in different types of endodontic pathology. Viruses that have been searched and associated are those belonging to the herpesvirus family, which are found mainly present in periapical pathologies. It has also sought to relate its presence pathologies with more symptoms, or radiographic image presented periapical bone destruction older. The role of viruses in the apical lesions of endodontic origin is still unclear, we speak of cumulative those of bacteria, in addition to possible local immunosuppression that would favor growth and the effect of the latter effects. KEYWORDS: herpesvirus, human papilloma virus, cytomegalovirus, Epstein-Barr, apical periodontitis, endodontic infection, endodontics virus. ABSTRACT: Endodontic infection is an infection of the root canal system and is the main etiological undoubtedly agent of apical periodontitis. In recent years, research has Aimed to associate the presence of virus and endodontic bacterial pathogens in the different types of endodontic disease.
The most common viruses That Have Been Associated researched and are members of the herpesvirus family, Which are mainly present in periapical pathologies. Furthermore, research has-been Carried out Relating to Their presence pathologies With Important symptoms, or radiographic imaging Those shows EXTENSIVE Where apical bone reabsorption. The role of viruses in apical lesions of endodontic origin are still unclear, it hypothesizes the cumulative effect With bacteria, in Addition to Local possible immunosuppression That favors the growth and the effect of bacteria. KEY WORDS: Herpes virus, human papillomavirus, human cytomegalovirus, Epstein-barr virus, apical periodontitis, endodontic infection, endodontic. INTRODUCTION Endodontic infection is defined as infection of the root canal system and undoubtedly is the main etiological agent of apical periodontitis. chemical and physical factors can induce periapical inflammation, but the microbiological factor is essential for this inflammation can persist and progress (Siqueira \x26amp; Rocks, 2009). Apical periodontitis or periapical lesions, the inflammatory disease is affecting the surrounding tissues of the apical portion of the tooth, causing destruction of these tissues (Graunaite et al, 2012;. Siqueira \x26amp; Rocks). These polymicrobial infections may have an acute or chronic course, and have various manifestations or clinical and radiographic features. The type of response or clinical characteristics variation may be due to different microbiological profiles that arise, or to the host immune response (Slots et al. , 2004). Currently, the consensus classification of the American Association of Endodontists (Glickman, 2009) is used, that in speaking of apical periodontitis, distinguished: i) Symptomatic, they can go or not accompanied by a periapical radiolucent area.
ii) Asymptomatic which, appearing as a periapical radiolucent area, but not accompanied by any clinical symptoms. The impact of apical periodontitis is not only at the level of oral cavity, but also in its possible relationship to various diseases or systemic conditions such as type 2 diabetes (López-López et al. , 2011) or snuff and hypertension (Segura-Egea et al. , 2011), among others. Over 500 species of microorganisms colonize the oral cavity, but only 15 to 30 are those which are frequently detected in infected channels may be responsible for most apical periodontitis in immunological-logically competent individuals. Another fewer species may be involved in other cases, particularly in cases of endodontic failures post (Siqueira \x26amp; Rocks). Viruses are cancerogénicos ulcerogenic agents and in the oral cavity and infestation is common in the mucosa and perioral area. Oral pathologies that are related to viral agents are oral ulcers, tumors and other diseases such as lichen planus and marginal periodontitis among others. Therefore, in recent years it has been sought to relate various viruses, and the specific bacteria, with symptomatic and asymptomatic apical periodontitis, using for techniques detection immunohistochemistry and detection in polymerase chain (PCR) (Li et al. , 2009; Sabeti et al. , 2003; Saboia-Dantas et al, 2007). . In recent years, attention has focused studies on the detection of virus of the herpesvirus family.
In particular, the studies focus on Epstein Barr or VHS-4 (EBV), Cytomegalovirus or VHS-5 (CV) and Herpes simplex (HSV 1 and 2) virus. However, Ferreira et al. (2011) sought and detected in samples of purulent exudate of acute apical abscesses, the presence of other viruses belonging to the herpesvirus family, like the VHS-6 and VHS-8, in addition to search and detect the presence of human papilloma virus. Endodontic pathologies associated virus. Herpesviruses or viruses belonging to the Herpesviridae family, are one of the major viral families present in the oral cavity. They are DNA (double straight chain) virus and herpesvirus virion size varies 120-150 nm. They have an icosahedral capsid, proteinaceous tegument and an envelope with viral glycoproteins. 8 types of species of human herpesviruses are known: herpes simplex 1 (HSV-1), herpes simplex 2 (HSV-2), Varicella-zoster virus (VZV) or herpes virus 3, Epstein-Barr virus (EBV) or herpesvirus 4 cytomegalovirus (CMV) or herpes virus 5, herpesvirus 6 (HHV-6), 7 (HHV-7) and 8 (HHV-8). Each of these viruses differ in biological and clinical characteristics (Slots, 2009). HSV-1 and 2 has been sought in several studies, however, none is presented with a statistically significant difference, isolated cases occur, suggesting that these viruses would not be associated with a potential role in endodontic diseases ( Chen et al, 2009;. Ferreira et al . ; Heling et al. , 2001; Li et al .
