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Medina-Torres L, Cochran C, Bauer PA, Valcanaia AJ, Sindu D, Cavalcanti B, McDonald N. Effect of different instrumentation techniques on students' performance and outcomes of nonsurgical root canal treatment. J Dent Educ 2024. [PMID: 38557969 DOI: 10.1002/jdd.13523] [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: 08/03/2023] [Revised: 01/18/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study compared, retrospectively, the incidence of clinical errors and effects on treatment outcomes, when students were exposed to two different instrumentation techniques: a hybrid rotary technique (HYB), consisting of both hand instrumentation with hand stainless steel and Ni-Ti files plus the use of a rotary system (Vortex Blue, Dentsply Sirona), versus a full reciprocation instrumentation technique (WaveOne Gold [WOG], Dentsply Sirona). METHODS A total of 368 endodontic cases (n = 184) in anterior and premolar teeth, completed by dental students at the University of Michigan School of Dentistry from 2013 to 2022, were used for the study. The groups were evaluated by two calibrated clinicians, observing the incidence of clinical errors: file separations, over-instrumentation, ledges and transportations. Treatment outcomes were also observed. Data were analyzed statistically by Fisher's exact test and Mann-Whitney U test (p < 0.05). RESULTS No significant difference in file separations, ledges, and transportation was observed between the two groups. However, the WOG Group experienced significantly more over-instrumentation than HYB group, although this did not significantly affect tooth survival or periapical index (PAI). Cases with PAI scores of 5 were found to have significantly less tooth survival compared to the other PAI scores. CONCLUSIONS It can be concluded that both techniques in our study are well suited to advancing the endodontic dental education of students and novice operators, anticipating relatively successful outcomes of tooth survival, as long as the cases selected are less severe in progression preoperatively.
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Affiliation(s)
- Luis Medina-Torres
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Clarence Cochran
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Patricia Ann Bauer
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Andre Joao Valcanaia
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Devika Sindu
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Bruno Cavalcanti
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Neville McDonald
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Sun X, Yang Y, Meng X, Li J, Liu X, Liu H. PANoptosis: Mechanisms, biology, and role in disease. Immunol Rev 2024; 321:246-262. [PMID: 37823450 DOI: 10.1111/imr.13279] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
Cell death can be executed through distinct subroutines. PANoptosis is a unique inflammatory cell death modality involving the interactions between pyroptosis, apoptosis, and necroptosis, which can be mediated by multifaceted PANoptosome complexes assembled via integrating components from other cell death modalities. There is growing interest in the process and function of PANoptosis. Accumulating evidence suggests that PANoptosis occurs under diverse stimuli, for example, viral or bacterial infection, cytokine storm, and cancer. Given the impact of PANoptosis across the disease spectrum, this review briefly describes the relationships between pyroptosis, apoptosis, and necroptosis, highlights the key molecules in PANoptosome formation and PANoptosis activation, and outlines the multifaceted roles of PANoptosis in diseases together with a potential for therapeutic targeting. We also discuss important concepts and pressing issues for future PANoptosis research. Improved understanding of PANoptosis and its mechanisms is crucial for identifying novel therapeutic targets and strategies.
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Affiliation(s)
- Xu Sun
- Department of Integrated Chinese and Western Medicine, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Yanpeng Yang
- Cardiac Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Xiaona Meng
- Department of Integrated Chinese and Western Medicine, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Jia Li
- Department of Integrated Chinese and Western Medicine, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Xiaoli Liu
- Department of Integrated Chinese and Western Medicine, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Huaimin Liu
- Department of Integrated Chinese and Western Medicine, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
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Sharaf PH, El Backly RM, Sherif RA, Zaazou AM, Hafez SF. Microbial identification from traumatized immature permanent teeth with periapical lesions using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. BMC Oral Health 2022; 22:661. [PMID: 36587207 PMCID: PMC9805193 DOI: 10.1186/s12903-022-02562-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/03/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study aims at identifying the microbiota in traumatized immature permanent teeth with periapical lesions using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). METHODS The study included 16 immature maxillary central incisors with periapical lesions in 13 patients. Field decontamination and negative control samples were performed before and after access cavity preparation. Root canal samples were taken using sterile stainless-steel hand files following field decontamination. In-office inoculation and pure sub-cultures were performed. Bacterial isolates were prepared for MALDI-TOF MS (Bruker, Billerica, MA USA) analysis using the formic acid extraction method. A comparison of the prevalence of isolated microorganisms was done using a one-sample chi-square test. Comparisons between identified microbial species with the, cone beam computed tomography periapical index (CBCT PAI) scores and lesion volume were also conducted. The Chi-square test was applied to investigate the association between the categorical variables . RESULTS Out of the forty isolates recovered from the 16 traumatized teeth included in the present study with the mean patients' age of 10.93 ± 1.77, 37 isolates were reliably identified by MALDI-TOF MS. Twelve teeth (62.5%) were polymicrobial. The recovered bacteria belonged to five phyla, 15 genera and 25 species. Firmicutes were the predominant phylum (P < 0.001) over Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. Gram positive bacteria were significantly more prevalent than Gram negative (p = 0.03). Facultative anaerobes were the most prevalent (P < 0.001) compared to the obligate anaerobes and the obligate aerobes. The latter were the least prevalent. Statistically, significant differences existed in the comparison between CBCT PAI scores according to bacterial gram staining. CONCLUSION Traumatized immature permanent teeth with periapical lesions showed a significant predominance of Gram-positive facultative anaerobes. MALDI-TOF MS provided accurate identification of numerous viable endodontic microbes.
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Affiliation(s)
- Pervine H. Sharaf
- grid.7155.60000 0001 2260 6941Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt, Endodontic Specialist, Ministry of Health, Alexandria, Egypt
| | - Rania M. El Backly
- grid.7155.60000 0001 2260 6941Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Raef A. Sherif
- grid.7155.60000 0001 2260 6941Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ashraf M. Zaazou
- grid.7155.60000 0001 2260 6941Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt ,Faculty of Dentistry, King Abdel Aziz University, Jeddah, Saudi Arabia
| | - Soad F. Hafez
- grid.7155.60000 0001 2260 6941Medical Microbiology and Immunology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Ahmad MZ, Merdad KA, Sadaf D. An overview of systematic reviews on endotoxins in endodontic infections and the effectiveness of root canal therapy in its removal. Evid Based Dent 2022:10.1038/s41432-022-0826-x. [PMID: 36482195 DOI: 10.1038/s41432-022-0826-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/16/2022] [Indexed: 06/17/2023]
Abstract
Background The objective of this overview was to synthesise the current evidence on the role of endotoxins in endodontics infections and to evaluate the effectiveness of endodontic procedures in its removal using information from published systematic reviews.Methods Electronic databases Medline, Scopus, Embase, Cochrane Library and Google Scholar were searched for reviews published up to July 2021. Systematic reviews on endotoxins based on clinical and/or observational studies were included. The quality of systematic reviews was assessed with the AMSTAR2 tool.Results A total of five systematic reviews were selected, of which two reviews were of high quality. A significantly higher level of endotoxins were found in teeth with exudation, teeth with a previous episode of pain and pain on percussion. Chemomechanical preparation of root canals significantly reduce endotoxin levels. Calcium hydroxide intracanal medication in symptomatic teeth was significantly effective in endotoxin reduction (standardised mean difference -1.051 [95% confidence interval -2.039 to -0.063]; p <0.05; I2 = 83.3%; certainty of evidence = very low). Multiple session root canal treatment in teeth with symptomatic apical periodontitis was significantly more effective in endotoxins/lipopolysaccharides removal than single-session treatment.Conclusion Limited quality of evidence showed a significant association of endotoxins in infected teeth with clinical symptoms. Conventional chemomechanical preparation of root canals and intracanal medication were unable to eliminate endotoxins from the root canal system. Future evolution of effective disinfection therapies is warranted.
