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Pimenta RMN, Dos Reis-Prado AH, de Castro Oliveira S, Goto J, Cosme-Silva L, Cintra LTA, Benetti F. Effects of diabetes mellitus on dental pulp: A systematic review of in vivo and in vitro studies. Oral Dis 2024; 30:100-115. [PMID: 35657117 DOI: 10.1111/odi.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/11/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This systematic review (PROSPERO CRD42021227711) evaluated the influence of diabetes mellitus (DM) on the response of the pulp tissue and in the pulp cells behaviour. MATERIALS AND METHODS Searches in PubMed/MEDLINE, Embase, Web of Science and OpenGrey were performed until March 2022. Studies evaluating the effects of DM in the pulp tissue inflammation and in the cell behaviour were included, followed by risk of bias assessment (Methodological Index for Non-Randomized Studies and SYRCLE's RoB tools). The meta-analysis was unfeasible, and a narrative synthesis for each outcome was provided. RESULTS Of the 615 studies, 21 were eligible, mainly with in vivo analysis (16 studies). The pulp inflammation (10 studies) was analysed mainly by haematoxylin-eosin stain; DM increased pulp inflammation/degeneration in 9 studies, especially after dental procedures. The cell viability (5 studies) was analysed mostly using MTT assay; DM and glycating agents decreased cellular viability in 3 studies. DM reduced collagen in all of three studies. There were controversial results regarding mineralization; however, increased alkaline phosphatase was reported in three of four studies. CONCLUSIONS DM seems to increase inflammation/degeneration and mineralization in the pulp tissue while reducing cell proliferation. Further analyses in human pulp are important to provide stronger evidence.
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Affiliation(s)
- Rafaella Milla Nunes Pimenta
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Leopoldo Cosme-Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Alagoas (UFAL), Maceió, Brazil
| | | | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Baldeon-Gutierrez R, Ohkura N, Yoshiba K, Yoshiba N, Tohma A, Takeuchi R, Belal RSI, Edanami N, Takahara S, Gomez-Kasimoto S, Ida T, Noiri Y. Wound-healing Processes After Pulpotomy in the Pulp Tissue of Type 1 Diabetes Mellitus Model Rats. J Endod 2024; 50:196-204. [PMID: 37939821 DOI: 10.1016/j.joen.2023.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Patients with type 1 diabetes mellitus (DM1) tend to have delayed wound healing, even in the pulp tissue. We hypothesized that hyperglycemia affects odontoblast-like cell (OLC) differentiation and is involved in macrophage polarization. Accordingly, we evaluated dental pulp stem cell differentiation and macrophage phenotypes after pulpotomy. METHODS After modifying DM1 rat models by streptozotocin, 8-week-old rats' upper left first molars were pulpotomized with mineral trioxide aggregate. Meanwhile, the control group was administered saline. Immunohistochemical localization of nestin, osteopontin, α-smooth muscles (α-SMAs), and CD68 (pan-macrophage marker) was conducted 7 days after pulpotomy. The OLC differentiation stage was determined using double immunofluorescence of nestin and α-SMA. Double immunofluorescence of CD68 and iNOS was counted as M1 macrophages and CD68 and CD206 as M2 macrophages. Proliferating cell nuclear antigen and Thy-1 (CD90) were evaluated by immunofluorescence. RESULTS In DM1 rats, the reparative dentin bridge was not complete; however, the osteopontin-positive area did not differ significantly from that in controls. Proliferating cell nuclear antigen, indicative of cell proliferation, increased in positive cells in DM1 rats compared with controls. Double-positive cells for α-SMA and nestin indicated many immature OLCs in DM1. CD90 was positive only in controls. CD68-positive cells, especially M1 macrophages, were increased in DM1 rats, allowing the inflammatory stage to continue 7 days after pulpotomy. CONCLUSIONS The condition of DM1 model rats can interfere at various stages of the wound healing process, altering OLC differentiation and macrophage polarization. These findings highlight the importance of normal blood glucose concentrations during pulp wound healing.
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Affiliation(s)
- Rosa Baldeon-Gutierrez
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoto Ohkura
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kunihiko Yoshiba
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Nagako Yoshiba
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Aiko Tohma
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryosuke Takeuchi
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Razi Saifullah Ibn Belal
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Edanami
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shintaro Takahara
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Susan Gomez-Kasimoto
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takako Ida
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Tao S, Yang T, Zhou JN, Zhang Q. Impaired pulp healing associated with underlying disorders in the dental pulp of rats with type 2 diabetes. J Dent Sci 2024; 19:310-320. [PMID: 38303798 PMCID: PMC10829554 DOI: 10.1016/j.jds.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 03/29/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Type 2 diabetes mellitus (T2DM), characterized by hyperglycemia, is a systematic disease affecting structure and healing ability in various tissues. This study aimed to investigate whether T2DM could impair the dental pulp healing and cause underlying pathological changes in the dental pulp before an injury occurred. Materials and methods Goto-Kakizaki rats were used as T2DM model animals and performed with direct pulp capping procedures on the first maxillary molars. The molars at 1, 2, 4 weeks after operation and non-injured molars were examined using hematoxylin and eosin staining, immunohistochemical staining, immunofluorescence staining, and Masson's trichrome staining. The fresh dental pulp of maxillary incisors was collected for transmission electron microscopy and glucose content evaluation. Results The T2DM rats showed deficient reparative dentin formation compared with the healthy rats. Before the occurrence of an injury, underlying pathological changes of major components in the pulp tissue were observed in T2DM rats, including vasculopathy; collagen abnormalities; decreased proliferation, decreased odontogenetic differentiation and damaged ultrastructure of dental pulp cells. High glucose content and advanced glycation end products accumulation were further found in the pulp tissue in T2DM rats. Conclusion T2DM can impede pulp healing process in rats, which is associated with underlying pathological changes in the non-injured pulp caused by the advanced glycation end products accumulation under high-glucose conditions.
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Affiliation(s)
- Shuo Tao
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Ting Yang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Jia-Ni Zhou
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
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Tao S, Yang T, Yin Y, Zhang Q. Mitochondrial reactive oxygen species promote mitochondrial damage in high glucose-induced dysfunction and apoptosis of human dental pulp cells. J Dent Sci 2024; 19:292-302. [PMID: 38303803 PMCID: PMC10829553 DOI: 10.1016/j.jds.2023.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/10/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose High glucose (HG)-induced aberrant proliferation, apoptosis and odontoblastic differentiation of dental pulp cells (DPCs) have been implicated in the pathogenesis of impaired diabetic pulp healing; however, the underlying mechanism remains unclear. This study aimed to investigate the role of mitochondrial reactive oxygen species (mtROS) and mitochondria in HG-induced dysfunction and apoptosis of DPCs. Materials and methods Human DPCs (hDPCs) were cultured in a low-glucose, high-glucose, mannitol, and MitoTEMPO medium in vitro. Methylthiazol tetrazolium assay, Annexin V-FITC/PI staining and scratch-wound assay were used to analyze cell proliferation, apoptosis and migration, respectively. Alkaline phosphatase staining and alizarin red S staining were used to evaluate cell differentiation. DCF-DA staining, MitoSOX staining, MitoTracker Red staining, JC-1 staining, and adenosine triphosphate (ATP) kit assay were performed to investigate total ROS and mtROS generation, mitochondrial density, mitochondrial membrane potential (MMP), and ATP synthesis, respectively. Quantitative PCR assay was performed to detect the mRNA expression of mitochondrial biogenesis- and dynamics-related markers. Transmission electron microscopy was used to observe the mitochondrial ultrastructure. Results HG augmented the production of total ROS and mtROS, and triggered mitochondrial damage in hDPCs, as reflected by decreased mitochondrial density, depolarized MMP, reduced ATP synthesis, altered mRNA expression of mitochondrial biogenesis- and dynamics-related markers, and abnormal mitochondrial ultrastructure. Supplementation of MitoTEMPO alleviated the mitochondrial damage and reversed the aberrant proliferation, apoptosis, migration and odontoblastic differentiation of HG-stimulated hDPCs. Conclusion HG triggers mitochondrial damage via augmenting mtROS generation, resulting in the inhibited proliferation, migration, and odontoblastic differentiation of hDPCs and enhanced their apoptosis.
