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Viruses in pulp and periapical inflammation: a review

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Abstract

The presence of viruses in endodontic disease has been studied in the last decade. Their presence is associated with periapical radiolucency and with clinical findings, such as pain. The aim of this review is to analyze the scientific evidence currently published about viruses in pulp and periapical inflammation, and its possible clinical implications. A literature review was carried out using the Medline/Pubmed database. The search was performed, in English and Spanish, using the following keyword combinations: virus AND endodontic; virus AND periapical; virus AND pulpitis; herpesvirus AND periapical; papillomavirus AND periapical. We subsequently selected the most relevant studies, which complied with the search criterion. A total of 21 articles were included, of which 18 detected the present of viruses in the samples. In 3 of the studies, viral presence was not found in the samples studied. The Epstein–Barr virus was found in about 41 % of cases compared to controls, in which it was present in about 2 %. The main association between viruses and endodontic pathosis is between Cytomegalovirus and Epstein–Barr virus; these are found in 114 of the 406 samples of different endodontic pathosis. Some evidence supports that the Epstein–Barr virus is present in a significant number of endodontic diseases, without exact knowledge of their action in these diseases.

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References

  1. Siqueira JF Jr, Rocas IN. Distinctive features of the microbiota associated with different forms of apical periodontitis. J Oral Microbiol. 2009;. doi:10.3402/jom.v1i0.2009.

    PubMed  PubMed Central  Google Scholar 

  2. Slots J, Nowzari H, Sabeti M. Cytomegalovirus infection in symptomatic periapical pathosis. Int Endod J. 2004;37:519–24.

    Article  PubMed  Google Scholar 

  3. Slots J, Sabeti M, Simon JH. Herpesviruses in periapical pathosis: an etiopathogenic relationship? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:327–31.

    Article  PubMed  Google Scholar 

  4. Figdor D. Apical periodontitis: a very prevalent problem. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:651–2.

    Article  PubMed  Google Scholar 

  5. Jiménez-Pinzón A, Segura-Egea JJ, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV. Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population. Int Endod J. 2004;37:167–73.

    Article  PubMed  Google Scholar 

  6. Lopez-Lopez J, Jane-Salas E, Estrugo-Devesa A, Velasco-Ortega E, Martín-Gonzalez J, Segura-Egea JJ. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod. 2011;37:598–601.

    Article  PubMed  Google Scholar 

  7. Marotta PS, Fontes TV, Armada L, Lima KC, Rôças IN, Siqueira JF. Type 2 diabetes mellitus and the prevalence of apical periodontitis and endodontic treatment in an adult Brazilian population. J Endod. 2012;38:297–300.

    Article  PubMed  Google Scholar 

  8. Segura-Egea JJ, Castellanos-Cosano L, Velasco-Ortega E, Ríos-Santos JV, Llamas-Carreras JM, Machuca G, López-Frías FJ. Relationship between smoking and endodontic variables in hypertensive patients. J Endod. 2011;37:764–7.

    Article  PubMed  Google Scholar 

  9. Lopez-Lopez J, Jane-Salas E, Martin-Gonzalez J, Castellanos-Cosano L, Llamas-Carreras JM, Velasco-Ortega E, Segura-Egea JJ. Tobacco smoking and radiographic periapical status: a retrospective case-control study. J Endod. 2012;38:584–8.

    Article  PubMed  Google Scholar 

  10. Caplan DJ, Chasen JB, Krall EA, Cai J, Kang S, Garcia RI, Offenbacher S, Beck JD. Lesions of endodontic origin and risk of coronary heart disease. J Dent Res. 2006;85:996–1000.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Caplan DJ, Pankow JS, Cai J, Offenbacher S, Beck JD. The relationship between self-reported history of endodontic therapy and coronary heart disease in the atherosclerosis risk in communities study. J Am Dent Assoc. 2009;140:1004–12.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod. 2006;32:828–32.

    Article  PubMed  Google Scholar 

  13. Wang CH, Chueh LH, Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment. J Endod. 2011;37:1–5.

    Article  PubMed  Google Scholar 

  14. Segura-Egea JJ, Jimenez-Moreno E, Calvo-Monroy C, Ríos-Santos JV, Velasco-Ortega E, Sánchez-Domínguez B, Castellanos-Cosano L, Llamas-Carreras JM. Hypertension and dental periapical condition. J Endod. 2010;36:1800–4.

    Article  PubMed  Google Scholar 

  15. Castellanos-Cosano L, Machuca-Portillo G, Segura-Sampedro JJ, Torres-Lagares D, López-López J, Velasco-Ortega E, Segura-Egea JJ. Prevalence of apical periodontitis and frequency of root canal treatments in liver transplant candidates. Med Oral Patol Oral Cir Bucal. 2013;. doi:10.4317/medoral.19148 (Epub ahead of print).

    Google Scholar 

  16. Castellanos-Cosano L, Machuca-Portillo G, Sánchez-Domínguez B, Torres-Lagarés D, López-López J, Segura-Egea JJ. High prevalence of radiolucent periapical lesions amongst patients with inherited coagulation disorders. Haemophilia. 2013;19:e110–5.