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Affiliation(s)
- Muhammad Z Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Alrass, Saudi Arabia
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Durre Sadaf
- Department of Microbial Diseases, University College London, Eastman Dental Institute, London, United Kingdom.
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Astorga J, Hernández M, Bravo D, Hoare A. Evaluation of PCR primers to identify Porphyromonas endodontalis in apical periodontitis clinical samples. Arch Microbiol 2022; 204:652. [PMID: 36173466 DOI: 10.1007/s00203-022-03260-7] [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: 07/09/2021] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 11/02/2022]
Abstract
We aimed to evaluate whether two commonly used PCR primers are effective to identify P. endodontalis and discriminate from other prevalent black-pigmented bacteria in apical periodontitis (AP). Endodontic canal samples from patients with asymptomatic AP (n = 20) were collected and cultured in anaerobiosis. Two primer sets to detect P. endodontalis were selected from the literature and first analyzed for their specificity in silico; and then tested on clinical isolates in vitro and finally, in apical exudates ex vivo. The identity of P. endodontalis was verified by PCR and Sanger sequencing with universal primers for bacterial V3-V6 regions 16S rDNA. Only one primer set showed specificity only for P. endodontalis clones in silico and also was specific for P. endodontalis in vitro and ex vivo.
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Affiliation(s)
- J Astorga
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - M Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile.,Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - D Bravo
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - A Hoare
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile.
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Kaval ME, Cakir B, Polatli E, Rençber S, Karavana SY, Nalbantsoy A, Güneri P. IL-1ß, IL-6 and TNF-α expression levels of macrophage cells induced by benzydamine hydrochloride, benzydamine hydrochloride with chitosan, calcium hydroxide and chlorhexidine medicaments: An ELISA study. Dent Mater J 2022; 41:545-551. [PMID: 35676045 DOI: 10.4012/dmj.2021-265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to evaluate IL-1ß, IL-6 and TNF-α expression levels of macrophage cells induced by benzydamine hydrochloride (BNZ), BNZ with chitosan, calcium hydroxide (CH) and chlorhexidine (CHX) medicaments. Half maximal inhibitory concentrations (IC50) were assessed on THP-1, Saos-2, and CRL-2014 cells using MTT assay. THP-1 cells were differentiated into macrophages with phorbol12-myristate13-acetate and activated with lipopolysaccharide. IL-1β, IL-6 and TNF-α levels in supernatants were determined using enzyme-linked immunosorbent assay (ELISA). The data were examined with one-way ANOVA and Tukey's multiple comparison test (p=0.05). At the selected concentrations, the cell viability was higher than 50% for chitosan and CH, whereas CHX presented lower IC50 values than BNZ and BNZ+chitosan. According to ELISA results, the lowest IL-1β, IL-6 and TNF-α values were observed with BNZ+Chitosan 50 µg/mL and BNZ 50 µg/mL. BNZ+chitosan 50 µg/mL combination has revealed promising anti-inflammatory effects. Nevertheless, these findings need to be examined in clinical conditions.
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Affiliation(s)
| | - Büşra Cakir
- Department of Bioengineering, Faculty of Engineering, Ege University
| | - Elifsu Polatli
- Department of Bioengineering, Faculty of Engineering, Ege University
| | - Seda Rençber
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Izmir Katip Celebi University
| | | | - Ayşe Nalbantsoy
- Department of Bioengineering, Faculty of Engineering, Ege University
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University
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Gomes BPFA, Berber VB, Marinho ACS, Louzada LM, Arruda-Vasconcelos R, Passini MRZ, Lopes EM, Pecorari VGA, Chen T, Paster BJ. Chemomechanical preparation influences the microbial community and the levels of LPS, LTA and cytokines in combined endodontic-periodontal lesions: A clinical study. J Periodontal Res 2021; 57:341-356. [PMID: 34910826 DOI: 10.1111/jre.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND This study was conducted to compare the microbiomes, the levels of lipopolysaccharides (LPS), lipoteichoic acid (LTA), and cytokines (interleukin [IL]-1β and tumor necrosis factor-alpha [TNF-α]), before and after chemomechanical preparation (CMP) of the root canals (RC) and their associated periodontal pockets (PP) in teeth with combined EPL. MATERIALS Samples were taken from 10 RC and PP, before and after CMP. The microbiomes (next-generation sequencing, V3-V4 hypervariable region of the 16S rRNA gene), microbiome diversity (bioinformatics analyses), LPS (limulus amebocyte lysate), LTA, IL-1β, and TNF-α (ELISA) were evaluated. A statistical analysis was performed with significance level set at 5%. RESULTS The most abundant phyla in both sites were Firmicutes and Proteobacteria. Comparative studies of bacterial genera species revealed that some increased and others decreased after CMP at both sites. A 3% reduction in Gram-negative bacteria (RC) and a 4% increase in Gram-positive bacteria (PP) were detected. LPS levels were 4.4 times higher in PP than in the RC. LTA was detected in all samples investigated. Higher levels of IL-1β and TNF-α were detected in both sites at baseline. After CMP, LPS, LTA, IL-1β and TNF-α were reduced in both sites. CONCLUSION The microbial community in the RC and PP in teeth with combined EPL indicated a similarity between both sites. CMP effectively reduced the microbial load and the LPS levels from teeth with EPL, and consequently diminished the cytokine levels. The reduction in LTA levels in the RC and PP proved challenging.