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Affiliation(s)
- Shuo Tao
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Ting Yang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Yue Yin
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai, China
- Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
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Barać M, Petrović M, Petrović N, Nikolić-Jakoba N, Aleksić Z, Todorović L, Petrović-Stanojević N, Anđelić-Jelić M, Davidović A, Milašin J, Roganović J. Melatonin Action in Type 2 Diabetic Parotid Gland and Dental Pulp: In Vitro and Bioinformatic Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6727. [PMID: 37754589 PMCID: PMC10530673 DOI: 10.3390/ijerph20186727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with functional deterioration of the salivary gland and dental pulp, related to oxidative stress. The aim was to integrate experimental and bioinformatic findings to analyze the cellular mechanism of melatonin (MEL) action in the human parotid gland and dental pulp in diabetes. Human parotid gland tissue was obtained from 16 non-diabetic and 16 diabetic participants, as well as human dental pulp from 15 non-diabetic and 15 diabetic participants. In human non-diabetic and diabetic parotid gland cells (hPGCs) as well as in dental pulp cells (hDPCs), cultured in hyper- and normoglycemic conditions, glial cell line-derived neurotrophic factor (GDNF), MEL, inducible nitric oxide synthase (iNOS) protein expression, and superoxide dismutase (SOD) activity were measured by enzyme-linked immunosorbent assay (ELISA) and spectrophotometrically. Bioinformatic analysis was performed using ShinyGO (v.0.75) application. Diabetic participants had increased GDNF and decreased MEL in parotid (p < 0.01) and dental pulp (p < 0.05) tissues, associated with increased iNOS and SOD activity. Normoglycemic hDPCs and non-diabetic hPGCs treated with 0.1 mM MEL had increased GDNF (p < 0.05), while hyperglycemic hDPCs treated with 1 mM MEL showed a decrease in up-regulated GDNF (p < 0.05). Enrichment analyses showed interference with stress and ATF/CREB signaling. MEL induced the stress-protective mechanism in hyperglycemic hDPCs and diabetic hPGCs, suggesting MEL could be beneficial for diabetes-associated disturbances in oral tissues.
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Affiliation(s)
- Milena Barać
- Department of Pharmacology in Dentistry, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Milan Petrović
- Clinic for Maxillofacial Surgery, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Nina Petrović
- Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (N.P.); (L.T.)
| | - Nataša Nikolić-Jakoba
- Department of Periodontology, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.N.-J.); (Z.A.)
| | - Zoran Aleksić
- Department of Periodontology, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.N.-J.); (Z.A.)
| | - Lidija Todorović
- Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (N.P.); (L.T.)
| | - Nataša Petrović-Stanojević
- Zvezdara University Medical Center, University of Belgrade, 11000 Belgrade, Serbia; (N.P.-S.); (M.A.-J.); (A.D.)
| | - Marina Anđelić-Jelić
- Zvezdara University Medical Center, University of Belgrade, 11000 Belgrade, Serbia; (N.P.-S.); (M.A.-J.); (A.D.)
| | - Aleksandar Davidović
- Zvezdara University Medical Center, University of Belgrade, 11000 Belgrade, Serbia; (N.P.-S.); (M.A.-J.); (A.D.)
| | - Jelena Milašin
- Department of Human Genetics, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Jelena Roganović
- Department of Pharmacology in Dentistry, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
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Veysari SK, Asghari M, Farshad F, Hodjat M. Epigenetic changes underlie the association between diabetes mellitus and oral diseases. Mol Biol Rep 2023; 50:6987-6996. [PMID: 37378745 DOI: 10.1007/s11033-023-08574-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/01/2023] [Indexed: 06/29/2023]
Abstract
Patients with diabetes mellitus (DM) suffer from oral complications related to oral infections, periodontal diseases, and endodontic lesions. Emerging evidence has revealed the contribution of the epigenetic process as the underlying mechanism of DM complications. DNA methylation, histone modifications, and non-coding RNAs are epigenetic regulators that directly affect gene expression. The present review elaborated on the role of epigenetic dysregulation in the etiology of diabetes-related periodontal and endodontic diseases. The narrative review study was prepared using databases such as PubMed, Google Scholar, Science Direct, and Scopus. The formation of glycation products as a result of hyperglycemic condition increases oxidative stress, and elevates chronic inflammatory mediators that could in turn adversely change the cellular environment and alter the epigenetic status. This process contributes to the alteration of regulatory genes expression, leading to the development of diabetes-induced bone complications and impaired odontogenic capacity of pulp. Indeed, epigenetic mechanisms mediate the interaction between gene expression and DM cellular environment. Further investigations on epigenetic factors involved in DM oral complications may provide novel therapeutic targets.
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Affiliation(s)
- Setareh Kazemi Veysari
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, 1417614411, Iran
| | - Mona Asghari
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, 1417614411, Iran
| | - Fatemeh Farshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, 1417614411, Iran
| | - Mahshid Hodjat
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, 1417614411, Iran.
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Nijakowski K, Ortarzewska M, Jankowski J, Lehmann A, Surdacka A. The Role of Cellular Metabolism in Maintaining the Function of the Dentine-Pulp Complex: A Narrative Review. Metabolites 2023; 13:metabo13040520. [PMID: 37110177 PMCID: PMC10143950 DOI: 10.3390/metabo13040520] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
The cellular metabolic processes ensure the physiological integrity of the dentine-pulp complex. Odontoblasts and odontoblast-like cells are responsible for the defence mechanisms in the form of tertiary dentine formation. In turn, the main defence reaction of the pulp is the development of inflammation, during which the metabolic and signalling pathways of the cells are significantly altered. The selected dental procedures, such as orthodontic treatment, resin infiltration, resin restorations or dental bleaching, can impact the cellular metabolism in the dental pulp. Among systemic metabolic diseases, diabetes mellitus causes the most consequences for the cellular metabolism of the dentine-pulp complex. Similarly, ageing processes present a proven effect on the metabolic functioning of the odontoblasts and the pulp cells. In the literature, several potential metabolic mediators demonstrating anti-inflammatory properties on inflamed dental pulp are mentioned. Moreover, the pulp stem cells exhibit the regenerative potential essential for maintaining the function of the dentine-pulp complex.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Martyna Ortarzewska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Jakub Jankowski
- Student's Scientific Group in the Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Lehmann
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Segura-Egea JJ, Cabanillas-Balsera D, Martín-González J, Cintra LTA. Impact of systemic health on treatment outcomes in endodontics. Int Endod J 2023; 56 Suppl 2:219-235. [PMID: 35752972 DOI: 10.1111/iej.13789] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The healing of periapical lesions after root canal treatment (RCT) is not the result of the curative action of the treatment. The process of healing begins with inflammation, and is resolved by the clearance of the immunogen that induces the immune response. Then, the periapical tissue itself carries out the healing of the periapical lesion, by repair or by a combination of repair and regeneration, depending on the host's reparative response working properly. The ultimate objective of RCT is to achieve wound healing by removing the source of bacterial antigens and toxins, allowing chronic inflammatory tissue to become reparative tissue. Some systemic conditions increase the susceptibility of the host to infection or impair the tissue reparative response, maintaining the inflammatory process and periapical bone resorption after RCT. This can cause the failure of RCT and even the need for extraction of the affected tooth. OBJECTIVE To analyse the scientific literature on the possible influence of systemic conditions on the treatment outcomes in endodontics, as well as to discuss the biological mechanisms that may be involved. METHODS The search was carried out in PubMed, SCOPUS and EMBASE. The inclusion criteria established were original scientific articles reporting data about some systemic condition in relation to treatment outcomes in endodontics, including clinical studies and studies carried out in animal models. RESULTS Systemic factors (age, nutrition, stress, hormones, smoking habits), and systemic diseases, such as diabetes, cardiovascular diseases, osteoporosis, HIV infection, inflammatory bowel disease, and others, can influence or interfere in the repair of periapical tissues after RCT. DISCUSSION Some of these systemic diseases can alter bone turnover and fibroblast function, preventing or delaying periapical wound healing. Others can alter the microvasculature, reducing nutrients and oxygen supply to periapical tissues. As a result, these systemic conditions can decrease the success rate of RCT and provoke incomplete wound healing (typically granulomatous tissue formation) in the periapical region. CONCLUSIONS The results of this narrative review show worse success rate of RCT, with higher percentage of postoperative radiolucent periapical lesions and higher proportion of non-retained teeth (RFT), associated with several systemic conditions, such as smoking habits and diabetes.
