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Exploring Persistent Apical Periodontitis in Humans: Integrative Genetic, Histological and Microbiological
Igor Bassi Ferreira Petean1, Alice Corrêa Silva-Sousa1, Rafael Verardino de Camargo1
1Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
International Endodontic Journal
|December 13, 2025
Summary
Genetic polymorphisms influence gene expression and protein activity in persistent apical periodontitis (PAP), impacting the host
Area of Science:
- Oral biology
- Immunogenetics
- Endodontics
Background:
- Persistent apical periodontitis (PAP) is a common complication following root canal treatment (RCT).
- The host's genetic makeup may influence the inflammatory and reparative processes in PAP.
- Specific gene polymorphisms, including those in SOCS-1, TNF-α, and RANKL, are investigated for their role in PAP.
Purpose of the Study:
- To assess the impact of SOCS-1, TNF-α, and RANKL gene polymorphisms on the expression of key genes involved in apical periodontitis.
- To analyze the histopathological, immunohistochemical, and microbiological characteristics of persistent apical periodontitis in Brazilian individuals.
- To correlate genetic variations with clinical and biological findings in PAP.
Main Methods:
- Genotyping of SOCS-1, TNF-α, and RANKL polymorphisms using real-time PCR in patients undergoing non-surgical root canal treatment (NSRCT).
- Analysis of gene expression (RANK, RANKL, TNFRSF1, SOCS-1, IL-10, IL-1β, TNF-α) in periapical lesions.
- Histopathological, immunohistochemical (SOCS-1, IL-1β), and microbiological analyses of periapical lesions from patients requiring endodontic surgery.
Main Results:
- Significant differences in gene expression were observed based on the genotypes of the evaluated polymorphisms in relation to PAP (p < 0.05).
- Histopathological examination revealed periapical granulomas (66.7%) and periapical cysts (33.3%).
- Immunohistochemistry showed strong SOCS-1 and IL-1β positivity in periapical cysts, while granulomas were negative. Four bacterial species were identified.
Conclusions:
- Genetic polymorphisms can modulate gene expression and protein activity in PAP, influencing the host's inflammatory and reparative responses.
- These findings suggest that genetic variations may serve as potential biomarkers for PAP.
- The study provides a foundation for future translational research into the genetic underpinnings of persistent apical periodontitis.
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