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Affiliation(s)
- Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Vanessa B Berber
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Ariane C S Marinho
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Lidiane M Louzada
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Rodrigo Arruda-Vasconcelos
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Maicon R Z Passini
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Erica M Lopes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - Vanessa G A Pecorari
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil.,BioStatistics, Universidade Paulista - UNIP, São Paulo, Brazil
| | - Tsute Chen
- Department of Molecular Genetics, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Bruce J Paster
- Microbiology Department, The Forsyth Institute, Cambridge, Massachusetts, USA
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Wan CY, Li L, Liu LS, Jiang CM, Zhang HZ, Wang JX. Expression of Matrix Metalloproteinases and Tissue Inhibitor of Matrix Metalloproteinases during Apical Periodontitis Development. J Endod 2021; 47:1118-1125. [DOI: 10.1016/j.joen.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/11/2022]
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9
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Gomes BP, Francisco PA, Godoi Jr EP, Endo MS, Barbosa-Ribeiro M, Delboni MG, Pecorari VG. Identification of Culturable and Nonculturable Microorganisms, Lipopolysaccharides, and Lipoteichoic Acids From Root Canals of Teeth With Endodontic Failure. J Endod 2021; 47:1075-1086. [DOI: 10.1016/j.joen.2021.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/20/2022]
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10
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Gabrielli ES, Lima AR, Francisco PA, Herrera DR, de-Jesus-Soares A, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BPFA. Comparative analysis of bacterial content, levels of lipopolysaccharides and lipoteichoic acid in symptomatic and asymptomatic endodontic infections at different stages of endodontic treatment. Clin Oral Investig 2021; 26:287-302. [PMID: 34114101 DOI: 10.1007/s00784-021-03998-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/19/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to detect the presence of specific bacteria and to evaluate the levels of lipopolysaccharides (LPS) and lipoteichoic acid (LTA) in symptomatic necrotic root canals associated with acute apical abscess (symptomatic group - GI). It also aimed to compare the findings with those presented by asymptomatic necrotic root canals (asymptomatic group - GII) in the different stages of the endodontic treatment. MATERIALS AND METHODS Microbiological samples were collected from 20 root canals, including purulent collection from acute apical abscesses, before and after chemo-mechanical preparation (CMP) preparation (CMP) with chlorhexidine gel 2% and after 30 days of intracanal medication (ICM) with (Ca[OH]2) + chlorhexidine. The culture method was used to evaluate the efficacy of CMP and ICM. Nested PCR was used to detect the presence of 17 specific bacteria. Levels of LPS were measured by using limulus amebocyte lysate, whereas enzyme-linked immunosorbent assay was used for the quantification of LTA. RESULTS CMP was effective in reducing the microbial load in both groups (P < 0.05). LPS levels were higher in GI than in GII (P < 0.05). There was a significant reduction in the LPS levels after CMP and ICM (P < 0.05) in GI and GII. LTA levels were significantly reduced in GI after ICM and in GII after CMP and ICM (both P < 0.05). Fusobacterium nucleatum and Enterococcus faecalis were frequently identified in both groups, alone or in combination with each other. CONCLUSION Different species were detected in all stages of the endodontic treatment. CMP was able to reduce bacterial content and the levels of LPS, but not of LTA in the symptomatic group. High levels of LPS were correlated with spontaneous pain and pain to percussion in the symptomatic group. CLINICAL RELEVANCE This clinical study showed that chemo-mechanical preparation was able to reduce bacterial load and levels of LPS, but not of LTA in the symptomatic group. Elevated levels of LPS were correlated with the presence of symptomatology.
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Affiliation(s)
- Ezequiel S Gabrielli
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Augusto R Lima
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Priscila A Francisco
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Daniel R Herrera
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil.,Department of Endodontics, Fluminense Federal University, Rua Mario Santos Braga, 28, Niterói, Rio de Janeiro, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Caio C R Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - José Flávio A Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Marina A Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School - State University of Campinas, UNICAMP, Av Limeira 901, Piracicaba, São Paulo, Brazil.
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11
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Martinho FC, Leite FRM, Arruda-Vasconcelos R, Louzada LM, Darveau RP, Gomes BPFA. Influence of Bacterial Profiles in Cytokine and Clinical Features of Endodontic Disease. J Endod 2021; 47:1265-1271. [PMID: 34015415 DOI: 10.1016/j.joen.2021.04.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We verified the association between selected bacterial profiles and levels of cytokines, chemokines, and the expression of signs and symptoms of primary endodontic infection with apical periodontitis. METHODS Samples were collected from 21 root canals, and macrophages were stimulated for 24 hours. Tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-10, IL-12p70, interferon gamma, and chemokine (C-C motif) ligand 2 (CCL2) were measured using cytometric bead array. We investigated the overlapping networks between cytokines and chemokines with regression analysis. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. Using factor analysis, bacterial species aggregated in 2 factors. The association of bacteria species-based factors on cytokine and chemokine levels and clinical features was estimated with regression analysis. RESULTS A negative relationship between IL-10 (anti-inflammatory cytokine) and CCL2, TNF-α, and IFN-γ (proinflammatory cytokines) (all P < .05) was observed. CCL2 was positively correlated with TNF-α (P < .01). Thirty-eight bacteria species were detected in primary endodontic infection with apical periodontitis. The first bacteria species-based factor was associated with the size of the radiolucent area (coefficient = 15.42) and tenderness to percussion/pain on palpation (coefficient = 20.79). The second factor was associated with CCL2 levels (coefficient = 1.28). CONCLUSIONS Different bacterial profiles can be differentially related to the expression of inflammatory proteins and the experience of clinical features.
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Affiliation(s)
- Frederico C Martinho
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil; Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland.
| | - Fabio R M Leite
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lidiane M Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Richard P Darveau
- Department of Periodontics, University of Washington, Seattle, Washington
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
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12
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Mahmood AA, AbdulAzeez AR, Hussein HM. The Effect of Smoking Habit on Apical Status of Adequate Endodontically Treated Teeth with and Without Periodontal Involvement. Clin Cosmet Investig Dent 2019; 11:419-428. [PMID: 31920402 PMCID: PMC6941597 DOI: 10.2147/ccide.s236747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background The possible connection between apical periodontitis (AP), periodontal disease (PD) and the bad habit of smoking is among the most interesting aspects faced by the dental scientific community. The aim of this study was to pinpoint the effect of smoking on the status of the apical region, in properly root-filled teeth with and without periodontal involvement of Iraqi males. Materials and methods Total number of 75 patients were chosen, divided into 3 groups of 25’s, teeth were subdivided into 6 subgroups (G-a: Light smokers without Periodontal involvement, G-b: Heavy smokers without Periodontal involvement, G-c: Non-smokers without Periodontal involvement, G-d: Light smokers with Periodontal involvement, G-e: Heavy smokers with Periodontal involvement, G-f: Non-smokers with Periodontal involvement), examination involved: clinical periodontal parameters, coronal restoration fitness. Panoramic and periapical radiographs were used to judge the quality of periodontal tissue in the apical region (AP) of root canal treated teeth. Results Among all the examined teeth (1859), only (89) were found with fitted both coronal and endodontic restorations. Rates of AP were: (G-a: 11.1%, G-b: 25%, G-c: 0%, G-d: 18.8%, G-e: 35.7%, G-f: 4.8%). Statistically, in related to the AP, there was a highly significant difference between heavy smokers’ groups (G-b, G-e). Moreover, heavy smokers with PD (G-e) showed a significant difference with light smokers without PD (G-a) and non-smokers without PD (G-c), also, there was a significant difference between heavy smokers without PD (G-b) and non-smokers with PD (G-f). While, there was a non-significant difference relationship between non–smokers’ groups (G-c, G-f), and light smokers’ groups (G-a, G-d). Conclusion There is a noticeable negative effect of smoking on the severity and prognosis of AP and this negative effect worsens when it is accompanied by lateral periodontitis.