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Affiliation(s)
- Juan J Segura-Egea
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Daniel Cabanillas-Balsera
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Jenifer Martín-González
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Luciano T A Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), São Paulo, Brazil
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9
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Expert consensus on regenerative endodontic procedures. Int J Oral Sci 2022; 14:55. [PMID: 36450715 PMCID: PMC9712432 DOI: 10.1038/s41368-022-00206-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 12/05/2022] Open
Abstract
Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
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10
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Li X, Xu W, Lin X, Wu J, Wu B. Effect of LncRNA-MALAT1 on mineralization of dental pulp cells in a high-glucose microenvironment. Front Cell Dev Biol 2022; 10:921364. [PMID: 36035997 PMCID: PMC9402893 DOI: 10.3389/fcell.2022.921364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022] Open
Abstract
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) belongs to the long non-coding RNA (LncRNA) family. LncRNA-MALAT1 is expressed in a variety of tissues and is involved in a variety of diseases and biological processes. Although LncRNA-MALAT1 is upregulated in a high-glucose microenvironment and may participate in odontogenic differentiation, the underlying mechanism is not yet well elucidated. Here, we show that MALAT1 was mainly expressed in the cytoplasm of dental pulp cells (DPCs) in situ hybridization. In addition, high levels of mineralization-related factors, namely, tumor growth factors β 1 and 2 (TGFβ-1 and TGFβ-2), bone morphogenetic proteins 2 and 4 (BMP2 and BMP4), bone morphogenetic protein receptor 1 (BMPR1), SMAD family member 2 (SMAD2), runt-related transcription factor 2 (RUNX2), Msh homeobox 2 (MSX2), transcription factor SP7 (SP7), alkaline phosphatase (ALP), dentin matrix acidic phosphoprotein 1 (DMP1), and dentin sialophosphoprotein (DSPP), were expressed, and MALAT1 was significantly overexpressed in DPCs 7 and 14 days after mineralization induction in a high-glucose microenvironment, but only TGFβ-1, BMP2, MSX2, SP7, ALP, and DSPP were significantly downregulated in DPCs after MALAT1 inhibition. MALAT1 may participate in the mineralization process of DPCs by regulating multiple factors (TGFβ-1, BMP2, MSX2, SP7, ALP, and DSPP).
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Affiliation(s)
- Xinzhu Li
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenan Xu
- Department of Pediatric Dentistry, Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China
| | - Xiaoyu Lin
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jingyi Wu
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Buling Wu
- Department of Pediatric Dentistry, Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China
- *Correspondence: Buling Wu,
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Niazi SA, Bakhsh A. Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:931. [PMID: 35888650 PMCID: PMC9319780 DOI: 10.3390/medicina58070931] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 02/06/2023]
Abstract
The 'Focal Infection Era in Dentistry' in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body parts, resulting in many types of degenerative systemic diseases. This theory was eventually refuted due to anecdotal evidence. However, lately there has been increased interest in investigating whether endodontic disease could have an impact on general health. There are reviews that have previously been carried out on this subject, but as new data have emerged since then, this review aims to appraise the available literature investigating the dynamic associations between apical periodontitis, endodontic treatment, and systemic health. The available evidence regarding focal infection theory, bacteraemia and inflammatory markers was appraised. The review also collated the available research arguing the associations of apical periodontitis with cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome and autoimmune disorders, along with the effect of statins and immunomodulators on apical periodontitis prevalence and endodontic treatment prognosis. There is emerging evidence that bacteraemia and low-grade systemic inflammation associated with apical periodontitis may negatively impact systemic health, e.g., development of cardiovascular diseases, adverse pregnancy outcomes, and diabetic metabolic dyscontrol. However, there is limited information supporting the effect of diabetes mellitus or autoimmune disorders on the prevalence and prognosis post endodontic treatment. Furthermore, convincing evidence supports that successful root canal treatment has a beneficial impact on systemic health by reducing the inflammatory burden, thereby dismissing the misconceptions of focal infection theory. Although compelling evidence regarding the association between apical periodontitis and systemic health is present, further high-quality research is required to support and establish the benefits of endodontic treatment on systemic health.
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Affiliation(s)
- Sadia Ambreen Niazi
- Department of Endodontics, Centre of Oral Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, Guy’s Dental Hospital, King’s College London, London SE1 9RT, UK
| | - Abdulaziz Bakhsh
- Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia;
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12
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Saghiri MA, Sheibani N, Kawai T, Nath D, Dadvand S, Amini S, Vakhnovetsky J, Morgano SM. Diabetes Negatively Affects Tooth Enamel and Dentine Microhardness: An In-vivo Study. Arch Oral Biol 2022; 139:105434. [DOI: 10.1016/j.archoralbio.2022.105434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/25/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022]
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13
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Alsamahi S, Milne TM, Hussaini H, Rich AM, Friedlander LT. Type 2 diabetes and the clinically normal pulp - An in-vitro study. Int Endod J 2022; 55:660-671. [PMID: 35322881 PMCID: PMC9324782 DOI: 10.1111/iej.13732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/15/2022]
Abstract
Aim The aim of this study was to investigate the effect of type 2 diabetes (T2D) on clinically normal dental pulp tissue by using special stains and immunohistochemistry (IHC) to determine the morphology of the coronal pulp and distribution of immune markers in non‐T2D and T2D groups. Methodology Ethics approval for this in vitro pilot study was obtained from the University of Otago Human Ethics Committee (16/069). Twenty extracted permanent molar teeth diagnosed as having clinically normal pulp status were collected. Ten teeth were from participants with well‐controlled T2D and ten from participants without diabetes (non‐T2D). Each tooth was sectioned transversely at the cemento‐enamel junction before the crowns were decalcified and embedded in paraffin. Sections were stained with haematoxylin and eosin, Massons trichrome, and van Gieson stains for histological and morphological evaluation. IHC using anti‐CD4, anti‐CD68 and anti‐CD83 and anti‐IL1β, anti‐IL6, anti‐IL17, anti‐TNF‐α, anti‐TLR2, anti‐TLR4 and anti‐FOXP3 identified proteins of interest. Qualitative and semi‐quantitative analyses evaluated the morphology of the dental pulp and protein expression. Data analyses were performed with GraphPad Prism, using Student's t‐test and multiple regression using SPSS at p < .05. Results Special stains demonstrated morphological differences in the T2D dental pulp compared with non‐T2D. Qualitative analysis indicated that the pulp in the T2D samples was consistently less cellular, less vascular, showed evidence of thickened blood vessel walls, increased pulp calcification and collagen deposition. Semi‐quantitative analysis of IHC samples showed the T2D pulp had significantly increased expression of macrophage and dendritic cell markers CD68 (p < .001) and CD83 (p = .04), and there was significantly greater expression of inflammatory cytokines IL1β (p = .01), IL6 (p < .0001), IL17 (p < .0001) and TNF‐α (p = .01). T2D samples showed a significant increase in markers of innate inflammation, TLR2 (p < .001) and TLR4 (p < .001) and decreased expression of regulatory T‐cell marker, FOXP3 (p = .01). Multiple regression showed that age‐corrected differences were statistically significant. Conclusion Preliminary findings suggest that T2D may exert a similar response in the pulp to complications in other body sites. Hyperglycaemia is associated with changes in the morphology of the clinically normal dental pulp with altered immune cell and cytokine expression.
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Affiliation(s)
- S Alsamahi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - T M Milne
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - H Hussaini
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - A M Rich
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - L T Friedlander
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
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Saghiri MA, Freag P, Nath D, Morgano SM. The effect of diabetes on the tensile bond strength of a restorative dental composite to dentin. Odontology 2022; 110:648-654. [PMID: 35246807 DOI: 10.1007/s10266-022-00697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
This study was performed to evaluate the effect of diabetes mellitus (DM) on the tensile bond strength (TBS) of dental composite resin bonding to enamel and dentin of extracted human teeth. Thirty caries-free human premolar teeth (10 from type 1 DM (D1), 10 from type 2 DM (D2), and 10 from non-diabetic individuals (control)) were wet ground and polished to obtain flat surfaces of dentin (n = 10). 37% phosphoric acid was used to etch dentin specimens for 15 s. After the application of the adhesive system, the composite resins were applied and cured for 20 s. Then, specimens were subjected to TBS testing by Universal Testing Machine (1 mm/min). One specimen from each group was prepared and observed under a scanning electron microscope (SEM) and a dot map was generated. Data were analyzed by ANOVA and post hoc Tukey tests (α = 0.05). The TBS values were significantly higher in the control group compared to the D1 and D2 groups (P < 0.05). Between DM groups, D2 values were significantly higher than those in the D1 group. Unlike DM groups, the zigzag fracture pattern was only noticed in the control group. DM adversely affected the TBS of dental composite resins to dentin; this negative effect is more exaggerated by type 1 DM than type 2 DM.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, MSB C639A-Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ, 07103, USA. .,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | | | - Devyani Nath
- Biomaterial and Prosthodontic Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Steven M Morgano
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
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15
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Marrero YG, Kobayashi Y, Ihsan MS, Pilch LA, Chen L, Jiang S, Ye Y, Fine DH, Falcon CY, Falcon PA, Hirschberg CS, Shimizu E. Altered Prevalence of Pulp Diagnoses in Diabetes Mellitus Patients: A Retrospective Study. J Endod 2022; 48:208-212.e3. [PMID: 34780805 PMCID: PMC8810723 DOI: 10.1016/j.joen.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/08/2021] [Accepted: 11/02/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) is a complex multisystemic disorder that affects an estimated 21 million Americans. No studies have evaluated the association of DM with the prevalence of each pulpal diagnosis. The objective of this study was to compare the prevalence of each pulp diagnosis including symptomatic irreversible pulpitis (SIP), asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and pulp necrosis (PN) in DM patients against a nondiabetic control group. METHODS A retrospective chart review was approved by Rutgers University Institutional Review Board. The prevalence of the diagnoses SIP, asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and PN was calculated from AxiUm (Exan software, Las Vegas, NV) electronic health records at Rutgers School of Dental Medicine. The chi-square test was used to see the relationship between the 2 categoric variables. Second, binary logistic regression analyses were performed for each group. RESULTS A total of 2979 teeth were diagnosed with a pulp condition between April 2013 and November 2018. The total tooth number of DM patients was 682, whereas the tooth number of nondiabetic patients was 2297. In the subgroup of patients younger than 40 years old, SIP was notably more prevalent in DM patients. In addition, the prevalence of PN in elderly DM patients (60-69 years old) was significantly higher than in the control group. CONCLUSIONS The prevalence of SIP in DM patients was significantly higher compared with the control group (<40 years old), suggesting the possibility that DM could hypersensitize the subgroup of patients younger than 40 years old to pulpitis pain.