; Rosaline et al, 2009;. Sabeti et al, 2003a;. Sabeti et al, 2003b;. Sabeti \x26amp; Slots, 2004 ; Sabeti et al 2003c). . In turn, the VZV has been sought in three studies, which appear present in a very low number of samples, even a case that appeared this, it was finally associated with a misdiagnosis of herpes zoster, which presented similar symptoms to symptomatic irreversible pulpitis (Chen et al . ; Ferreira et al . ; Li et al. ). HHV-4 or EBV is one of the most commonly been associated in studies endodontic pathology, being present in a significant number of samples compared to healthy control groups (Chen et al . ; et al . ; Hernádi Ferreira et al. , 2010; Li et al .
; Ozbek et al, 2013;. Rosaline et al . ; Sabeti et al, 2012;. Sabeti et al, 2003a, 2003b, 2003c;. Sabeti \x26amp; Slots, 2004; Saboia-Dantas et al. ; Slots et al . ; Sunde et al, 2008;. Yazdi et al, 2008;. Yildirim et al, 2006). . HHV-5 or Cytomegalovirus (CMV) also along EBV is one of the most studied (Andric et al. , 2007; Chen et al . ; Ferreira et al .
; Hernádi et al, 2010;. Li et al . ; Rosaline Ozbek et al . ; et al. ,; Sabeti et al, 2012;. Sabeti et al, 2003a, 2003b, 2003c;. Sabeti \x26amp; Slots, 2004; Saboia-Dantas et al Slots et al . ; Sunde et al. . ; Yazdi et al . ; Yildirim et al. ); however, in studies in which it appears present in samples endodontic pathology no statistically significant compared with control group difference (Hernádi et al, 2010;. .
Li et al), so its potential role in endodontic pathology is controversial. The main viral association was found in studies of CMV and EBV is present in almost one third of the samples with endodontic pathology studied (Hernádi et al, 2010;. . Li et al . ; et al . ; Sabeti Ozbek et al, 2012; Sabeti et al, 2003a, 2003b, 2003c;. Sabeti \x26amp; Slots. , 2004; Saboia-Dantas et al Slots et al . ; Sunde et al . ; Yazdi et al . ; Yildirim et al. ). In primary teeth with periapical pathology has also been evaluated for the presence of these viruses in a total of 12 samples, the EBV is present in 8 and CMV in 7 statistically significant when compared with the control group (healthy premolars extracted for reasons difference orthodontic) (Yildirim et al.
). With respect to the detection of HHV-6, two studies have looked for this virus. Hernádi et al. (2011), which was detected in 8 of 40 samples of periapical lesions, and Ferreira et al. their presence detected in 2 of 33 samples of acute apical abscesses. Ferreira et al. , Also studied the presence of HHV-7 and HHV-8 in acute apical abscesses, finding HHV-7 in only a sample of apical abscesses and in a control instead albuscar HHV-8, found that in 18 of the 33 samples abscesses, it appeared virus present. The presence of this virus population is strongly associated with HIV (+), however, patients in the study, none was HIV (Ferreira et al. ). HPV belongs to the Papillomaviridae family, it is a double-stranded virus DNA, circular, which have identified more than 120 types. It is a small virus, has epithelial tropism and no envelope. In humans they have been associated with a variety of proliferative epithelial lesions, even been associated with premalignant or malignant conditions (Kumaraswamy \x26amp; Vidhya, 2011). However we found few studies that detect its presence associated with endodontic pathology, most recently, associates it with acute apical abscesses (Ferreira et al.
), Resulting positive in 3 of the 33 samples of purulent exudate. Virus and its relationship with the symptoms and the size of the root apical lesions. You searched correlate the presence of specific viral agents with endodontic disease that causes symptoms such as swelling, pain, tenderness to biting, tenderness or percussion. Viruses that have appeared associated with this type of injury are the Epstein-Barr virus and Cytomegalovirus, alone or in combination (Sabeti et al, 2003c, 2012;. Sabeti \x26amp; Slots, Slots et al. ). However, other studies have not found any statistically significant difference when comparing the viral presence among apical periodontitis symptomatic and asymptomatic ratio (Andric et al . ; Hernádi et al, 2010;. Li et al . ; Ozbek et al. ). Regarding the presence of virus by size of the apical lesion, the results differ. Sabeti et al.
(2003a), Sabeti \x26amp; Slots and Hernádi et al. (2010, 2011) will encuentraron a relationship between the presence of EBV, CMV and HHV-6 subtype B virus in large apical lesions. Conversely Li et al. found no statistically significant difference. Currently, lack describe the role of viruses in periapical lesions, postulating possible additive effects of the presence of virus, more endopatógenas bacteria and activation of proinflammatory immune mechanisms that may manifest in an increase periapical resorption and clinical symptoms . The virus can cause local immunosuppression, which favors bacterial growth in the periapex. On the other hand the virus may be present and replicate in humans, but without causing symptoms, so care must be taken when considering the clinical relevance of viral presence. It is important to know and understand the new microbiological interactions that occur in endodontic diseases, which could shed light for new therapeutic approaches, seeking to improve the prognosis of therapies. BIBLIOGRAPHIC REFERENCES Andric, M . ; Milasin, J . ; Jovanovic, T. \x26amp; Todorovic, L.
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Austral University of Chile Rudloff 1640, Valdivia CHILE Email: shernandez@uach. cl Received: 27/03/2014 Accepted: 23/07/2014