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Affiliation(s)
- Athraa A Mahmood
- Department of Periodontology, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - Ali R AbdulAzeez
- Department of Periodontology, College of Dentistry, Uruk University, Baghdad, Iraq
| | - Hashim M Hussein
- Department of Dentistry, Al-Rafidain University-College, Baghdad, Iraq
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13
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Martinho FC, de Rabello DGD, Ferreira LL, Nascimento GG. Participation of endotoxin in root canal infections: A systematic review and meta-analysis. Eur J Dent 2019; 11:398-406. [PMID: 28932155 PMCID: PMC5594974 DOI: 10.4103/ejd.ejd_84_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features in patients with endodontic infection. Electronic searches were performed on Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge and Scopus databases for identification of relevant studies published up to December 2016. Grey literature was searched in Google Scholar. The selected literature was reviewed independently by two authors. Clinical studies evaluating the levels of endotoxin and the presence of clinical and radiographic features were included in this review. In order to determine the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features meta-analyses were performed. Among the 385 articles identified in the initial search, 30 were included for full-text appraisal and only eight studies met the inclusion criteria for this systematic review. Meta-analysis revealed that individuals having teeth with tenderness to percussion (TTP) (P = 0.04; I2 57%) and previous episode of pain (PEP) (P = 0.001; I2 81%) had higher levels of endotoxin than their counterparts. Size of radiographic lesion >2 mm (P = 0.02; I2 68%) and presence of root canal exudation (EX) (P = 0.0007; I2 0%) were associated with higher levels of endotoxin. This systematic review and meta-analyses provided a strong evidence that endotoxin are related with the presence of clinical signs/symptoms and radiographic features in patients with endodontic infection.
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Affiliation(s)
- Frederico Canato Martinho
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
| | | | - Luciana Louzada Ferreira
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
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14
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Georgiou AC, Crielaard W, Armenis I, de Vries R, van der Waal SV. Apical Periodontitis Is Associated with Elevated Concentrations of Inflammatory Mediators in Peripheral Blood: A Systematic Review and Meta-analysis. J Endod 2019; 45:1279-1295.e3. [PMID: 31542282 DOI: 10.1016/j.joen.2019.07.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/18/2019] [Accepted: 07/28/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Apical periodontitis (AP), except for the local known consequences, may also be a systemic burden. Circulating inflammatory mediators that are released to sustain the AP lesion can in theory harm other bodily tissues. The aim of this systematic review was to summarize the existing evidence on the influence of AP on the peripheral blood levels of inflammatory mediators and markers of systemic stress. METHODS A search of MEDLINE-PubMed, Embase, and Cochrane was conducted up to and including February 2019 to identify studies in 5 different languages. The Newcastle-Ottawa Scale was used for quality assessment of the included studies. RESULTS Twelve of the 20 included studies were case-control studies, and 8 were intervention studies. The data of all the included studies were analyzed descriptively, whereas the data of 11 studies were available for meta-analyses. The study designs were heterogeneous. Nevertheless, the meta-analyses revealed statistically significant differences in C-reactive protein, interleukin 6, and asymmetric dimethylarginine levels between AP subjects and controls in peripheral blood. In addition, the concentration of C3 complement fragment in peripheral blood was significantly lower after the treatment and resolution of AP than before. CONCLUSIONS The existing literature indicates that AP adds on to systemic inflammation by elevating C-reactive protein, interleukin 6, asymmetric dimethylarginine, and C3 levels. In order to overcome the issue of large variation between study designs, future studies should have clear inclusion criteria, preferably larger cohorts, adequate follow-up of all subjects, and a thorough presentation of the data to enable further exploration of the possible burden of AP on general human health. Nevertheless, there is now stronger evidence that AP contributes to low-grade systemic inflammation.
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Affiliation(s)
- Athina Christina Georgiou
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Iakovos Armenis
- Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece; Department of Internal Medicine, "Laiko" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - Suzette V van der Waal
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands; Department of Endodontics, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
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15
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Saliva and Serum Immune Responses in Apical Periodontitis. J Clin Med 2019; 8:jcm8060889. [PMID: 31234349 PMCID: PMC6617293 DOI: 10.3390/jcm8060889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/26/2022] Open
Abstract
Apical periodontitis is an inflammatory reaction at the apex of an infected tooth. Its microbiota resembles that of marginal periodontitis and may induce local and systemic antibodies binding to bacteria- and host-derived epitopes. Our aim was to investigate the features of the adaptive immune response in apical periodontitis. The present Parogene cohort (n = 453) comprises patients with cardiac symptoms. Clinical and radiographic oral examination was performed to diagnose apical and marginal periodontitis. A three-category endodontic lesion score was designed. Antibodies binding to the bacteria- and host-derived epitopes were determined from saliva and serum, and bacterial compositions were examined from saliva and subgingival samples. The significant ORs (95% CI) for the highest endodontic scores were observed for saliva IgA and IgG to bacterial antigens (2.90 (1.01-8.33) and 4.91 (2.48-9.71)/log10 unit), saliva cross-reacting IgG (2.10 (1.48-2.97)), serum IgG to bacterial antigens (4.66 (1.22-10.1)), and Gram-negative subgingival species (1.98 (1.16-3.37)). In a subgroup without marginal periodontitis, only saliva IgG against bacterial antigens associated with untreated apical periodontitis (4.77 (1.05-21.7)). Apical periodontitis associates with versatile adaptive immune responses against both bacterial- and host-derived epitopes independently of marginal periodontitis. Saliva immunoglobulins could be useful biomarkers of oral infections including apical periodontitis-a putative risk factor for systemic diseases.
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16
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Cardoso FGDR, Martinho FC, Ferreira NDS, Prado RFD, Manhães-Júnior LRC, Rocco MA, Valera MC. Correlation Between Volume of Root Canal, Cultivable Bacteria, Bacterial Complexes and Endotoxins in Primary Infection. Braz Dent J 2019; 30:117-122. [PMID: 30970053 DOI: 10.1590/0103-6440201902239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/14/2018] [Indexed: 11/22/2022] Open
Abstract
This clinical study was conducted to correlate the levels of endotoxins and culturable bacteria found in primary endodontic infection (PEI) with the volume of root canal determined by using Cone Beam Computed Tomography (CBCT); and to evaluate the bacterial diversity correlating with clinical features. Twenty patients with PEI were selected and clinical features were recorded. The volume (mm3) of root canal was determined by CBCT analysis. Root canal samples were analyzed by using kinetic LAL-assay test to determine the levels of endotoxins and anaerobic technique to determine the bacterial count (CFU/mL). DNA was extracted from all samples to determine bacterial diversity and quantified by using Checkerboard-DNA-DNA- Hybridization. Culturable bacteria and endotoxins were detected in 100% of the root canal samples. Linear regression analysis revealed a correlation between root canal volume and presence of anaerobic bacteria (p<0.05). Positive correlations were found between bacteria species and presence of different clinical features (p<0.05). After grouping the bacteria species into bacterial complexes, positive associations were found between green, orange and red complexes with presence of sinus tract (p<0.05). This clinical study revealed that larger root canals hold higher levels of culturable bacteria in PEI. Thus, the interaction of different virulent bacteria species in complexes seems to play an important role in the development of clinical features.