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Affiliation(s)
| | | | | | - Lisa A. Pilch
- Office of Information Technology, Rutgers University
| | - Liyaa Chen
- Office of Information Technology, Rutgers University
| | | | - Yi Ye
- Bluestone Center for Clinical Research, New York University College of Dentistry, Department of Oral & Maxillofacial Surgery, New York University College of Dentistry, Department of Molecular Pathobiology, New York University College of Dentistry
| | - Daniel H. Fine
- Department of Oral Biology, Rutgers School of Dental Medicine
| | - Carla Y. Falcon
- Department of Endodontics, Rutgers School of Dental Medicine
| | - Paul A. Falcon
- Department of Endodontics, Rutgers School of Dental Medicine
| | | | - Emi Shimizu
- Department of Endodontics, Rutgers School of Dental Medicine, Department of Oral Biology, Rutgers School of Dental Medicine,Corresponding author Emi Shimizu, Department of Oral Biology, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, , 973-972-8892
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16
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Odonto/Osteogenic Differentiation of Dental Pulp Stem Cells of Type 1 Diabetic Patients with Mineral Trioxide Aggregate/1α,25-Dihydroxyvitamin D3 Combination. J Endod 2022; 48:516-526. [DOI: 10.1016/j.joen.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/20/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022]
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17
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Horsophonphong S, Sritanaudomchai H, Nakornchai S, Kitkumthorn N, Surarit R. Odontogenic gene expression profile of human dental pulp-derived cells under high glucose influence: a microarray analysis. J Appl Oral Sci 2021; 29:e20201074. [PMID: 34586189 PMCID: PMC8477757 DOI: 10.1590/1678-7757-2020-1074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 01/23/2023] Open
Abstract
Hyperglycemia, a major characteristic of diabetes, is considered to play a vital role in diabetic complications. High glucose levels have been found to inhibit the mineralization of dental pulp cells. However, gene expression associated with this phenomenon has not yet been reported. This is important for future dental therapeutic application. OBJECTIVE Our study aimed to investigate the effect of high glucose levels on mineralization of human dental pulp-derived cells (hDPCs) and identify the genes involved. METHODOLOGY hDPCs were cultured in mineralizing medium containing 25 or 5.5 mM D-glucose. On days 1 and 14, RNA was extracted and expression microarray performed. Then, differentially expressed genes (DEGs) were selected for further validation using the reverse transcription quantitative polymerase chain reaction (RT-qPCR) method. Cells were fixed and stained with alizarin red on day 21 to detect the formation of mineralized nodules, which was further quantified by acetic acid extraction. RESULTS Comparisons between high-glucose and low-glucose conditions showed that on day 1, there were 72 significantly up-regulated and 75 down-regulated genes in the high-glucose condition. Moreover, 115 significantly up- and 292 down-regulated genes were identified in the high-glucose condition on day 14. DEGs were enriched in different GO terms and pathways, such as biological and cellular processes, metabolic pathways, cytokine-cytokine receptor interaction and AGE-RAGE signaling pathways. RT-qPCR results confirmed the significant expression of pyruvate dehydrogenase kinase 3 (PDK3), cyclin-dependent kinase 8 (CDK8), activating transcription factor 3 (ATF3), fibulin-7 (Fbln-7), hyaluronan synthase 1 (HAS1), interleukin 4 receptor (IL-4R) and apolipoprotein C1 (ApoC1). CONCLUSIONS The high-glucose condition significantly inhibited the mineralization of hDPCs. DEGs were identified, and interestingly, HAS1 and Fbln-7 genes may be involved in the glucose inhibitory effect on hDPC mineralization.
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Affiliation(s)
- Sivaporn Horsophonphong
- Mahidol University, Faculty of Dentistry, Department of Oral Biology, Thailand
- Mahidol University, Faculty of Dentistry, Department of Pediatric Dentistry, Thailand
| | | | - Siriruk Nakornchai
- Mahidol University, Faculty of Dentistry, Department of Pediatric Dentistry, Thailand
| | - Nakarin Kitkumthorn
- Mahidol University, Faculty of Dentistry, Department of Oral Biology, Thailand
| | - Rudee Surarit
- Mahidol University, Faculty of Dentistry, Department of Oral Biology, Thailand
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18
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Pulpal outcomes in orthodontic tooth movement in diabetes mellitus. Odontology 2021; 109:921-929. [PMID: 33914191 DOI: 10.1007/s10266-021-00609-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
Diabetes mellitus impairs angiogenesis and tissue reorganization during orthodontic tooth movement (OTM). Thus, this study evaluated pulpal outcomes in orthodontic tooth movement through metabolic changes in diabetes. Male Wistar rats were used, and the in vivo study design consisted of four groups (n = 10/group): C-non-diabetic animals not subjected to orthodontic tooth movement; D-diabetic animals not subjected to orthodontic tooth movement; OTM-non-diabetic animals subjected to orthodontic tooth movement; and D + OTM-diabetic animals subjected to orthodontic tooth movement. In addition, the pulps of the distovestibular root (DV) and mesiovestibular root (MV) were assessed by histomorphometric analyses and immunoexpression of the RANKL/OPG system. Pulpal analysis of the MV root showed an increase in blood vessels in diabetic animals. Inflammatory infiltrate and fibroblastic cells were elevated in diabetic animals with tooth movement in the DV and MV roots. In the DV and MV roots, diabetic rats with OTM showed a reduction in birefringent collagen fibers. The immunostaining for RANKL was higher in the pulp tissue of OTM in diabetic and non-diabetic animals. It was concluded that the pulp tissue has less adaptive and repair capacity during OTM in diabetes. Orthodontic strength can alter the inflammatory processes in the pulp.
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20
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Saghiri MA, Nath D, Rahmani B, Amini S, Karamifar K, Peters OA. The effect of diabetes on Fracture Resistance of Teeth: An in vitro study. AUST ENDOD J 2021; 47:499-505. [PMID: 33813800 DOI: 10.1111/aej.12512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
The root fracture resistance (RFR) of premolars extracted from diabetic patients and the effect of biomaterials: white mineral trioxide aggregate (WMTA) and WMTA+Na2 HPO4 as an additive, on enhancing RFR were evaluated. Diabetic and non-diabetic teeth were divided into 4 subgroups (n = 5): root canals were obturated with WMTA, WMTA+Na2 HPO4 , gutta-percha and one unfilled (control). A plunger (1 mm diameter) applied a downward compressive load with crosshead speed of 1 mm min-1 on the specimens mounted on resin blocks, and the ultimate force to fracture was measured. The mean RFR values of diabetic specimens were significantly lower. The lowest and highest means of RFR were recorded in the control and WMTA, in normal group and the control and WMTA+Na2 HPO4 in the diabetic group, respectively. The RFR in diabetic patients was significantly lower, indicating their higher susceptibility to fracture under vertical forces. The use of WMTA (with or without Na2 HPO4 ) for obturation enhances the RFR.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA.,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Devyani Nath
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, NJ, USA
| | - Behnam Rahmani
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Saied Amini
- Statistics Department, George Washington University, Washington, DC, USA
| | - Kasra Karamifar
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Ove A Peters
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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21
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Effect of Diabetes on Rotary Instrumentation of Dentin. J Endod 2021; 47:1301-1307. [DOI: 10.1016/j.joen.2021.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
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22
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Diabetes Mellitus and Periapical Abscess: A Cross-sectional Study. J Endod 2020; 46:1605-1609. [DOI: 10.1016/j.joen.2020.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/23/2020] [Accepted: 08/13/2020] [Indexed: 12/29/2022]
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Song W, Sun W, Chen L, Yuan Z. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Front Bioeng Biotechnol 2020; 8:580954. [PMID: 33195142 PMCID: PMC7658386 DOI: 10.3389/fbioe.2020.580954] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Endodontic therapy aims to preserve or repair the activity and function of pulp and periapical tissues. Due to their excellent biological features, a substantial number of calcium silicate-based bioceramics have been introduced into endodontics and simultaneously increased the success rate of endodontic treatment. The present manuscript describes the in vivo biocompatibility and bioactivity of four types of calcium silicate-based bioceramics in endodontics.
