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Matos-Sousa JM, Chemelo VS, Frazão DR, Bittencourt LO, de Moura JDM, Mesquita CM, Marañón-Vásquez G, Fagundes NCF, Paranhos LR, Maia LC, Monteiro MC, Lima RR. Is there any association between the presence of biomarkers and apical periodontitis? A systematic review. Front Immunol 2024; 15:1366954. [PMID: 38840914 PMCID: PMC11150667 DOI: 10.3389/fimmu.2024.1366954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/15/2024] [Indexed: 06/07/2024] Open
Abstract
This systematic review aimed to verify whether there is evidence of an association between apical periodontitis and the presence of systemic biomarkers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. For this, the acronym PECO was used; population (P) of adult humans exposed (E) to the presence of apical periodontitis, compared (C) to adult humans without apical periodontitis, and the outcome (O) of the presence of biomarkers was observed. The articles were searched in PubMed, Scopus, Web of Science, LILACS, Cochrane Library, OpenGray, and Google Scholar grey databases. Subsequently, studies were excluded based on title, abstract, and full article reading, following the eligibility criteria. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa qualifier. After exclusion, 656 studies were identified, resulting in 17 final articles that were divided into case-control, cross-sectional, and cohort studies. Eight studies were considered to have a low risk of bias, one had a medium risk of bias, and eight had a high risk of bias. In addition, 12 articles evaluated biomarkers in blood plasma, four evaluated them in saliva, and only one evaluated them in gingival crevicular fluid. The results of these studies indicated an association between apical periodontitis and the systemic presence of biomarkers. These markers are mainly related to inflammation, such as interleukins IL-1, IL-2, and IL-6, oxidative markers, such as nitric oxide and superoxide anions, and immunoglobulins IgG and IgM. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier (CRD42023493959).
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Affiliation(s)
- José Mário Matos-Sousa
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Victória Santos Chemelo
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - João Daniel Mendonça de Moura
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Caio Melo Mesquita
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Guido Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luiz Renato Paranhos
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
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2
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Vera J, Castro-Nuñez MA, Troncoso-Cibrian MF, Carrillo-Varguez AG, Méndez Sánchez ER, Sarmiento V, Lanzagorta-Rebollo L, Neelakantan P, Romero M, Arias A. Effect of cryotherapy duration on experimentally induced connective tissue inflammation in vivo. Restor Dent Endod 2023; 48:e29. [PMID: 37675446 PMCID: PMC10477420 DOI: 10.5395/rde.2023.48.e29] [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: 02/15/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives This study tested the hypothesis that cryotherapy duration influences lipopolysaccharide (LPS)-induced inflammation in a rat model. Materials and Methods Six Wistar rats (Rattus norvegicus albinus) were used. Five sites were selected per animal and divided into 5 groups: a negative control group (NC), 2 positive control groups (PC1 and PC2), and 2 experimental groups (E1 and E2). Cryotherapy was applied for 1 minute (E1) or 5 minutes (E2). An acute inflammatory response was induced in the PC and E groups via subcutaneous administration of 0.5 mL/kg. In the PC2 group, a catheter was inserted without additional treatment. For the E1 and E2 groups, 2.5°C saline solution was administered through the implanted catheters for 1 and 5 minutes, respectively. The rats were sacrificed, and samples were obtained and processed for histological analysis, specifically examining the presence of polymorphonuclear neutrophils and hemorrhage. The χ2 test was used to compare the presence of acute inflammation across groups. Dependent variables were compared using the linear-by-linear association test. Results Inflammation and hemorrhage varied significantly among the groups (p = 0.001). A significantly higher degree of acute inflammation was detected (p = 0.0002) in the PC and E1 samples than in the E2 group, in which cryotherapy was administered for 5 minutes. The PC and E1 groups also exhibited significantly greater numbers of neutrophils (p = 0.007), which were essentially absent in both the NC and E2 groups. Conclusions Cryotherapy administration for 5 minutes reduced the acute inflammation associated with LPS and catheter implantation.