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Affiliation(s)
- Flávia Goulart da Rosa Cardoso
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Dentistry, Endodontic Division, University of Taubaté - UNITAU, Taubaté, SP, Brazil
| | - Frederico Canato Martinho
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Advanced Oral Science & Therapeutics, Endodontic Division, University of Maryland, School of Dentistry, Maryland, USA
| | - Nádia de Souza Ferreira
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Semiology, UFPel - Universidade Federal de Pelotas, School of Dentistry, Pelotas, RS, Brazil
| | - Renata Falchete do Prado
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | | | - Marco Antônio Rocco
- Department of Radiology, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
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17
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Álvares PR, de Arruda JAA, Oliveira Silva LV, da Silva LP, do Nascimento GJF, da Silveira MMF, Sobral APV. Immunohistochemical Analysis of Cyclooxygenase-2 and Tumor Necrosis Factor Alpha in Periapical Lesions. J Endod 2018; 44:1783-1787. [DOI: 10.1016/j.joen.2018.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/22/2018] [Accepted: 09/06/2018] [Indexed: 12/19/2022]
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18
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Effectiveness of calcium hydroxide-based intracanal medication on infectious/inflammatory contents in teeth with post-treatment apical periodontitis. Clin Oral Investig 2018; 23:2759-2766. [DOI: 10.1007/s00784-018-2719-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023]
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19
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Gomes BPFDA, Herrera DR. Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res 2018; 32:e69. [PMID: 30365610 DOI: 10.1590/1807-3107bor-2018.vol32.0069] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 12/16/2022] Open
Abstract
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
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Affiliation(s)
| | - Daniel Rodrigo Herrera
- Universidade Estadual de Campinas -Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
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20
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Chow AT, Quah SY, Bergenholtz G, Lim KC, Yu VSH, Tan KS. Bacterial species associated with persistent apical periodontitis exert differential effects on osteogenic differentiation. Int Endod J 2018; 52:201-210. [PMID: 30099741 DOI: 10.1111/iej.12994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/06/2018] [Indexed: 01/11/2023]
Abstract
AIM To determine if bacteria associated with persistent apical periodontitis induce species-specific pro-inflammatory cytokine responses in macrophages, and the effects of this species-specific microenvironment on osteogenic differentiation. METHODOLOGY Macrophages were exposed to Enterococcus faecalis, Streptococcus oralis, Streptococcus mitis, Fusobacterium nucleatum, Treponema denticola or Tannerella forsythia, and levels of TNF-α and IL-1β elicited were determined by immunoassay. Following treatment of MG-63 pre-osteoblasts with conditioned media from bacteria-exposed macrophages, osteogenic differentiation and viability of osteoblasts were analyzed by Alizarin Red Staining and MTS assay, respectively. Statistical analysis was carried out by one-way anova with the Tukey post-hoc test. Differences were considered to be significant if P < 0.05. RESULTS Macrophages exposed to Gram-positive bacteria did not produce significant amounts of cytokines. F. nucleatum-challenged macrophages produced up to four-fold more TNF-α and IL-1β compared to T. denticola or T. forsythia. Only conditioned media from macrophages treated with Gram-negative bacteria decreased mineralization and viability of osteoblasts. CONCLUSIONS Gram-positive bacteria did not impact osteogenic differentiation and appeared innocuous. Gram-negative bacteria, in particular F. nucleatum elicited an enhanced pro-inflammatory response in macrophages, inhibited osteogenic differentiation and reduced cell viability. The findings suggest that the presence of this organism could potentially increase the severity of persistent apical periodontitis.
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Affiliation(s)
- A T Chow
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - S Y Quah
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - G Bergenholtz
- The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - K C Lim
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - V S H Yu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - K S Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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21
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Muniz FWMG, Montagner F, Jacinto RC, Rösing CK, Gomes BPFA. Correlation between crestal alveolar bone loss with intracanal bacteria and apical lesion area in necrotic teeth. Arch Oral Biol 2018; 95:1-6. [PMID: 30025275 DOI: 10.1016/j.archoralbio.2018.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/14/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aimed to analyze the correlation between crestal alveolar bone loss with the presence of some bacterial species in root canals and the apical lesion area of necrotic teeth. DESIGN Data from 20 patients with diagnosis of pulp necrosis and acute apical abscesses, without active periodontal diseases, were evaluated. Patients with history of antibiotic usage three months prior to the study, with exposed pulp cavity, and with probing depth >3 mm were not included. The root size, the distance between the bone crest to the tooth apex in the mesial and distal surfaces, and the apical lesion area were measured from standard periapical radiographies by a calibrated examiner. Root canal samples were collected using sterilized paper points. In multirooted teeth, the largest root canal was sampled. Culture, microbial isolation and identification by phenotypic methods were performed. Spearman correlation and exact Fischer test were calculated between higher/lower existing bone crests, according to the median and the presence of specific bacteria. RESULTS No statistically significant differences were found between occurrence of pathogenic bacteria, such as Porphyromonas gingivalis, Porphyromonas endodontalis, and Prevotella intermedia, and groups with higher/lower degree of bone loss (p > 0.05). A negative significant correlation was found between Parvimonas micra and periodontal bone loss (p = 0.02). Additionally, no statistically significant association was found between crestal bone loss and the apical lesion area. CONCLUSIONS It was concluded that, in patients without active periodontitis, the presence of pathogenic bacteria in the root canal was not correlated with periodontal bone loss.
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Affiliation(s)
- Francisco Wilker M G Muniz
- Department of Periodontology, Faculty of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil.
| | - Francisco Montagner
- Department of Endodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
| | - Rogério C Jacinto
- Department of Endodontics, Araçatuba Dental School, State University of São Paulo, Rua José Bonifácio, 1193, Araçatuba, São Paulo, 16015-050, Brazil.
| | - Cassiano K Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Avenida Limeira, 901, Piracicaba, SP, 13414-903, Brazil.
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22
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Neelakantan P, Herrera DR, Pecorari VGA, Gomes BPFA. Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. Int Endod J 2018; 52:19-27. [DOI: 10.1111/iej.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - D. R. Herrera
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
| | - V. G. A. Pecorari
- Dental Research Division; School of Dentistry; Paulista University; São Paulo SP Brazil
| | - B. P. F. A. Gomes
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
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23
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Clinical comparison of the effectiveness of 7- and 14-day intracanal medications in root canal disinfection and inflammatory cytokines. Clin Oral Investig 2017; 22:523-530. [DOI: 10.1007/s00784-017-2143-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/30/2017] [Indexed: 11/26/2022]
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24
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Martinho FC, Leite FRM, Nóbrega LMM, Endo MS, Nascimento GG, Darveau RP, Gomes BPFA. Comparison of Fusobacterium nucleatum and Porphyromonas gingivalis Lipopolysaccharides Clinically Isolated from Root Canal Infection in the Induction of Pro-Inflammatory Cytokines Secretion. Braz Dent J 2017; 27:202-7. [PMID: 27058385 DOI: 10.1590/0103-6440201600572] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 03/08/2016] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to compare the biological activity of lipopolysaccharides (LPS) purified from Fusobacterium nucleatum and Porphyromonas gingivalis strains, both isolated from primary endodontic infection (PEI) in the levels of IL-1β and TNF-α released by macrophage cells. Moreover, LPS was purified from F. nucleatum and P. gingivalis American Type Collection (ATCC) and its biological activity was compared to respectively clinical isolates strains. F. nucleatum and P. gingivalis strains clinically isolated from PEI had their identification confirmed by sequencing the 16S rRNA gene. LPS from F. nucleatum and P. gingivalis and their respective ATCC strains were extracted by using Tri-reagent method. Macrophages (Raw 264.7) were stimulated with LPS at 100 ng/mL for 4, 8 and 12 h. Secretion of IL-1 β and TNF-α was also determined. Paired t-test, repeated measures ANOVA and one-way ANOVA were employed. All LPS induced significant production of IL-1β and TNF-α, with the former being secreted at higher levels than the latter in all time-points. F. nucleatum induced a higher expression of both cytokines compared to P. gingivalis (p<0.05). No differences were observed between clinical and ATCC strains, as both presented the same potential to induce pro-inflammatory response. It was concluded that F. nucleatum and P. gingivalis LPS presented different patterns of activation against macrophages as seen by the IL-1β and TNF-α production, which may contribute to the immunopathogenesis of apical periodontitis. Moreover, clinical and ATCC strains grown under the same in vitro environment conditions presented similar biological activity.