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Affiliation(s)
- Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Wei Sun
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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24
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Pérez-Losada FDL, López-López J, Martín-González J, Jané-Salas E, Segura-Egea JJ, Estrugo-Devesa A. Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study. J Clin Exp Dent 2020; 12:e964-e971. [PMID: 33154799 PMCID: PMC7600214 DOI: 10.4317/jced.57191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. MATERIAL AND METHODS In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. RESULTS The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 - 3.09; p = 0.31). CONCLUSIONS The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Key words:Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.
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Affiliation(s)
- Flor de Liz Pérez-Losada
- DDS, Doctoral fellow, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona. L'Hospitalet de Llobregat, Barcelona, Spain
| | - José López-López
- MD, DDS, PhD, Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona- Dental Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jenifer Martín-González
- DDS, PhD, Associate Professor, Division of Endodontics, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Enric Jané-Salas
- MD, DDS, PhD, Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona- Dental Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan J Segura-Egea
- MD, DDS, PhD, Professor, Division of Endodontics, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Albert Estrugo-Devesa
- MD, DDS, PhD, Associate Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona- Dental Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Saghiri MA, Karamifar K, Fakharzadeh A, Conte M, Morgano SM. Effect of Diabetes on Tubular Density and Push-out Bond Strength of Mineral Trioxide Aggregate to Dentin. J Endod 2020; 46:1584-1591. [PMID: 32738338 DOI: 10.1016/j.joen.2020.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This study compared the tubular density and push-out bond strength of mineral trioxide aggregate (MTA) to dentin in diabetic and nondiabetic patients. METHODS Ten extracted single-rooted human teeth from diabetic and nondiabetic patients (n = 5 in each group) were decoronated, prepared up to a #5 Gates-Glidden drill, and sectioned horizontally at the midroot area to prepare 3 dentin slices, each measuring 2 mm in thickness (1 slice for the push-out test and 2 slices for the tubular density test). MTA was prepared and packed into the root canal space followed by incubation for 3 days. The push-out bond strength values were determined using a universal testing machine. Specimens were viewed under a stereomicroscope and a scanning electron microscope to determine the failure types at the cement-dentin interface. Ten slice specimens in each group were evaluated under SEM at 3 different sites to determine the tubular density. Comparisons were performed using the Mann-Whitney U test (P < .05). RESULTS Diabetic patients exhibited significantly lower push-out bond strength of MTA to root canal dentin (P < .05). The pattern of failure at the MTA-dentin interface was different between the 2 groups. The tubular density was significantly higher in diabetic patients (P < .05). CONCLUSIONS The dentin in diabetic patients exhibited different physicochemical properties. The failure patterns and modes in diabetic patients might be explained by the changes in the push-out bond strength, the calcification mechanism of the dentin-pulp complex, a higher dentinal tubule density, and less peritubular dentin. These differences could explain the higher failure rate of root canal treatment in these patients.
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Affiliation(s)
- Mohammad Ali Saghiri
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey; Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California.
| | - Kasra Karamifar
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster, Hackensack, New Jersey
| | - Amir Fakharzadeh
- Office for Clinical Affairs, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Michael Conte
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Steven M Morgano
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey
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Horsophonphong S, Kitkumthorn N, Sritanaudomchai H, Nakornchai S, Surarit R. High Glucose Affects Proliferation, Reactive Oxygen Species and Mineralization of Human Dental Pulp Cells. Braz Dent J 2020; 31:298-303. [PMID: 32667524 DOI: 10.1590/0103-6440202003120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/05/2020] [Indexed: 12/17/2022] Open
Abstract
Diabetes is a group of metabolic disorders that can lead to damage and dysfunction of many organs including the dental pulp. Increased inflammatory response, reduction of dentin formation and impaired healing were reported in diabetic dental pulp. Hyperglycemia, which is a main characteristic of diabetes, was suggested to play a role in many diabetic complications. Therefore our aim was to investigate the effects of high glucose levels on proliferation, reactive oxygen species (ROS) production and odontogenic differentiation of human dental pulp cells (HDPCs). HDPCs were cultured under low glucose (5.5mM Glucose), high glucose (25 mM Glucose) and mannitol (iso-osmolar control) conditions. Cell proliferation was analyzed by MTT assay for 11 days. Glutathione and DCFH-DA assay were used to assess ROS and antioxidant levels after 24 h of glucose exposure. Odontogenic differentiation was evaluated and quantified by alizarin red staining on day 21. Expression of mineralization-associated genes, which were alkaline phosphatase, dentin sialophosphoprotein and osteonectin, was determined by RT-qPCR on day 14. The results showed that high glucose concentration decreased proliferation of HDPCs. Odontogenic differentiation, both by gene expression and mineral matrix deposit, was inhibited by high glucose condition. In addition, high DCF levels and low reduced glutathione levels were observed in high glucose condition. However, no differences were observed between mannitol and low glucose conditions. In conclusion, the results clearly showed the negative effect of high glucose condition on HDPCs proliferation and differentiation. Moreover, it also induced ROS production of HDPCs.
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Affiliation(s)
| | - Nakarin Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Siriruk Nakornchai
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Rudee Surarit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Sarmento EB, Gomes CC, Pires FR, Pinto LC, Antunes LAA, Armada L. Immunoexpression of bone resorption biomarkers in apical periodontitis in diabetics and normoglycaemics. Int Endod J 2020; 53:1025-1032. [DOI: 10.1111/iej.13305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Affiliation(s)
- E. B. Sarmento
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - C. C. Gomes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - F. R. Pires
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
| | - L. C. Pinto
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. A. A. Antunes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. Armada
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
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Root Canal Treatment and Apical Periodontitis in a Brazilian Population with Type 1 Diabetes Mellitus: A Cross-sectional Paired Study. J Endod 2020; 46:756-762. [PMID: 32299700 DOI: 10.1016/j.joen.2020.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/15/2020] [Accepted: 02/23/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study radiographically analyzed the prevalence of root canal treatment (RCT) and apical periodontitis (AP) in type 1 diabetes mellitus (T1DM) and nondiabetic individuals and its association with the history/current status of T1DM. METHODS In a cross-sectional paired study, the radiographic records of 50 individuals with T1DM and 100 age- and sex-matched nondiabetic subjects were examined. The presence of RCT and AP was evaluated. Information regarding the history and current status of T1DM was collected from the medical records of each patient. RESULTS One or more RCTs were found in 76% and 44% of diabetic and nondiabetic subjects, respectively (P = .000). AP in 1 or more teeth was found in most T1DM patients (58%) and in 15% of the control subjects (P = .000). One or more RCTs associated with AP were found in 52% and 8% of T1DM and nondiabetic subjects, respectively (P = .000). Bivariate logistic regression analyses suggested that RCT (odds ratio [OR] = 10.435, P = .000), AP (OR = 3.508, P = .011), and RCT + AP (OR = 7.220, P = .000) were significantly associated with the presence of T1DM. Multivariate logistic regression showed that among T1DM individuals, there is an association between 11-15 years of diagnosis time and at least 1 RCT (OR = 46.316, P = .038) and an association between T1DM control and at least 1 tooth with AP (OR = 15.611, P = .016). CONCLUSIONS RCT, AP, and RCT with AP were more prevalent in individuals with T1DM than in nondiabetic individuals. RCT and AP were associated with the presence of T1DM, specifically RCT with diagnostic time and AP with glycemic control.