    Article  PubMed  Google Scholar 

  17. Slots J. Oral viral infections of adults. Periodontol. 2000;2009(49):60–86.

    Google Scholar 

  18. Bagan JV, Jimenez Y, Murillo J, Poveda R, Díaz JM, Gavaldá C, Margaix M, Scully C, Alberola TM, Torres Puente M, Pérez Alonso M. Epstein–Barr virus in oral proliferative verrucous leukoplakia and squamous cell carcinoma: a preliminary study. Med Oral Patol Oral Cir Bucal. 2008;13:e110–3.

    PubMed  Google Scholar 

  19. Campisi G, Giovannelli L, Arico P, Lama A, Di Liberto C, Ammatuna P, D’Angelo M. HPV DNA in clinically different variants of oral leukoplakia and lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:705–11.

    Article  PubMed  Google Scholar 

  20. Chua KB, Lam SK, AbuBakar S, Lim ST, Paranjothy M, Koh MT, Lee WS. The predictive value of uvulo-palatoglossal junctional ulcers as an early clinical sign of exanthem subitum due to human herpesviridae 6. J Clin Virol. 2000;17:83–90.

    Article  PubMed  Google Scholar 

  21. da Silva CE, da Silva ID, Cerri A, Weckx LL. Prevalence of human papillomavirus in squamous cell carcinoma of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:497–500.

    Article  PubMed  Google Scholar 

  22. Ramos-Casals M, Loustaud-Ratti V, De Vita S, Zeher M, Zeher M, Bosch JA, Toussirot E, Medina F, Rosas J, Anaya JM, Font J, SS-HCV Study Group. Sjögren syndrome associated with hepatitis C virus: a multicenter analysis of 137 cases. Medicine (Baltimore). 2005;84:81–9.

    Article  Google Scholar 

  23. Contreras A, Zadeh HH, Nowzari H, Slots J. Herpesvirus infection of inflammatory cells in human periodontitis. Oral Microbiol Immunol. 1999;14:206–12.

    Article  PubMed  Google Scholar 

  24. Rider CA, Rupkalvis R, Miller AS, Chen SY. Search for evidence of three viral agents in radicular (periapical) cysts with immunohistochemistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80:87–91.

    Article  PubMed  Google Scholar 

  25. Li H, Chen V, Chen Y, Baumgartner JC, Machida CA. Herpesviruses in endodontic pathoses: association of Epstein–Barr virus with irreversible pulpitis and apical periodontitis. J Endod. 2009;35:23–9.

    Article  PubMed  Google Scholar 

  26. Sabeti M, Simon JH, Nowzari H, Slots J. Cytomegalovirus and Epstein–Barr virus active infection in periapical lesions of teeth with intact crowns. J Endod. 2003;29:321–3.

    Article  PubMed  Google Scholar 

  27. Ferreira DC, Paiva SS, Carmo FL, Rôças IN, Rosado AS, Santos KR, Siqueira JF Jr. Identification of herpesviruses types 1 to 8 and human papillomavirus in acute apical abscesses. J Endod. 2011;37:10–6.

    Article  PubMed  Google Scholar 

  28. Ferreira DC, Rocas IN, Paiva SS, Carmo FL, Cavalcante FS, Rosado AS, Santos KR, Siqueira JF Jr. Viral-bacterial associations in acute apical abscesses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:264–71.

    Article  PubMed  Google Scholar 

  29. Sabeti M, Simon JH, Slots J. Cytomegalovirus and Epstein–Barr virus are associated with symptomatic periapical pathosis. Oral Microbiol Immunol. 2003;18:327–8.

    Article  PubMed  Google Scholar 

  30. Sabeti M, Slots J. Herpesviral-bacterial coinfection in periapical pathosis. J Endod. 2004;30:69–72.

    Article  PubMed  Google Scholar 

  31. Chen V, Chen Y, Li H, Kent K, Baumgartner JC, Machida CA. Herpesviruses in abscesses and cellulitis of endodontic origin. J Endod. 2009;35:182–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Vandenbroucke JP, Von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, Iniciativa STROBE. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Gac Sanit. 2009;23:158.

    Article  PubMed  Google Scholar 

  33. Heling I, Morag-Hezroni M, Marva E, Hochman N, Zakay-Rones Z, Morag A. Is herpes simplex virus associated with pulp/periapical inflammation? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:359–61.

    Article  PubMed  Google Scholar 

  34. Sabeti M, Valles Y, Nowzari H, Simon JH, Kermani-Arab V, Slots J. Cytomegalovirus and Epstein–Barr virus DNA transcription in endodontic symptomatic lesions. Oral Microbiol Immunol. 2003;18:104–8.

    Article  PubMed  Google Scholar 

  35. Rosaline H, Satish ES, Kandaswamy D. Detection of presence or absence of herpes simplex virus, Epstein Barr virus and human cytomegalovirus in infected pulp using a polymerase chain reaction. Aust Endod J. 2009;35:9–12.

    Article  PubMed  Google Scholar 

  36. Sabeti M, Kermani V, Sabeti S, Simon JH. Significance of human cytomegalovirus and Epstein–Barr virus in inducing cytokine expression in periapical lesions. J Endod. 2012;38:47–50.