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Affiliation(s)
- Frederico C Martinho
- Department of Restorative Dentistry, Endodontics Division, São José dos Campos Dental School, Universidade Estadual de São Paulo, São José dos Campos, SP, Brazil
| | - Fábio R M Leite
- Postgraduate Program in Dentistry, Dental School, Universidade Federal de Pelotas, RS, Brazil, Brazil
| | - Letícia M M Nóbrega
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Marcos S Endo
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Gustavo G Nascimento
- Postgraduate Program in Dentistry, Dental School, Universidade Federal de Pelotas, RS, Brazil, Brazil
| | - Richard P Darveau
- Department of Periodontics and Oral Biology, University of Washington, Seattle, WA, USA
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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25
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Cardoso FGDR, Chung A, Martinho FC, Camargo CHR, Carvalho CAT, Gomes BPFDA, Valera MC. Investigation of Bacterial Contents From Persistent Endodontic Infection and Evaluation of Their Inflammatory Potential. Braz Dent J 2017; 27:412-8. [PMID: 27652703 DOI: 10.1590/0103-6440201600520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 05/03/2016] [Indexed: 11/21/2022] Open
Abstract
This clinical study investigated and quantified cultivable bacteria and their levels of endotoxins in persistent endodontic infection, determining their antigenicity against macrophages and fibroblast cells by IL-1β and TNF-α secretion and evaluating their relationship with clinical and radiographic features. Samples from the root canals were obtained after root filling removal. Culture techniques were used to determine the bacterial count and the endotoxins were determined by LAL-assay. PCR analysis (16S rDNA) was used for bacterial detection. Raw 264.5 macrophages and V79 fibroblast were stimulated with endodontic contents. ELISA assay measured the amounts of IL-1ß/TNF-?#61537; secretion. Bacteria and endotoxin medians were 1.24x105 CFU/mL and 9.62 EU/mL, respectively. Porphyromonas endodontalis was the most frequently detected species. Higher levels of endotoxins were found in teeth with pain on palpation (23.56 EU/mL) rather than in its absence (8.21 EU/mL). Larger areas of bone destruction were related to higher levels of endotoxins and IL-1β and TNF-α secretion. The study findings revealed the presence of Gram-negative bacteria species in persistent endodontic infection, with their endotoxins related to both severity of bone destruction and development of symptomatology. Moreover, larger areas of bone destruction were related to higher levels of IL-1β and TNF-α secreted by macrophages and fibroblast cells.
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Affiliation(s)
- Flávia Goulart da Rosa Cardoso
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Odontology, Endodontic Division, UNITAU - Universidade de Taubaté, Taubaté, SP, Brazil
| | - Adriana Chung
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Frederico Canato Martinho
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Carlos Henrique Ribeiro Camargo
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Claudio Antônio Talge Carvalho
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | | | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
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Liljestrand J, Mäntylä P, Paju S, Buhlin K, Kopra K, Persson G, Hernandez M, Nieminen M, Sinisalo J, Tjäderhane L, Pussinen P. Association of Endodontic Lesions with Coronary Artery Disease. J Dent Res 2016; 95:1358-1365. [DOI: 10.1177/0022034516660509] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finnish Parogene study consists of 508 patients (mean age, 62 y) who underwent coronary angiography and extensive clinical and radiographic oral examination. The cardiovascular outcomes included no significant CAD ( n = 123), stable CAD ( n = 184), and acute coronary syndrome (ACS; n = 169). EL was determined from a panoramic tomography. We combined data of widened periapical spaces (WPSs) and apical rarefactions to a score of EL: 1, no EL ( n = 210); 2, ≥1 WPS per 1 apical rarefaction ( n = 222); 3, ≥2 apical rarefactions ( n = 76). Subgingival P. endodontalis was defined by checkerboard DNA-DNA hybridization analysis, and corresponding serum antibodies were determined by ELISA. In our population, 50.4% had WPSs, and 22.8% apical rarefactions. A total of 51.2% of all teeth with apical rarefactions had received endodontic procedures. Subgingival P. endodontalis levels and serum immunoglobulin G were associated with a higher EL score. In the multiadjusted model (age, sex, smoking, diabetes, body mass index, alveolar bone loss, and number of teeth), having WPSs associated with stable CAD (odds ratio [OR] = 1.94, 95% confidence interval [95% CI] = 1.13 to 3.32, P = 0.016) and highest EL score were associated with ACS (OR = 2.46, 95% CI = 1.09 to 5.54, P = 0.030). This association was especially notable in subjects with untreated teeth with apical rarefactions ( n = 59, OR = 2.72, 95% CI = 1.16 to 6.40, P = 0.022). Our findings support the hypothesis that ELs are independently associated with CAD and in particular with ACS. This is of high interest from a public health perspective, considering the high prevalence of ELs and CAD.
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Affiliation(s)
- J.M. Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P. Mäntylä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S. Paju
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K. Buhlin
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - K.A.E. Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - G.R. Persson
- Departments of Oral Medicine, and Periodontics, University of Washington, Seattle, Washington, USA
| | - M. Hernandez
- Laboratory of Periodontal Biology and Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - M.S. Nieminen
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - J. Sinisalo
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - L. Tjäderhane
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Unit of Oral Health Sciences, and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - P.J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Gama TGV, Pires FR, Armada L, Gonçalves LS. Cellular Profile and Expression of Immunologic Markers in Chronic Apical Periodontitis from HIV-infected Patients Undergoing Highly Active Antiretroviral Therapy. J Endod 2016; 42:921-7. [PMID: 27118467 DOI: 10.1016/j.joen.2016.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 03/07/2016] [Accepted: 03/13/2016] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This study tested the hypothesis that the inflammatory cell profile (CD3-, CD4-, CD8-, CD20-, and CD68-positive cells) and the expression of immunologic markers (tumor necrosis factor α, interferon-γ, interleukin-6, and interleukin-18) in chronic apical periodontitis are the same between non-HIV-infected patients and HIV-infected patients undergoing highly active antiretroviral therapy (HAART). METHODS Thirty-four surgically excised chronic apical periodontitis lesions were sampled from 34 patients (17 HIV-infected and 17 non-HIV-infected). The lesions were extracted from teeth with no previous endodontic treatment. All HIV-infected patients were undergoing HAART. The specimens were submitted to histopathologic and immunohistochemical analyses by using an optical microscope. Immunoexpression was graded into 2 levels, focal to weak and moderate to strong. The χ(2), Fisher exact, and Mann-Whitney tests were used to analyze all significant differences between groups. RESULTS Periapical cysts represented 70.6% and 52.9% of the lesions in the HIV-infected and non-HIV-infected groups, respectively; however, no statistically significant difference was observed (P = .481). There were no statistically significant differences between groups for the inflammatory cell profile and for any of the immunologic markers (P > .05). CONCLUSIONS There are no statistically significant differences of the cellular profile and expression of immunologic markers in chronic apical periodontitis between non-HIV-infected patients and HIV-infected patients undergoing HAART.