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Tavakolinejad Kermani M, Sanjari M, Nakhaei N, Parirokh M, Abbott P. Comparison of Pulp Sensibility Tests Responses in Type 2 Diabetes Patients and Healthy Individuals. J Endod 2020; 46:364-369. [DOI: 10.1016/j.joen.2019.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/18/2019] [Accepted: 11/29/2019] [Indexed: 02/08/2023]
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Tohma A, Ohkura N, Yoshiba K, Takeuchi R, Yoshiba N, Edanami N, Shirakashi M, Ibn Belal RS, Ohshima H, Noiri Y. Glucose Transporter 2 and 4 Are Involved in Glucose Supply during Pulpal Wound Healing after Pulpotomy with Mineral Trioxide Aggregate in Rat Molars. J Endod 2020; 46:81-88. [DOI: 10.1016/j.joen.2019.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/05/2019] [Accepted: 10/02/2019] [Indexed: 12/20/2022]
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Almeida LHS, Pilownic KJ, Tarquínio SBC, Felix AC, Pappen FG, Romano AR. Influence of Pregnancy on the Inflammatory Process Following Direct Pulp Capping: a Preliminary Study in Rats. Braz Dent J 2019; 30:22-30. [PMID: 30864642 DOI: 10.1590/0103-6440201902093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/02/2018] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to evaluate the inflammatory process following direct pulp capping during pregnancy. This experimental study involved 48 maxillary first molars of female Wistar rats. The procedures were performed in pregnant and non-pregnant animals (n =20 each). Direct pulp capping with mineral trioxide aggregate (MTA) and restoration with a light-cured resin composite was performed in half of exposed pulp specimens. In the other half of specimens, light-cured composite was placed directly on the exposed pulp. In the control groups (n=4 each), no intervention was performed. Animals were euthanized at 3 and 7 days. All sections (three per slide) were viewed under an optical microscope. One previously calibrated pathologist performed descriptive analysis and assigned scores for inflammatory response and tissue organization adjacent to the pulp exposure. The Kappa value for intra-examiner variability was 0.91. At 3 days, in animals treated with MTA, inflammatory infiltrate was absent in non-pregnant animals while mild inflammatory infiltrate was observed in some pregnant animals. The inflammatory response ranged from mild to severe in both groups treated with composite alone. At 7 days, the inflammatory response was more intense in pregnant than in non-pregnant animals treated with MTA; while this difference were not evident in animals treated with composite alone. In conclusion, pregnancy may not influence the inflammatory process following direct pulp capping with light-cured resin composite, which was always harmful to the pulp; while the tissue response after the direct pulp with MTA were more favorable in non-pregnant animals.
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Affiliation(s)
| | | | | | - Anelize Campello Felix
- Central Vivarium, Faculty of Veterinary, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Ana Regina Romano
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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de Azevedo Queiroz ÍO, Gonçalves LO, Takamiya AS, Rezende GC, Machado T, Siveiri-Araujo G, Ervolino E, Oliveira SHP, Gomes-Filho JE. Hyperglycemic condition influence on mineral trioxide aggregate biocompatibility and biomineralization. J Biomed Mater Res B Appl Biomater 2019; 108:663-673. [PMID: 31106523 DOI: 10.1002/jbm.b.34420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/08/2019] [Accepted: 05/05/2019] [Indexed: 01/22/2023]
Abstract
This study aimed to investigate in vitro and in vivo the influence of hyperglycemic condition on biocompatibility and biomineralization of gray mineral trioxide aggregate (GMTA) and white mineral trioxide aggregate (WMTA). For the in vitro study, fibroblast-like cells L929 were cultured under high or normal glucose concentration to investigate the effects of both MTA's on cell proliferation and inflammatory cytokines production IL-1β, IL-6, and TNF-α. For the in vivo study, polyethylene tubes containing MTA materials and empty tubes were implanted into dorsal connective tissues of Wistar rats previously assigned normal and hyperglycemic. After 7 and 30 days, the tubes with surrounding tissues were removed and subjected to histological, fluorescence and immunohistochemical analyzes of IL-1β, IL-6, and TNF-α. In vitro study showed that, under high glucose condition, GMTA reduced cell proliferation and IL-6 production compared with WMTA. Moreover, in vivo study revealed that hyperglycemic condition did not modify the inflammatory response and cytokines production in the tissue close to both materials. Independently of hyperglycemic status, mineralized areas were observed with both materials, but the fluorescence intensity of WMTA was diminished on 14 days in hyperglycemic animals. It is possible to conclude that GMTA was able to inhibit the proliferation rate and IL-6 production under high glucose concentration in vitro. Furthermore, cytokines production and inflammatory response were not upregulated in hyperglycemic animals; however, a decrease in the calcium deposition was observed in presence of WMTA, suggesting a delay in the mineralization process.
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Affiliation(s)
| | - Luanna O Gonçalves
- Department of Endodontics, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | - Aline S Takamiya
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | - Gabriely C Rezende
- Department of Endodontics, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | - Thiago Machado
- Department of Oral and Maxillofacial Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | | | - Edilson Ervolino
- Department of Basic Science, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | - Sandra H P Oliveira
- Department of Basic Science, Araçatuba Dental School, UNESP, Araçatuba, Brazil
| | - João E Gomes-Filho
- Department of Endodontics, Araçatuba Dental School, UNESP, Araçatuba, Brazil
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Sisli SN. Evaluation of the Relationship between Type II Diabetes Mellitus and the Prevalence of Apical Periodontitis in Root-Filled Teeth Using Cone Beam Computed Tomography: An Observational Cross-Sectional Study. Med Princ Pract 2019; 28:533-538. [PMID: 30999319 PMCID: PMC6944896 DOI: 10.1159/000500472] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/18/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence of apical periodontitis (AP) in patients with type II diabetes mellitus (DM) with either optimal glycemic control (OGC) or poor glycemic control (PGC) compared with nondiabetics using cone beam computed tomography (CBCT). SUBJECTS AND METHODS The periapical status of 75 teeth with adequate root canal treatment performed at least 1 year ago that could be visualized in the field of view of CBCT images of 43 DM patients (29 females, 14 males) was compared with a control group consisting of 162 teeth of 86 nondiabetics (56 females, 30 males). In addition, the DM group was divided into subgroups according to the patients' mean glycated hemoglobin level as either having OGC or PGC. The periapical status of the teeth was evaluated using the CBCT periapical index (CBCTPAI), and AP was diagnosed as a CBCTPAI ≥1. χ2, Fisher's exact test, and independent-samples t tests were used for the statistical analysis, and p < 0.05 was considered significant. RESULTS Significant differences between the DM group and the control group were observed (p< 0.05) in terms of AP (the frequencies of both CBCTPAI ≥1 and CBCTPAI ≥3) and the frequency of cardiovascular disease, while there were no significant differences between the DM subgroups (p > 0.05). CONCLUSION The prevalence of AP and severe bone destruction in periapical tissues was significantly higher in the DM patients compared with the nondiabetic patients.