    Article  PubMed  Google Scholar 

  37. Hernádi K, Szalmás A, Mogyorósi R, Czompa L, Veress G, Csoma E, Márton I, Kónya J. Prevalence and activity of Epstein–Barr virus and human cytomegalovirus in symptomatic and asymptomatic apical periodontitis lesions. J Endod. 2010;36:1485–9.

    Article  PubMed  Google Scholar 

  38. Sunde PT, Olsen I, Enersen M, Beiske K, Grinde B. Human cytomegalovirus and Epstein–Barr virus in apical and marginal periodontitis: a role in pathology? J Med Virol. 2008;80:1007–11.

    Article  PubMed  Google Scholar 

  39. Yazdi KA, Sabeti M, Jabalameli F, Eman eini M, Kolahdouzan SA, Slots J. Relationship between human cytomegalovirus transcription and symptomatic apical periodontitis in Iran. Oral Microbiol Immunol. 2008;23:510–4.

    Article  PubMed  Google Scholar 

  40. Saboia-Dantas CJ, Coutrin de Toledo LF, Sampaio-Filho HR, Siqueira JF. Herpesviruses in asymptomatic apical periodontitis lesions: an immunohistochemical approach. Oral Microbiol Immunol. 2007;22:320–5.

    Article  PubMed  Google Scholar 

  41. Yildirim S, Yapar M, Kubar A, Slots J. Human cytomegalovirus, Epstein–Barr virus and bone resorption-inducing cytokines in periapical lesions of deciduous teeth. Oral Microbiol Immunol. 2006;21:107–11.

    Article  PubMed  Google Scholar 

  42. Ozbek SM, Ozbek A, Yavuz MS. Detection of human Cytomegalovirus and Epstein–Barr virus in symptomatic and asymptomatic apical periodontitis lesions by real-time PCR. Med Oral Patol Oral Cir Bucal. 2013;. doi:10.4317/medoral.18905 (Epub ahead of print).

    PubMed  PubMed Central  Google Scholar 

  43. Verdugo F, Castillo A, Simonian K, Castillo F, Farez-Vidal E, D’Addona A. Periodontopathogen and Epstein–Barr virus associated periapical periodontitis may be the source of retrograde infectious peri-implantitis. Clin Implant Dent Relat Res. 2015;17(1):199–207.

    Article  PubMed  Google Scholar 

  44. Andric M, Milasin J, Jovanovic T, Todorovic L. Human cytomegalovirus is present in odontogenic cysts. Oral Microbiol Immunol. 2007;22:347–51.

    Article  PubMed  Google Scholar 

  45. Hernadi K, Csoma E, Adam B, Szalmás A, Gyöngyösi E, Veress G, Márton IJ, Kónya J. Association of human herpesviridae 6 subtypes with symptomatic apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:401–6.

    Article  PubMed  Google Scholar 

  46. Rautava J, Syrjänen S. Human papillomavirus infections in the oral mucosa. J Am Dent Assoc. 2011;142:905–14.

    Article  PubMed  Google Scholar 

  47. Bernard HU, Burk RD, Chen Z, van Doorslaer K, zur Hausen H, de Villiers EM. Classification of papillomaviruses (PVs) based on 189 PV types and proposal of taxonomic amendments. Virology. 2010;401:70–9.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Kumaraswamy KL, Vidhya M. Human papiloma virus and oral infections: an update. J Canc Res Ther. 2011;7:120–7.

    Article  Google Scholar 

  49. Chung CH, Bagheri A, D’Souza G. Epidemiology of oral human papillomavirus infection. Oral Oncol. 2014;50:364–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This research was supported by Dirección de Investigación y Desarrollo, Universidad Austral de Chile, Chile, Proyecto DID S-2012-05.

Conflict of interest

The authors declare that they have no conflict of interest or financial support.

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Authors and Affiliations

  1. Faculty of Medicine, School of Dentistry, Universidad Austral de Chile, Valdivia, Chile

    Scarlette Hernández Vigueras & Manuel Donoso Zúñiga

  2. PhD Program in Odontology Science, Faculty of Dentistry, University of Barcelona, Barcelona, Spain

    Scarlette Hernández Vigueras

  3. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain

    Enric Jané-Salas & José López-López

  4. Laboratory of Molecular Biology and Pharmacogenetics, Department of Basic Science, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile

    Luis Salazar Navarrete

  5. Department of Stomatology Endodontics, University Sevilla, Seville, Spain

    Juan José Segura-Egea & Eugenio Velasco-Ortega

  6. Department of Odontostomatology, Pabellón de Gobierno 2ª Planta, Bellvitge University Campus, C/Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907, Barcelona, Spain

    José López-López

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  1. Scarlette Hernández Vigueras
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  2. Manuel Donoso Zúñiga
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Correspondence to José López-López.

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Hernández Vigueras, S., Donoso Zúñiga, M., Jané-Salas, E. et al. Viruses in pulp and periapical inflammation: a review. Odontology 104, 184–191 (2016). https://doi.org/10.1007/s10266-015-0200-y

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