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Affiliation(s)
- Jorge Vera
- Department of Endodontics, University of Missouri, Kansas City, MO, USA
| | | | | | | | | | - Viviana Sarmiento
- Department of Endodontics, Autonomous University of Baja California (UABC), Tijuana, Mexico
| | | | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Monica Romero
- Department of Endodontics, University of Missouri, Kansas City, MO, USA
| | - Ana Arias
- Faculty of Dentistry Complutense University of Madrid, Madrid, Spain
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3
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Menon N, Kishen A. Nociceptor-Macrophage Interactions in Apical Periodontitis: How Biomolecules Link Inflammation with Pain. Biomolecules 2023; 13:1193. [PMID: 37627258 PMCID: PMC10452348 DOI: 10.3390/biom13081193] [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: 06/20/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Periradicular tissues have a rich supply of peripheral afferent neurons, also known as nociceptive neurons, originating from the trigeminal nerve. While their primary function is to relay pain signals to the brain, these are known to be involved in modulating innate and adaptive immunity by initiating neurogenic inflammation (NI). Studies have investigated neuroanatomy and measured the levels of biomolecules such as cytokines and neuropeptides in human saliva, gingival crevicular fluid, or blood/serum samples in apical periodontitis (AP) to validate the possible role of trigeminal nociceptors in inflammation and tissue regeneration. However, the contributions of nociceptors and the mechanisms involved in the neuro-immune interactions in AP are not fully understood. This narrative review addresses the complex biomolecular interactions of trigeminal nociceptors with macrophages, the effector cells of the innate immune system, in the clinical manifestations of AP.
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Affiliation(s)
| | - Anil Kishen
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada;
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4
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Nunez N, Erdogan O, Casey SM, Hernandez R, Tan S, Gibbs JL. Elevated Cytokine Levels in Gingival Crevicular Fluid of Teeth with Apical Periodontitis. J Endod 2023:S0099-2399(23)00140-1. [PMID: 36965768 DOI: 10.1016/j.joen.2023.03.010] [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: 11/01/2022] [Revised: 03/06/2023] [Accepted: 03/18/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION Biomarkers assayed from gingival crevicular fluid (GCF) are a potential tool for endodontic diagnosis and for monitoring treatment response. This cross-sectional study measured cytokines in GCF from teeth with apical periodontitis and evaluated their relationship with preoperative pain and other clinical findings. METHODS Participants presenting for root-end resection surgery due to apical periodontitis diagnosis (n=56) underwent standardized clinical testing and completed preoperative questionnaires. GCF from diseased and control teeth were collected, processed, and analyzed. Mann-Whitney U and Wilcoxon tests were used to examine the cytokine levels in diseased compared to healthy control teeth. We also assessed the associations of cytokine levels with clinical findings. RESULTS Cytokines IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, IFN-γ, and TNF-⍺ were detected in GCF. TNF-⍺ levels were significantly higher in GCF collected from diseased versus control teeth (p=0.02) and increased IL-1β levels in diseased teeth were detected (p=0.06). Lower IL-10 levels were observed in teeth with a sinus tract and/or swelling compared to teeth without a sinus tract and/or swelling (p=0.08). Cytokine levels did not clearly relate to the presence of pain. CONCLUSIONS Elevated levels of pro-inflammatory cytokines, including TNF-⍺ and IL1- β, were detected in GCF from diseased teeth compared to the healthy controls. Additional studies are needed to further investigate the utility of these biomarkers for objectively evaluating periradicular pathology.
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Affiliation(s)
- Natali Nunez
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Ozge Erdogan
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA; Department of Endodontics, New York University College of Dentistry, New York, NY.
| | - Sharon M Casey
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA; Department of Endodontics, New York University College of Dentistry, New York, NY
| | - Reinaldo Hernandez
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Summer Tan
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Jennifer L Gibbs
- Division of Endodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA; Department of Endodontics, New York University College of Dentistry, New York, NY
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5
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Silvent J, Robin M, Bussola Tovani C, Wang Y, Soncin F, Delgado S, Azaïs T, Sassoye C, Giraud-Guille MM, Sire JY, Nassif N. Collagen Suprafibrillar Confinement Drives the Activity of Acidic Calcium-Binding Polymers on Apatite Mineralization. Biomacromolecules 2021; 22:2802-2814. [PMID: 34101426 DOI: 10.1021/acs.biomac.1c00206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bone collagenous extracellular matrix provides a confined environment into which apatite crystals form. This biomineralization process is related to a cascade of events partly controlled by noncollagenous proteins. Although overlooked in bone models, concentration and physical environment influence their activities. Here, we show that collagen suprafibrillar confinement in bone comprising intra- and interfibrillar spaces drives the activity of biomimetic acidic calcium-binding polymers on apatite mineralization. The difference in mineralization between an entrapping dentin matrix protein-1 (DMP1) recombinant peptide (rpDMP1) and the synthetic polyaspartate validates the specificity of the 57-KD fragment of DMP1 in the regulation of mineralization, but strikingly without phosphorylation. We show that all the identified functions of rpDMP1 are dedicated to preclude pathological mineralization. Interestingly, transient apatite phases are only found using a high nonphysiological concentration of additives. The possibility to combine biomimetic concentration of both collagen and additives ensures specific chemical interactions and offers perspectives for understanding the role of bone components in mineralization.
