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Association between polymorphisms in Catechol-O-Methyl Transferase, Opioid Receptor Mu 1 and Serotonin Receptor Genes with postoperative pain following root canal treatment.

AIM
To evaluate the effect of single nucleotide polymorphisms in the COMT, OPRM1, 5HT1A, 5HT2A and 5HTR3B genes on the intensity of postoperative pain following root canal treatment METHODOLOGY: Ninety-five patients with mandibular/maxillary molar teeth diagnosed with symptomatic apical periodontitis and a level of preoperative pain greater than 50 on a 100 mm visual analog scale (VAS) were included. Salivary DNA was collected from the participants and stored in Eppendorf tubes at -80˚C. Preoperative percussion pain values were recorded before the root canal treatment procedures. After completion of root canal treatment, the participants were given instructions to record their postoperative pain levels at 24, 48, and 72 hours, five days and one week after treatment, using the VAS. A second visit for the patients after seven days was planned to record their levels of percussion pain on VAS. The percussion test was performed by tapping on the occlusal surface of the tooth with a blunt instrument. A QIAamp DNA Mini Kit was used to isolate DNA from saliva and SNP Genotyping Analysis software version 1 was used to analyze the genotypes by calculating FAM and HEX signals. The Kruskal-Wallis and Mann-Whitney U tests were used to evaluate pain intensity values among the genotypes, alleles, haplotypes and allele combinations. Nominal data (gender, intake and tooth number) were analyzed using a Chi-square test. Bonferroni correction was performed. Thus, the significance level was set at 1.6% (P = 0.016), 2.5% (P = 0.025) and 1.25% (P = 0.0125) for genotype, allele, and haplotype comparisons respectively.


RESULTS
There was no significant difference among the genotypes and alleles in terms of pre- and postoperative pain intensity. There was no significant difference among the haplotypes formed for the COMT gene in terms of pain intensity. Additionally, there was no significant association between the allelic combination formed for 5HT1A+5HT2A genes and the intensity of postoperative pain CONCLUSION: The findings indicate that none of the evaluated SNPs for COMT, OPRM1, 5HT1A, 5HT2A and 5HTR3B genes were associated with the intensity of postoperative pain.