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Affiliation(s)
- Selen Nihal Sisli
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey,
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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Cintra LTA, Estrela C, Azuma MM, Queiroz ÍODA, Kawai T, Gomes-Filho JE. Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials. Braz Oral Res 2018; 32:e68. [DOI: 10.1590/1807-3107bor-2018.vol32.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
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Cabanillas‐Balsera D, Martín‐González J, Montero‐Miralles P, Sánchez‐Domínguez B, Jiménez‐Sánchez MC, Segura‐Egea JJ. Association between diabetes and nonretention of root filled teeth: a systematic review and meta‐analysis. Int Endod J 2018; 52:297-306. [DOI: 10.1111/iej.13011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- D. Cabanillas‐Balsera
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - J. Martín‐González
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - P. Montero‐Miralles
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - B. Sánchez‐Domínguez
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - M. C. Jiménez‐Sánchez
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - J. J. Segura‐Egea
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
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Milosavljević A, DJukić L, Toljić B, Milašin J, DŽeletović B, Brković B, Roganović J. Melatonin levels in human diabetic dental pulp tissue and its effects on dental pulp cells under hyperglycaemic conditions. Int Endod J 2018; 51:1149-1158. [PMID: 29617040 DOI: 10.1111/iej.12934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/31/2018] [Indexed: 01/07/2023]
Abstract
AIM To investigate melatonin (MEL) levels in human dental pulp tissue (hDP) in type 2 diabetic (T2D) participants and the underlying molecular mechanisms of its effects in human dental pulp cells (hDPCs) under hyperglycaemia. METHODOLOGY The study included 16 healthy and 16 T2D participants who underwent vital pulp extirpation for hDP and four healthy participants undergoing third molar extraction for hDPCs analyses. MTT and NRU were used as tests for cytotoxicity. The pulp tissue levels of MEL, inducible NO synthase (iNOS) and superoxide dismutase (SOD) activity, as well as iNOS, histone acetyltransferase p300 (p300) and SOD activity levels in hDPCs incubated with MEL (0.1 and 1.0 mmol L-1 ) under normoglycaemia and hyperglycaemia were measured by enzyme-linked immunosorbent assay. Comparisons between the two groups were made by unpaired t-tests or Mann-Whitney test whilst the chi-square test was used for dichotomous variables. To compare more groups, the Kruskal-Wallis test with Dunn's multiple comparison was used, whilst Spearman correlation was used to assess association between two variables. RESULTS Melatonin was decreased (124.30 ± 21.6 vs. 240.0 ± 19.1 pg mL-1 , P < 0.01), whilst iNOS levels increased (0.92 ± 0.08 vs. 0.32 ± 0.09 ng mL-1 , P < 0.01) in hDP from T2D compared to nondiabetic participants. In hDPCs, MEL (0.1 and 1.0 mmol L-1 ) had no cytotoxicity. Incubation with 1.0 mmol L-1 of MEL (24 h) decreased hyperglycaemia-induced increases of iNOS (0.34 ± 0.01 ng mL-1 vs. 0.40 ± 0.01 ng mL-1 , P < 0.01) and p300 (11.59 ± 0.58 ng mL-1 vs. 16.12 ± 0.39 ng mL-1 , P < 0.01), and also, increased SOD activity (87.11 ± 3.10% vs. 68.56 ± 3.77%, P < 0.01) to the levels comparable to the normoglycaemic; iNOS and p300 protein expression levels showed strong positive correlation under hyperglycaemia (Spearman r = 0.8242, P < 0.001). CONCLUSION Type 2 diabetic participants had decreased MEL in hDP. At pharmacological concentrations, MEL is not cytotoxic for hDPCs and normalizes iNOS and SOD activity levels in hyperglyceamic hDPCs suggesting its antioxidant and protective effects in human dental pulp tissue under hyperglycaemia.
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Affiliation(s)
- A Milosavljević
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Lj DJukić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - B Toljić
- Department of Physiology and Biochemistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Milašin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - B DŽeletović
- Department of Restorative Odontology and Endodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - B Brković
- Department of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Abstract
Summary
Diabetes mellitus is one of the most common chronic diseases which continue to increase in number and significance. It presents the third most prevalent condition among medically compromised patients referring for dental treatment. Diabetes mellitus has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Hyperglycemia leads to widespread multisystem damage which has an effect on oral tissue. The present article summarizes current knowledge regarding the association between diabetes mellitus and oral and dental health.
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Holland R, Gomes JE, Cintra LTA, Queiroz ÍODA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017; 25:465-476. [PMID: 29069143 PMCID: PMC5804382 DOI: 10.1590/1678-7757-2016-0464] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/11/2017] [Indexed: 12/20/2022] Open
Abstract
Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.
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Affiliation(s)
- Roberto Holland
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - João Eduardo Gomes
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Índia Olinta de Azevedo Queiroz
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil
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Azuma MM, Gomes-Filho JE, Prieto AKC, Samuel RO, de Lima VMF, Sumida DH, Ervolino E, Cintra LTA. Diabetes increases interleukin-17 levels in periapical, hepatic, and renal tissues in rats. Arch Oral Biol 2017; 83:230-235. [DOI: 10.1016/j.archoralbio.2017.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 12/11/2022]
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Ferreira LL, Gomes-Filho JE, Benetti F, Carminatti M, Ervolino E, Briso ALF, Cintra LTA. The effect of dental bleaching on pulpal tissue response in a diabetic animal model: a study of immunoregulatory cytokines. Int Endod J 2017; 51:347-356. [PMID: 28857196 DOI: 10.1111/iej.12852] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 08/25/2017] [Indexed: 12/20/2022]
Abstract
AIM To evaluate the influence of tooth bleaching on immunoregulatory cytokines production (IL-6, Tumour necrosis factor (TNF)-α and IL-17) in the pulp tissue of normoglycaemic and diabetic rats. METHODOLOGY Twenty-eight rats were divided into normoglycaemic and diabetic rats (n = 14). Diabetes mellitus (DM) was induced with a single dose of alloxan diluted in citrate buffer via intramuscular injection. After DM confirmation, all rats were sedated and tooth bleaching was performed using 35% hydrogen peroxide on the right maxillary molars for 30 min. Left molars were used as controls. Bleaching resulted in four hemimaxillae groups: normoglycaemic (N), N-bleached (NBle), diabetic (D) and D-bleached (DBle). After 2 and 30 days, rats were euthanized and hemimaxillae processed for analysis by haematoxylin and eosin and immunohistochemistry. Results within and between animals were submitted to Wilcoxon signed-rank and Mann-Whitney tests (P < 0.05). RESULTS At 2 days, the NBle group had mild, and the DBle had severe inflammatory infiltration in the pulpal tissue (P < 0.05). TNF-α and IL-6 cytokines were associated with increased immunolabelling in the bleached groups compared to nonbleached (P < 0.05). However, IL-17 had increased immunolabelling in the NBle compared to the N and DBle group (P < 0.05). At 30 days, reactionary dentine was observed in the coronal pulp of all bleached teeth and no inflammation was present (P > 0.05). TNF-α cytokines had increased immunolabelling in the DBle group compared to the D group (P < 0.05). However, for IL-6 and IL-17, no difference was observed in this period (P > 0.05). CONCLUSIONS Tooth bleaching increased IL-6 and TNF-α in the pulp tissue regardless of diabetes mellitus; however, diabetic rats had higher TNF-α levels for longer periods. Tooth bleaching influenced the increase in IL-17 in the early periods in normoglycaemic rats.
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Affiliation(s)
- L L Ferreira
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J E Gomes-Filho
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - F Benetti
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - M Carminatti
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - L T A Cintra
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
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Yan L, Sun S, Qu L. Insulin-like growth factor-1 promotes the proliferation and odontoblastic differentiation of human dental pulp cells under high glucose conditions. Int J Mol Med 2017; 40:1253-1260. [PMID: 28902344 DOI: 10.3892/ijmm.2017.3117] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 08/07/2017] [Indexed: 12/24/2022] Open
Abstract
Insulin-like growth factor-1 (IGF-1) promotes human dental pulp stem cell proliferation and osteogenic differentiation. However, the effects of IGF-1 on the proliferation, apoptosis and odontoblastic differentiation (mineralization) of dental pulp cells (DPCs) under high glucose (GLU) conditions remain unclear. In this study, isolated primary human DPCs were treated with various concentrations of high GLU. Cell proliferation and apoptosis were determined by Cell Counting Kit-8 and Annexin V-FITC/PI assays, respectively. The cells were cultured in odontoblastic induction medium containing various concentrations of high GLU. Odontoblastic differentiation was determined by alkaline phosphatase (ALP) activity assay. Mineralization formation was evaluated by von Kossa staining. The expression levels of IGF family members were measured by western blot analysis and RT-qPCR during proliferation and differentiation. The cells were then exposed to 25 mM GLU and various concentrations of IGF-1. Cell proliferation, apoptosis, ALP activity, mineralization formation and the levels of mineralization-related proteins were then evaluated. Our results revealed that high GLU significantly inhibited cell proliferation and promoted cell apoptosis. GLU (25 and 50 mM) markedly reduced ALP activity and mineralization on days 7 and 14 after differentiation. The levels of IGF family members were markedly decreased by high GLU during proliferation and differentiation. However, IGF-1 significantly reversed the effects of high GLU on cell proliferation and apoptosis. Additionally, IGF-1 markedly restored the reduction of ALP activity and mineralization induced by high GLU. Our findings thus indicate that IGF-1 attenuates the high GLU-induced inhibition of DPC proliferation, differentiation and mineralization.