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Affiliation(s)
- Jérémie Silvent
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France.,MNHN, CNRS, EPHE, Institut Systématique Évolution Biodiversité, ISYEB, Equipe Homologies, Sorbonne Université, 75005 Paris, France
| | - Marc Robin
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Camila Bussola Tovani
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Yan Wang
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Fabrice Soncin
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Target Therapies, F-59000 Lille, France
| | - Sidney Delgado
- MNHN, CNRS, EPHE, Institut Systématique Évolution Biodiversité, ISYEB, Equipe Homologies, Sorbonne Université, 75005 Paris, France
| | - Thierry Azaïs
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Capucine Sassoye
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Marie-Madeleine Giraud-Guille
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
| | - Jean-Yves Sire
- MNHN, CNRS, EPHE, Institut Systématique Évolution Biodiversité, ISYEB, Equipe Homologies, Sorbonne Université, 75005 Paris, France
| | - Nadine Nassif
- Laboratoire Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS, Collège de France, F-75005 Paris, France
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6
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Riis JL, Ahmadi H, Silke O, Granger SW, Bryce CI, Granger DA. Correspondence Between Cytomegalovirus Immunoglobulin-G Levels Measured in Saliva and Serum. Front Immunol 2020; 11:2095. [PMID: 32983163 PMCID: PMC7484902 DOI: 10.3389/fimmu.2020.02095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/03/2020] [Indexed: 12/05/2022] Open
Abstract
Human cytomegalovirus (HCMV) infects more than 80% of the global population. While mostly asymptomatic, HCMV infection can be serious among the immunocompromised, and it is implicated in chronic disease pathophysiology in adulthood. Large-scale minimally invasive HCMV screening could advance research and public health efforts to monitor infection prevalence and prevent or mitigate downstream risks associated with infection. We examine the utility of measuring HCMV immunoglobulin-G (IgG) levels in saliva as an index of serum levels. Matched serum and saliva samples from healthy adults (N = 98; 44% female; 51% white) were assayed for HCMV IgG, total salivary protein, and salivary markers related to oral inflammation, blood, and tissue integrity. We examine the serum-saliva association for HCMV IgG and assess the influence of participant characteristics and factors specific to the oral compartment (e.g., oral inflammation) on HCMV IgG levels and cross-specimen relations. We found a robust serum-saliva association for HCMV IgG with serum antibody levels accounting for >60% of the variance in salivary levels. This relation remained after adjusting for key demographic and oral immune-related variables. Compared to the serum test, the salivary HCMV IgG test had 51% sensitivity and 97% specificity. With improvements in assay performance and sample optimization, HCMV antibody levels in oral fluids may be a useful proxy for serum levels.