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Affiliation(s)
- Túlio Gustavo Veiga Gama
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabio Ramoa Pires
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Armada
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucio Souza Gonçalves
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
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Quantification of Lipoteichoic Acid Contents and Cultivable Bacteria at the Different Phases of the Endodontic Retreatment. J Endod 2016; 42:552-6. [DOI: 10.1016/j.joen.2016.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/15/2015] [Accepted: 01/10/2016] [Indexed: 12/20/2022]
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Marinho ACS, Polay ARO, Gomes BPFA. Accuracy of Turbidimetric Limulus Amebocyte Lysate Assay for the Recovery of Endotoxin Interacted with Commonly Used Antimicrobial Agents of Endodontic Therapy. J Endod 2015; 41:1653-9. [PMID: 26254546 DOI: 10.1016/j.joen.2015.05.020] [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: 03/25/2015] [Revised: 05/29/2015] [Accepted: 05/30/2015] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This study was conducted to investigate whether the interaction between the turbidimetric limulus amebocyte lysate (LAL) substrate for endotoxin measurement and the substances/antimicrobial agents used in endodontic therapy can lead to the inhibition/enhancement of endotoxin recovery. METHODS Ten microliters of a suspension of Escherichia coli endotoxin (O55:B55) was inoculated and kept in contact for 1 hour with different substances categorized as follows: group 1: auxiliary chemical substances: 5.25% and 2.5% sodium hypochlorite solutions, 2% chlorhexidine (CHX) (gel and solution), 1% Natrosol gel (Drogal Chemicals and Pharmaceuticals Ltd, Piracicaba, SP, Brazil), 17% EDTA, 10% citric acid, 3% hydrogen peroxide, 5% sodium thiosulfate, and 0.5% Tween 80 associated with 0.07% soy lecithin (Drogal Chemicals and Pharmaceuticals Ltd) and group 2: intracanal medications: neomycin/polymyxin B/hydrocortisone (Otosporin; Glaxo Wellcome, Rio de Janeiro, RJ, Brazil); calcium hydroxide (Ca[OH]2); Ca(OH)2 + 2% CHX gel; Ca(OH)2 + 2% CHX gel + zinc oxide eugenol; Ca(OH)2 + camphorated paramonochlorophenol (Calen; S.S. White, Rio de Janeiro, RJ, Brazil); triple antibiotic paste; mineral trioxide aggregate (MTA); and iodoform. Positive and negative controls consisted of root canal hemorrhagic exudate and pyrogen-free sterile water, respectively. All samples were diluted up to a 10:4 dilution. Each dilution was individually examined by the turbidimetric LAL assay. Collected data were analyzed through performance characteristics of the LAL assay such as linearity, coefficient of variation percentage, and product positive control (PPC) values. RESULTS Correlation coefficient (≥0.980) and coefficient of variation percentage (<10%) of the standard curve in triplicate showed the tests' linearity. Spike recovery of auxiliary chemical substances achieved PPC values ranging from 50%-197%, showing no interferences with LAL substrate. Conversely, 3% hydrogen peroxide achieved product inhibition in which endotoxin values were underestimated even after the 10:4 dilutions. Regarding intracanal medicaments, neomycin/polymyxin B/hydrocortisone also inhibited endotoxin detection in all dilutions investigated (PPC values <50%). In contrast, Ca(OH)2 + 2% CHX gel + ZOE as well as triple antibiotic paste led to the enhancement of endotoxin detection in which endotoxin values could not be validated by the turbidimetric kinetic LAL assay (PPC value >200%). CONCLUSIONS The performance characteristics of the kinetic turbidimetric assay for endotoxin measurement, such as precision and reproducibility, are modulated by the interaction of the LAL substrate with the substances/antimicrobial agents used in endodontic therapy.
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Affiliation(s)
- Ariane C S Marinho
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School-State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Ana R O Polay
- Lonza do Brasil Especialidades Químicas, Brooklin Novo, São Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School-State University of Campinas, Piracicaba, São Paulo, Brazil.
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Lu B, Zhang J, Huang X, Xiao S, Zhang M, Cai Z. Expression of Interleukin-1β and Matrix Metalloproteinase-8 in Cytolytic and Noncytolytic Enterococcus faecalis–induced Persistent Apical Periodontitis: A Comparative Study in the Rat. J Endod 2015; 41:1288-93. [DOI: 10.1016/j.joen.2015.04.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 03/18/2015] [Accepted: 04/28/2015] [Indexed: 01/12/2023]
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Sato Y, Yamagishi J, Yamashita R, Shinozaki N, Ye B, Yamada T, Yamamoto M, Nagasaki M, Tsuboi A. Inter-Individual Differences in the Oral Bacteriome Are Greater than Intra-Day Fluctuations in Individuals. PLoS One 2015; 10:e0131607. [PMID: 26121551 PMCID: PMC4487993 DOI: 10.1371/journal.pone.0131607] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/03/2015] [Indexed: 01/15/2023] Open
Abstract
Given the advent of massively parallel DNA sequencing, human microbiome is analyzed comprehensively by metagenomic approaches. However, the inter- and intra-individual variability and stability of the human microbiome remain poorly characterized, particularly at the intra-day level. This issue is of crucial importance for studies examining the effects of microbiome on human health. Here, we focused on bacteriome of oral plaques, for which repeated, time-controlled sampling is feasible. Eighty-one supragingival plaque subjects were collected from healthy individuals, examining multiple sites within the mouth at three time points (forenoon, evening, and night) over the course of 3 days. Bacterial composition was estimated by 16S rRNA sequencing and species-level profiling, resulting in identification of a total of 162 known bacterial species. We found that species compositions and their relative abundances were similar within individuals, and not between sampling time or tooth type. This suggests that species-level oral bacterial composition differs significantly between individuals, although the number of subjects is limited and the intra-individual variation also occurs. The majority of detected bacterial species (98.2%; 159/162), however, did not fluctuate over the course of the day, implying a largely stable oral microbiome on an intra-day time scale. In fact, the stability of this data set enabled us to estimate potential interactions between rare bacteria, with 40 co-occurrences supported by the existing literature. In summary, the present study provides a valuable basis for studies of the human microbiome, with significant implications in terms of biological and clinical outcomes.