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Affiliation(s)
- Lu Yan
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
| | - Shangmin Sun
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
| | - Liu Qu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, Liaoning 110002, P.R. China
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Al-Zahrani MS, Abozor BM, Zawawi KH. The relationship between periapical lesions and the serum levels of glycosylated hemoglobin and C-reactive protein in type 2 diabetic patients. Saudi Med J 2017; 38:36-40. [PMID: 28042628 PMCID: PMC5278063 DOI: 10.15537/smj.2017.1.16052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objectives: To investigate the relationship between the presence of periapical lesions (PL) and levels of glycosylated hemoglobin (HbA1c), and C-reactive protein (CRP) in patients with type 2 diabetes. Methods: This cross-sectional study was conducted at Ibn Sina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia, between September 2013 and February 2015. Medical and dental history and Sociodemographic data were obtained from participants. Dental and periodontal examinations were conducted and blood samples were obtained to determine levels of HbA1c and CRP. The presence of PL was recorded from panoramic and periapical radiographs. Descriptive statistics and multivariable linear and logistic regression models were used for data analyses. Results: One hundred patients were included; mean age was 48.9 ± 8.5 years. Of these patients, 14% had no PL, whereas 25% had one or 2 lesions, 32% had 3 or 4 lesions, and 29% had ≥5 PL. The mean HbA1c was 9.8% (± 2.5) mg/L and CRP was 6.9 mg/L (± 6.3). The presence of PL was significantly associated with a higher level of HbA1c independent of age, gender, probing depth, and plaque index (p=0.023). Individuals with PL were also more likely to have a high CRP level (>3 mg/L) independent of the previous covariates (odds ratio: 1.19; 95% confidence interval: 1.01-1.41). Conclusion: Periapical lesions are associated with a poorer glycemic control and a higher CRP level in type 2 diabetic patients.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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Cintra LTA, Ferreira LL, Benetti F, Gastélum AA, Gomes-Filho JE, Ervolino E, Briso ALF. The effect of dental bleaching on pulpal tissue response in a diabetic animal model. Int Endod J 2016; 50:790-798. [PMID: 27614116 DOI: 10.1111/iej.12692] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 09/07/2016] [Indexed: 02/06/2023]
Abstract
AIM To evaluate pulpal tissue response after dental bleaching in normal and alloxan-induced diabetic rats. METHODOLOGY Twenty-eight rats were divided into two groups of normoglycaemic and diabetic rats (n = 14). Diabetes mellitus (DM) was induced with alloxan. After DM confirmation, all rats were anaesthetized and dental bleaching was performed with 35% hydrogen peroxide (H2 O2 ) on the right maxillary molars for 30 min. Left molars were used as controls. Bleaching resulted in four hemimaxillae groups: normoglycaemic (N), N-bleached (NBle), diabetic (D) and D-bleached (DBle). After 2 or 30 days, the animals were euthanized and the hemimaxillae were removed, processed for histopathological analysis and stained with haematoxylin-eosin (HE), Masson's trichrome (MT) and picrosirius red (PSR). Results obtained within animals (normoglycaemic or diabetic rats) were submitted to Wilcoxon or paired t-tests, and between animal (normoglycaemic and diabetic rats), to Mann-Whitney test or t-tests. RESULTS At 2 days, the NBle group had a mild inflammatory infiltration in the pulpal tissue, whilst the DBle had severe inflammation or necrosis (P < 0.05). At 30 days, no inflammation was present. However, a significant difference in pulp chamber area reduction by reactionary dentine deposition was found between the NBle and DBle groups (P < 0.05). At 2 days, fewer immature collagen fibres and more mature collagen fibres were noted in the NBle, D and DBle groups; this was significantly different when compared to the N group (P < 0.05). At 30 days, significantly fewer immature collagen fibres and more mature collagen fibres were noted in NBle compared with DBle group (P < 0.05). CONCLUSIONS The inflammatory tissue response in rats' teeth after dental bleaching was greater in diabetic rats. Additionally, the increase in reactionary dentine deposition and mature collagen fibres observed in diabetic rats needs further evaluation to confirm the present results.
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Affiliation(s)
- L T A Cintra
- Departments of Endodontics, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - L L Ferreira
- Departments of Endodontics, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - F Benetti
- Departments of Endodontics, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - A A Gastélum
- Centro de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, JAL, México
| | - J E Gomes-Filho
- Departments of Endodontics, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, Araçatuba Dental School, Unesp - Univ Estadual Paulista, Araçatuba, SP, Brazil
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Segura-Egea JJ, Martín-González J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, López-López J. Association between diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Investig 2016; 20:1133-41. [DOI: 10.1007/s00784-016-1805-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/16/2016] [Indexed: 11/29/2022]
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Brasil SC, Santos RMM, Fernandes A, Alves FRF, Pires FR, Siqueira JF, Armada L. Influence of oestrogen deficiency on the development of apical periodontitis. Int Endod J 2016; 50:161-166. [PMID: 26821330 DOI: 10.1111/iej.12612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/22/2016] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effects of a long period of oestrogen deficiency on the development of apical periodontitis in rats. METHODOLOGY Wistar rats (n = 24), 3 months old, evaluated by vaginal cytology, were included in the study. Twelve animals were ovariectomized (OVX group) and the other 12 were sham operated (control group). One hundred and twenty days after castration, the pulps of the left mandibular first molars were exposed to induce the development of apical periodontitis. Body mass was verified on a weekly basis. Following 21 and 40 days of lesion induction, the animals were sacrificed. Blood was collected for biochemical analysis, and mandibles were removed for radiographic analysis. Comparative analysis of the data was performed by the nonparametric Kruskal-Wallis and Dunn's multiple-comparisons tests. The t-test was applied to compare the oestrogen levels between control and OVX groups. RESULTS Radiographs revealed that apical periodontitis lesions were significantly larger in the 40-day OVX group when compared with both 40-day (P < 0.05) and 21-day (P < 0.001) control groups. Serum oestrogen levels were significantly lower in the OVX group (P < 0.01), confirming the efficacy of castration. Oestrogen deficiency resulted in significantly greater body mass gain (P < 0.01) in 40-day OVX group when compared with 40-day control group. Serum concentrations of calcium were similar between groups (P > 0.05). Alkaline phosphatase levels, although higher in the OVX groups (21 and 40 days), were not significantly different. CONCLUSIONS Ovariectomized rats had significantly larger apical periodontitis lesions after 40 days of pulp exposure when compared with controls. These findings suggest that bone alterations as a result of long periods of oestrogen deficiency can influence the progression of apical periodontitis.
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Affiliation(s)
- S C Brasil
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - R M M Santos
- Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - A Fernandes
- Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Niterói, Brazil
| | - F R F Alves
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - F R Pires
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - J F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - L Armada
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
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GOMES FILHO JE, QUEIROZ ÍODA, WATANABE S, CINTRA LTA, ERVOLINO E. Influence of diabetes mellitus on the mineralization ability of two endodontic materials. Braz Oral Res 2016; 30:S1806-83242016000100218. [DOI: 10.1590/1807-3107bor-2016.vol30.0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/01/2015] [Indexed: 01/06/2023] Open
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Sasaki H, Hirai K, Martins CM, Furusho H, Battaglino R, Hashimoto K. Interrelationship Between Periapical Lesion and Systemic Metabolic Disorders. Curr Pharm Des 2016; 22:2204-15. [PMID: 26881444 PMCID: PMC4856634 DOI: 10.2174/1381612822666160216145107] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/15/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Periapical periodontitis, also known as periapical lesion, is a common dental disease, along with periodontitis (gum disease). Periapical periodontitis is a chronic inflammatory disease, caused by endodontic infection, and its development is regulated by the host immune/inflammatory response. Metabolic disorders, which are largely dependent on life style such as eating habits, have been interpreted as a "metabolically-triggered" low-grade systemic inflammation and may interact with periapical periodontitis by triggering immune modulation. The host immune system is therefore considered the common fundamental mechanism of both disease conditions. METHOD We have reviewed >200 articles to discuss the interrelationship between periapical lesions and metabolic disorders including type 2 diabetes mellitus, hypertension, and non-alcoholic fatty liver diseases (NAFLD), and their common pathological background in immunology/osteoimmunology and cytokine biology. RESULTS An elevated inflammatory state caused by metabolic disorders can impact the clinical outcome of periapical lesions and interfere with wound healing after endodontic treatment. Although additional well-designed clinical studies are needed, periapical lesions appear to affect insulin sensitivity and exacerbate non-alcoholic steatohepatitis. CONCLUSION Immune regulatory cytokines produced by various cell types, including immune cells and adipose tissue, play an important role in this interrelationship.
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Affiliation(s)
- Hajime Sasaki
- Department of Immunology & Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02494, U.S.A.
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Uncoupling of Vascular Endothelial Growth Factor (VEGF) and Inducible Nitric Oxide Synthase (iNOS) in Gingival Tissue of Type 2 Diabetic Patients. Inflammation 2015; 39:632-42. [DOI: 10.1007/s10753-015-0288-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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50
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Claudino M, Nunes IS, Gennaro G, Cestari TM, Spadella CT, Garlet GP, de Assis GF. Diabetes triggers the loss of tooth structure associated to radiographical and histological dental changes and its evolution to progressive pulp and periapical lesions in rats. Arch Oral Biol 2015; 60:1690-8. [DOI: 10.1016/j.archoralbio.2015.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 08/20/2015] [Accepted: 08/31/2015] [Indexed: 11/28/2022]
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