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Affiliation(s)
- Jenna L. Riis
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Hedyeh Ahmadi
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Olivia Silke
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Steve W. Granger
- Salimetrics Research and Technology Center, Carlsbad, CA, United States
| | - Crystal I. Bryce
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
- Salimetrics Research and Technology Center, Carlsbad, CA, United States
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, United States
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Salivary Bioscience Laboratory, Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE, United States
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7
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Comparison of Neurokinin A, Substance P, Interleukin 8, and Matrix Metalloproteinase-8 Changes in Pulp tissue and Gingival Crevicular Fluid Samples of Healthy and Symptomatic Irreversible Pulpitis Teeth. J Endod 2020; 46:1428-1437. [PMID: 32702349 DOI: 10.1016/j.joen.2020.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022]
Abstract
INTRODUTION The aim of this study was to compare levels of neurokinin A (NKA), substance P (SP), interleukin (IL)-8, and matrix metalloproteinase-8 (MMP-8) in pulp tissue and gingival crevicular fluid (GCF) samples of healthy and symptomatic irreversible pulpitis teeth. METHODS Forty patients diagnosed with healthy and symptomatic irreversible pulpitis teeth were included in this study. NKA, SP, IL-8, and MMP-8 levels were measured using the enzyme-linked immunosorbent assay test after pulp and GCF samples were obtained from healthy (n = 20) and symptomatic irreversible pulpitis teeth (n = 20). GCF sampling of 40 teeth was repeated 1 week later. Routine root canal treatment procedures of the teeth were performed, and the treatment process was completed. As a control group, GCF samples were taken from the contralateral teeth in both groups. Statistical analysis was performed using dependent and independent t tests, analysis of variance, Kruskal-Wallis, Mann-Whitney U tests, and Pearson correlation analysis. RESULTS Comparing the groups, all mediator levels were significantly higher in the pulp samples in the pulpitis group compared with the healthy group (NKA: P < .001, SP: P = .005, IL-8: P < .001, and MMP-8: P < .001). Likewise, in the pulpitis group, all mediator levels were significantly higher in the first GCF samples compared with the healthy group (NKA: P = .01, SP: P < .001, IL-8: P = .001, and MMP-8: P < .001). CONCLUSIONS It was observed that NKA, SP, IL-8, and MMP-8 increased significantly in pulp tissue and GCF specimens of symptomatic irreversible pulpitis teeth compared with pulp tissue and GCF specimens of healthy teeth. Second, it was determined that NKA, SP, IL-8, and MMP-8 levels decreased significantly in GCF samples in teeth diagnosed with symptomatic irreversible pulpitis 1 week after the removal of inflamed pulp. Finally, SP, IL-8, and MMP-8 levels were found to be higher in pulp tissue samples of the patients with symptomatic irreversible pulpitis with higher pain scores than those with low pain scores.
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8
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Karteva T, Manchorova-Veleva N. Biomarker for Asymptomatic Apical Periodontitis in Gingival Crevicular Fluid: aMMP-8. Eur J Dent 2020; 14:239-244. [PMID: 32396973 PMCID: PMC7274820 DOI: 10.1055/s-0040-1709827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives
Asymptomatic apical periodontitis (AAP) is one of the most widespread chronic inflammatory diseases in the field of dental medicine. Active matrix metalloproteinase (aMMP-8) previously demonstrated diagnostic potential as a biomarker for AAP in gingival crevicular fluid (GCF). The aim of this study was to determine the levels and diagnostic accuracy of aMMP-8 in GCF from teeth with AAP.
Materials and Methods
In this cross-sectional study, GCF samples were obtained from teeth with AAP (sample group,
n
= 31) and their contralateral teeth (control group,
n
= 31). Clinical and cone beam computed tomography (CBCT) parameters were used for the diagnosis and assessment of AAP and the determination of clinically healthy marginal periodontal tissues. One pool GCF sample per tooth was obtained from the whole crevice’s perimeter. aMMP-8 levels were determined by enzyme-linked immunosorbent assay (ELISA).
Statistical Analysis
Wilcoxon signed ranks test and Spearman rank correlation coefficient (rs) were used as statistical tools. The significance level was set at
p
< .05.
Results
The two groups demonstrated biomarker levels corresponding to a healthy marginal periodontal tissue. aMMP-8 levels were statistically and significantly higher in the samples collected from teeth with AAP. Lesions with greater volume showed correspondingly larger diameters. No statistically significant correlation between aMMP-8 levels and lesions’ volume or diameter was discovered.
Conclusion
GCF composition is modified by AAP only to a minimal extent. Further research is needed to substantiate the utilization of aMMP-8 as a potential biomarker for the diagnosis of the disease as well as to explore its relationship with other biomarkers.
