Journal
JOURNAL OF ENDODONTICS
Volume 35, Issue 2, Pages 182-188Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.joen.2008.11.018
Keywords
Acute apical abscess; apical periodontitis; cellulitis; endodontic infections; Epstein-Barr virus; herpes simplex virus; herpesviruses; human cytomegalovirus; Varicella zoster virus
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Funding
- American Association of Endodontists Foundation
- Oregon Clinical and Translational Research Institute [OCTRI]
- National Center for Research Resources (NCRR) [UL1 RR024140]
- National Institutes of Health (NIH)
- OHSU School of Dentistry
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Acute apical abscesses and cellulitis are severe endodontic diseases caused by opportunistic bacteria with possible coinfection with latent herpesviruses. The objectives of this study are to identify herpesviruses, including human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus-1 (HSV-1), and Varicella zoster virus (VZV) in patients (n = 31) presenting with acute apical abscesses and cellulitis of endodontic origin. Primary and nested polymerase chain reaction (PCR) was conducted using virus-specific primers and DNA isolated from cell-free abscess fluid. From patients exhibiting concurrent spontaneous pain (n = 28), nine abscesses contained HCMV, two abscesses contained EBV, one abscess contained HSV-1, and no abscesses contained VZV. Control PCR using genomic or recombinant templates showed detection limits to a single genomic copy of HCMV, 100 genomic copies for EBV, and 1 to 10 copies for HSV-1 with no cross-amplification between herpesviral DNA targets. Nested PCR was required for detection of herpesviral DNA in the abscess specimens, indicating that these viruses were present in low copy number. Filtration of abscess specimens and virus transfer experiments using human fibroblastic MRC-5 cells confirmed the presence of HCMV particles in several abscess specimens. We conclude that herpesviruses are present but not required for the development of acute apical abscesses and cellulitis of endodontic origin. (J Endod 2009;35:182-188)
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