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Affiliation(s)
- Teodora Karteva
- Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Neshka Manchorova-Veleva
- Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Plovdiv, Plovdiv, Bulgaria
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9
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Bıçakcı H, Çapar İD, Genç S, İhtiyar A, Sütçü R. Influence of Rotary Instrumentation with Continuous Irrigation on Pain and Neuropeptide Release Levels: A Randomized Clinical Trial. J Endod 2017; 42:1613-1619. [PMID: 27788771 DOI: 10.1016/j.joen.2016.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 08/03/2016] [Accepted: 08/11/2016] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The first objective was to determine correlation among various experimental and clinical pain measurement procedures. The second objective was to evaluate the influence of rotary instrumentation with continuous irrigation on pain and neuropeptide release levels. METHODS Forty patients who had preoperative pain at the levels of 3-8 on the visual analogue scale were included. Gingival crevicular fluid (GCF) samples were collected. Patients were randomly assigned to 2 treatment groups, the standard preparation group and the preparation with continuous irrigation group. Apical fluid samples (AFS) were collected after instrumentation. In the second visit, the patients' pain levels were recorded, and GCF and AFS were obtained. Substance P, calcitonin-gene related peptide (CGRP), interleukin (IL)-1β, and IL-10 levels were analyzed from the GCF and AFS samples. For comparison between groups, the Mann-Whitney test was used (P < .05). RESULTS In terms of clinical data, no significant difference was detected in the first and second sessions between groups. The IL-10 level obtained from AFS significantly decreased in the second session in both groups (P < .001). Visual analogue scale scores of spontaneous pain correlated with percussion pain positively (r = 0.718, P < .001). CGRP (GCF) (second session) and IL-10 (GCF) (second session) positively correlated with percussion pain (r = 0.425, P < .01) (r = 0.379, P < .05). CONCLUSIONS Rotary preparation with continuous irrigation has not been more effective than the standard preparation method for reducing pain. Because of determination of the correlation between CGRP and IL-10 with percussion pain, these neuropeptides can be used in further studies.
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Affiliation(s)
| | | | - Selin Genç
- Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - Alperen İhtiyar
- Department of Biochemistry and Clinical Biochemistry, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
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10
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Lombardo L, Carinci F, Martini M, Gemmati D, Nardone M, Siciliani G. Quantitive evaluation of dentin sialoprotein (DSP) using microbeads - a potential early marker of root resorption. ORAL & IMPLANTOLOGY 2016; 9:132-142. [PMID: 28042441 DOI: 10.11138/orl/2016.9.3.132] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE This study had the aim of comparing two different methods of analysing dentin sialoprotein (DSP) in the gingival crevicular fluid (GCF): the conventional eLISA approach and a new method involving the use of magnetic micro-beads coated with an antibody specific for DSP prior to eLISA analysis. MATERIALS AND METHODS GCF was taken from six patients following twelve weeks of orthodontic treatment using paper strips inserted into the mesial and distal sulci of the upper incisors, and analysed using both methods. RESULTS Statistical analysis of the results using the Mann-Whitney non-parametric test showed that the micro-bead approach conferred more reliability and less variability on the conventional eLISA approach. Furthermore, this method, for the first time, enables the quantification of the DSP in the sample in ng/μl. CONCLUSIONS The innovative micro-bead/eLISA approach proposed provides a reliable means of quantifying the DSP in the GCF.
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Affiliation(s)
- L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - M Martini
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - D Gemmati
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - G Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
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11
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Baeza M, Garrido M, Hernández-Ríos P, Dezerega A, García-Sesnich J, Strauss F, Aitken JP, Lesaffre E, Vanbelle S, Gamonal J, Brignardello-Petersen R, Tervahartiala T, Sorsa T, Hernández M. Diagnostic accuracy for apical and chronic periodontitis biomarkers in gingival crevicular fluid: an exploratory study. J Clin Periodontol 2016; 43:34-45. [DOI: 10.1111/jcpe.12479] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Mauricio Baeza
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Mauricio Garrido
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Patricia Hernández-Ríos
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Andrea Dezerega
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Jocelyn García-Sesnich
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Franz Strauss
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Juan Pablo Aitken
- Department of Pathology and Oral Medicine; Faculty of Dentistry; University of Chile; Santiago Chile
| | - Emmanuel Lesaffre
- Leuven Biostatistics and Statistical Bioinformatics Centre; KU Leuven; Leuven Belgium
| | - Sophie Vanbelle
- Department of Methodology and Statistics; CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Jorge Gamonal
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
- Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
| | | | - Taina Tervahartiala
- Departments of Oral and Maxillofacial Diseases; Helsinki University and Helsinki University Central Hospital; Helsinki Finland
| | - Timo Sorsa
- Departments of Oral and Maxillofacial Diseases; Helsinki University and Helsinki University Central Hospital; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - Marcela Hernández
- Laboratory of Periodontal Biology; Department of Conservative Dentistry; Faculty of Dentistry; University of Chile; Santiago Chile
- Department of Pathology and Oral Medicine; Faculty of Dentistry; University of Chile; Santiago Chile
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Inflammatory Mediators of Leprosy Reactional Episodes and Dental Infections: A Systematic Review. Mediators Inflamm 2015; 2015:548540. [PMID: 26339136 PMCID: PMC4539113 DOI: 10.1155/2015/548540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/19/2015] [Indexed: 11/17/2022] Open
Abstract
Reactional episodes in leprosy are a result of complex interactions between the immune system, Mycobacterium leprae, and predisposing factors, including dental infections. To determine the main inflammatory mediators in the immunopathological process of dental infections and leprosy reactions, we conducted a systematic review of primary literature published between 1996 and 2013. A three-stage literature search was performed (Stage I, "leprosy reactions" and "inflammatory mediators"; Stage II, "dental infections" and "inflammatory mediators"; and Stage III, "leprosy reactions," "dental infections," and "inflammatory mediators"). Of the 911 eligible publications, 10 were selected in Stage I, 68 in Stage II, and 1 in Stage III. Of the 27 studied inflammatory mediators, the main proinflammatory mediators were IL-6, IFN-γ, TNF-α, IL-1β, and IL-17; the main anti-inflammatory mediators were IL-10 and IL-4. Serum IL-6 and TNF-α concentrations were significant during periodontal and reactional lesion evolution; IFN-γ and IL-1β were associated with types 1 and 2 reactions and chronic periodontal disease. The proinflammatory mediators in dental infections and leprosy reactions, especially IL-6 and TNF-α, were similar across studies, regardless of the laboratory technique and sample type. IFN-γ and IL-1β were significant for leprosy reactions and periodontal diseases. This pattern was maintained in serum.
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Periapical cytokine expression in sickle cell disease. J Endod 2015; 41:358-62. [PMID: 25576201 DOI: 10.1016/j.joen.2014.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 09/08/2014] [Accepted: 11/26/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Sickle cell anemia (SCA) is the most prevalent genetic disease worldwide. Patients with SCA exhibit increased levels of proinflammatory mediators as part of a permanently activated immunoinflammatory status. METHODS The aim of this study was to evaluate the mRNA expression levels of the cytokines interferon (IFN-γ), tumor necrosis factor, interleukin (IL-1β, IL-17A, IL-10), receptor activator for nuclear factor kappa B ligand, and the chemokines CCL2/MCP-1 and CCL5 in the periapical interstitial fluid from SCA individuals compared with healthy individuals. Samples were collected from 12 teeth of SCA patients and 12 non-SCA patients with apical periodontitis. In addition, 12 teeth were sampled from the periapical region of healthy patients with vital pulp (control). The expression of cytokine mRNA was detected by using real-time polymerase chain reaction. RESULTS The expression of mRNA for the Th1-associated cytokines IFN-γ, tumor necrosis factor-α, and IL-1β were significantly higher in SCA individuals than in the control individuals (P < .05). Among Th1-associated cytokines, only IFN-γ was significantly increased in non-SCA compared with control patients (vital pulp). The expression of IL-17A mRNA was significant higher in SCA cases than in control samples (P < .05), whereas the IL-10 mRNA expression was significantly increased in SCA and non-SCA individuals when compared with the control group. Similar levels of receptor activator for nuclear factor kappa B ligand, CCL2, and CCL5 mRNA expression were observed in all samples. However, no significant differences were observed in the expression of cytokine or chemokine mRNA between SCA and non-SCA individuals (P > .05). CONCLUSIONS The results were able to demonstrate that SCA patients presented prone proinflammatory ability, despite the fact that any differences in periapical immune responses between SCA and non-SCA individuals were not observed.
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Garrido M, Dezerega A, Castro-Martínez A, Hernández M. Host-derived biomarkers in gingival crevicular fluid for complementary diagnosis of apical periodontitis. World J Stomatol 2014; 3:19-24. [DOI: 10.5321/wjs.v3.i2.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/07/2014] [Accepted: 05/14/2014] [Indexed: 02/07/2023] Open
Abstract
Apical periodontitis (AP) develops as a result of the host’s immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin (ALEO) and potentially to systemic metabolic alterations. Misdiagnosed ALEO is not infrequent due to the lack of diagnostic tools to differentiate apical lesions of different natures. Despite the conservative endodontic treatment shows a high success rate, there are refractory cases that can not be identified early enough during follow up. This evidences the need to develop complementary diagnostic tools, such as oral fluid biomarker analysis. Gingival crevicular fluid (GCF) is a serum transudate that becomes an exudate under inflammatory conditions, carrying molecules from local periodontal tissues and general circulation than can be harvested non-invasively. We aimed to review the available literature analyzing GCF composition in AP patients to evaluate whether GCF has any potential for complementary diagnosis. To the date, only few studies addressing changes of GCF components in AP are available. Most studies support GCF modifications in specific components in AP-affected teeth, suggesting that it might reflect periapical inflammation. GCF has potential for diagnostic tool, treatment follow-up and eventually to assess systemic comprise.
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Wang Y, Yan M, Wang Z, Wu J, Wang Z, Zheng Y, Yu J. Dental pulp stem cells from traumatically exposed pulps exhibited an enhanced osteogenic potential and weakened odontogenic capacity. Arch Oral Biol 2013; 58:1709-17. [PMID: 24112738 DOI: 10.1016/j.archoralbio.2013.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 08/22/2013] [Accepted: 09/02/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Traumatic pulp exposure can bring about some permanent damages to tooth tissues including dental pulps. This study was designed to evaluate the effects of traumatic pulp exposure on the osteo/odontogenic capacity of dental pulp stem cells (DPSCs). METHODS Rat incisors were artificially fractured and dental pulps were exposed to the oral environment for 48 h. Then, multi-colony-derived DPSCs from the injured pulps (iDPSCs) were isolated. Their osteo/odontogenic differentiation and the involvement of NF-κB pathway were subsequently investigated. RESULTS iDPSCs presented a lower proliferative capacity than normal DPSCs (nDPSCs), as indicated by MTT and FCM assay. ALP levels in iDPSCs were significantly higher (P<0.01) than those in nDPSCs. Alizarin red staining revealed that iDPSCs exhibited an increased capacity of calcium deposition. Moreover, iDPSCs expressed stronger osteogenic markers (Runx2/RUNX2 and Ocn/OCN) and less odontogenic gene/protein (Dspp/DSP) than nDPSCs in vitro. In vivo transplantation showed that nDPSCs implants generated the typical dentine-pulp complex while all iDPSCs pellets formed the osteodentin-like tissues which were immunopositive for OCN. Mechanistically, iDPSCs expressed the higher levels of cytoplasmic phosphorylated IκBα/P65 and nuclear P65 than nDPSCs, indicating an active cellular NF-κB pathway in iDPSCs. After the inhibition of NF-κB pathway, the osteogenic potential in iDPSCs was significantly down-regulated while odontogenic differentiation was up-regulated, as indicated by the decreased Alp/Runx2/Ocn and uprised Dspp expression. CONCLUSIONS Pulp exposure for 48 h decreased the odontogenic capacity and enhanced the osteogenic potential of DPSCs via the NF-κB signalling pathway.
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Affiliation(s)
- Yanping Wang
- Institute of Stomatology, Nanjing Medical University, 140 Hanzhong Road, Nanjing, Jiangsu 210029, China; Endodontic Department, The Affiliated Stomatological Hospital of Soochow University, Suzhou Stomatological Hospital, 1505 Renmin Road, Suzhou, Jiangsu 215005, China
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Liu J, Duan Y. Saliva: A potential media for disease diagnostics and monitoring. Oral Oncol 2012; 48:569-77. [DOI: 10.1016/j.oraloncology.2012.01.021] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/28/2011] [Accepted: 01/26/2012] [Indexed: 01/22/2023]
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Martinho FC, Chiesa WMM, Leite FRM, Cirelli JA, Gomes BPFA. Correlation between clinical/radiographic features and inflammatory cytokine networks produced by macrophages stimulated with endodontic content. J Endod 2012; 38:740-5. [PMID: 22595105 DOI: 10.1016/j.joen.2012.02.021] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 02/11/2012] [Accepted: 02/15/2012] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Macrophages are highly activated by endodontic contents. This study investigated the correlation between different clinical signs/symptoms and radiographic features according to the levels of interleukin (IL)-1β, tumor necrosis factor α (TNF-α), IL-6, IL-10, prostaglandin E(2) (PGE(2)), and their networks produced by endodontic content-stimulated macrophages collected from primary endodontic infection with apical periodontitis (PEIAP). METHODS Samples were taken from 21 root canals with PEIAP by using paper points. The presence of exudate (EX), pain on palpation (POP), tenderness to percussion (TTP), and the size of the radiographic lesion (SRL) were recorded. Polymerase chain reaction (16S rDNA) was used for bacterial detection and limulus amebocyte lysate (LAL) assay for endotoxin measurement. Raw 264.7 macrophages were stimulated with bacterial contents during 24 hs. The amounts of IL-1β, TNF-α, IL-6, IL-10 and PGE(2) were measured by enzyme-linked immunosorbent assay. Log-based data were correlated by multiple logistic regression (P < .05). RESULTS Bacteria and endotoxin were detected in 100% of the samples. IL-6 and TNF-α were positively correlated with SRL and EX, respectively (P < .05). Clinical signs/symptoms and radiographic findings were set as dependent variables for EX-positive correlations between PGE(2), IL-1β, and TNF-α (P < .05), whereas IL-6 and PGE(2) were positively correlated to each other in POP but negatively correlated in SRL (P < .05). When POP and TTP-POP were set as dependent variables, different cytokine networks were found. CONCLUSIONS Our findings suggest different roles for each cytokine in the development of apical periodontitis, whose effects of overlapping networks depend on the signs/symptoms and radiographic features found in endodontic infection.
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Affiliation(s)
- Frederico C Martinho
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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de Brito LCN, Fonseca Teles FR, Teles RP, Totola AH, Vieira LQ, Ribeiro Sobrinho AP. T-Lymphocyte and Cytokine Expression in Human Inflammatory Periapical Lesions. J Endod 2012; 38:481-5. [DOI: 10.1016/j.joen.2011.12.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 12/08/2011] [Accepted: 12/08/2011] [Indexed: 10/14/2022]
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Dezerega A, Madrid S, Mundi V, Valenzuela MA, Garrido M, Paredes R, García-Sesnich J, Ortega AV, Gamonal J, Hernández M. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response. JOURNAL OF INFLAMMATION-LONDON 2012; 9:8. [PMID: 22436166 PMCID: PMC3358239 DOI: 10.1186/1476-9255-9-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/21/2012] [Indexed: 01/22/2023]
Abstract
Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p < 0.05). Total oxidant status correlated positively with matrix metalloproteinase-2 and lesion size (p < 0.05). Gingival crevicular fluid showed significantly lower levels of total antioxidant status in diseased teeth at baseline compared to controls and endodontically-treated groups. Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF.
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Affiliation(s)
- Andrea Dezerega
- Laboratorio de Biología Periodontal, Facultad de Odontología, Avenida Sergio Livingstone 943, Comuna de Independencia, Santiago, Chile.
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Morsani JM, Aminoshariae A, Han YW, Montagnese TA, Mickel A. Genetic predisposition to persistent apical periodontitis. J Endod 2011; 37:455-9. [PMID: 21419289 DOI: 10.1016/j.joen.2011.01.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The proinflammatory cytokine interleukin (IL)-1 is a key regulator of host responses to microbial infection and a major modulator of extracellular matrix catabolism and bone resorption. Allele2 of IL-1β is associated with a four-fold increase in IL-1β production. The aim of this case-control study was to evaluate the gene polymorphism of IL-1β in the pathogenesis of endodontic failure. We hypothesized that the gene polymorphism (allele2 of IL-1β) would influence host response and enhance inflammatory reactions predisposing to persistent apical periodontitis (PAP). MATERIALS AND METHODS Subjects with at least 1 year of follow-up after root canal therapy (RCT) were recalled. Inclusion and exclusion criteria were applied, and 34 subjects with signs/symptoms of PAP with otherwise acceptable RCT were included. Sixty-one controls showed healing with acceptable RCT. Genomic DNA from buccal mucosa was amplified by polymerase chain reaction followed by restriction fragment length polymorphism to distinguish the alleles of IL-1β gene polymorphism. RESULTS A significant difference in the distribution of the polymorphic genotype among cases (70.6%) and controls (24.6%) (P < .001, Pearson χ(2)) was shown. CONCLUSIONS These findings suggest that specific genetic markers associated with increased IL-1β production may contribute to increased susceptibility to PAP.
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Affiliation(s)
- Jussara M Morsani
- American Board of Endodontics, Case Western Reserve School of Dental Medicine, Cleveland, Ohio, USA
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