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Affiliation(s)
- Yukuto Sato
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
| | - Junya Yamagishi
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
- Division of Collaboration and Education, Research Center for Zoonosis Control, Hokkaido University, North 20, West 10 Kita-ku, Sapporo, Hokkaido, 001–0020, Japan
- Global Station for Zoonosis Control, GI-CoRE, Hokkaido University, North 20, West 10 Kita-ku, Sapporo, Hokkaido, 001–0020, Japan
| | - Riu Yamashita
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
| | - Natsuko Shinozaki
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
| | - Bin Ye
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
| | - Takuji Yamada
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
- Department of Bioinformation, School and Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, 4259 Nagatsutacho, Midoriku, Yokohama, Kanagawa, 226–8501, Japan
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
| | - Masao Nagasaki
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
- * E-mail: (MN); (AT)
| | - Akito Tsuboi
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, 2–1, Seiryo-machi, Aoba-ku, Sendai, 980–8573, Japan
- * E-mail: (MN); (AT)
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Marinho AC, Martinho FC, Leite FR, Nascimento GG, Gomes BP. Proinflammatory Activity of Primarily Infected Endodontic Content against Macrophages after Different Phases of the Root Canal Therapy. J Endod 2015; 41:817-23. [DOI: 10.1016/j.joen.2015.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/27/2014] [Accepted: 01/17/2015] [Indexed: 10/23/2022]
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Prevalence of Treponema Species Detected in Endodontic Infections: Systematic Review and Meta-regression Analysis. J Endod 2015; 41:579-87. [DOI: 10.1016/j.joen.2015.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/25/2014] [Accepted: 01/17/2015] [Indexed: 11/20/2022]
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Cardoso FGR, Ferreira NS, Martinho FC, Nascimento GG, Manhães LRC, Rocco MA, Carvalho CAT, Valera MC. Correlation between Volume of Apical Periodontitis Determined by Cone-beam Computed Tomography Analysis and Endotoxin Levels Found in Primary Root Canal Infection. J Endod 2015; 41:1015-9. [PMID: 25935504 DOI: 10.1016/j.joen.2015.02.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 12/09/2014] [Accepted: 02/04/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This clinical study was conducted to correlate the levels of endotoxins and bacterial counts found in primary endodontic infection with the volume of periapical bone destruction determined by cone-beam computed tomography (CBCT) analysis. Moreover, the levels of bacteria and endotoxins were correlated with the development of clinical features. METHODS Twenty-four root canals with primary endodontic disease and apical periodontitis were selected. Clinical features such as pain on palpation, pain on percussion, and previous episode of pain were recorded. The volume (cubic millimeters) of periapical bone destruction was determined by CBCT analysis. Endotoxins and bacterial samplings were collected by using sterile/apyrogenic paper points. Endotoxins were quantified by using limulus amebocyte lysate assay (KQCL test), and bacterial count (colony-forming units [CFU]/mL) was determined by using anaerobic culture techniques. Data were analyzed by Pearson correlation and multiple logistic regression (P < .05). RESULTS Endotoxins and bacteria were detected in 100% of the root canal samples (24 of 24), with median values of 10.92 endotoxin units (EU)/mL (1.75-128 EU/mL) and 7.5 × 10(5) CFU/mL (3.20 × 10(5)-8.16 × 10(6) CFU/mL), respectively. The median volume of bone destruction determined by CBCT analysis was 100 mm(3) (10-450 mm(3)). The multiple regression analysis revealed a positive correlation between higher levels of endotoxins present in root canal infection and larger volume of bone destruction (P < .05). Moreover, higher levels of endotoxins were also correlated with the presence of previous pain (P < .05). CONCLUSIONS Our findings revealed that the levels of endotoxins found in root canal infection are related to the volume of periapical bone destruction determined by CBCT analysis. Moreover, the levels of endotoxin are related to the presence of previous pain.
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Affiliation(s)
- Flávia G R Cardoso
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Nádia S Ferreira
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Frederico C Martinho
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Gustavo G Nascimento
- Department of Semiology, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil
| | - Luiz R C Manhães
- Department of Radiology, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Marco A Rocco
- Department of Radiology, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Cláudio A T Carvalho
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Institute of Science Technology, Universidade Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil.
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Caetano da Silva SD, Mendes de Souza MG, Oliveira Cardoso MJ, da Silva Moraes T, Ambrósio SR, Sola Veneziani RC, Martins CHG. Antibacterial activity of Pinus elliottii against anaerobic bacteria present in primary endodontic infections. Anaerobe 2014; 30:146-52. [PMID: 25270831 DOI: 10.1016/j.anaerobe.2014.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/28/2014] [Accepted: 09/19/2014] [Indexed: 11/29/2022]
Abstract
Endodontic infections have a polymicrobial nature, but anaerobic bacteria prevail among the infectious microbes. Considering that it is easy to eliminate planktonic bacteria, biofilm-forming bacteria still challenge clinicians during the fight against endodontic diseases. The chemical constituents of the oleoresin of Pinus elliottii, a plant belonging to the family Pinaceae, stand out in the search for biologically active compounds based on natural products with potential application in the treatment of endodontic infections. Indeed, plant oleoresins are an abundant natural source of diterpenes that display significant and well-defined biological activities as well as potential antimicrobial action. In this context, this study aimed to (1) evaluate the in vitro antibacterial activity of the oleoresin, fractions, and subfractions of P. elliottii as well as the action of dehydroabietic acid against 11 anaerobic bacteria that cause endodontic infection in both their planktonic and biofilm forms and (2) assess the in vitro antibiofilm activity of dehydroabietic acid against the same group of bacteria. The broth microdilution technique helped to determine the minimum inhibitory concentration (MIC) of the oleoresin and fractions. This same technique aided determination of the MIC values of nine subfractions of Fraction 1, the most active fraction. The MIC, minimum bactericidal concentration, and antibiofilm activity of dehydroabietic acid against the tested anaerobic bacteria were also examined. The oleoresin and fractions, especially fraction PE1, afforded promising MIC values, which ranged from 0.4 to 50 μg/mL. Concerning the nine evaluated subfractions, PE1.3 and PE1.4 furnished the most noteworthy MIC values, between 6.2 and 100 μg/mL. Dehydroabietic acid displayed antibacterial activity, with MIC values lying from 6.2 to 50 μg/mL, as well as bactericidal effect for all the investigated bacteria, except for Prevotella nigrescens. Assessment of the antibiofilm activity revealed significant results--MICB50 lay between 7.8 and 62.5 μg/mL, and dehydroabietic acid prevented all the evaluated bacteria from forming a biofilm. Hence, the chemical constituents of P. elliottii are promising biomolecules to develop novel therapeutic strategies to fight against endodontic infections.
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Affiliation(s)
| | | | | | - Thais da Silva Moraes
- Laboratório de Pesquisa em Microbiologia Aplicada, Universidade de Franca, Franca, São Paulo, Brazil
| | | | | | - Carlos Henrique G Martins
- Laboratório de Pesquisa em Microbiologia Aplicada, Universidade de Franca, Franca, São Paulo, Brazil.
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Sousa ELR, Martinho FC, Leite FRM, Nascimento GG, Gomes BPFA. Macrophage cell activation with acute apical abscess contents determined by interleukin-1 Beta and tumor necrosis factor alpha production. J Endod 2014; 40:1752-7. [PMID: 25205261 DOI: 10.1016/j.joen.2014.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/22/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This clinical study has investigated the antigenic activity of bacterial contents from exudates of acute apical abscesses (AAAs) and their paired root canal contents regarding the stimulation capacity by levels of interleukin (IL)-1 beta and tumor necrosis factor alpha (TNF-α) throughout the root canal treatment against macrophage cells. METHODS Paired samples of infected root canals and exudates of AAAs were collected from 10 subjects. Endodontic contents were sampled before (root canal sample [RCS] 1) and after chemomechanical preparation (RCS2) and after 30 days of intracanal medication with calcium hydroxide + chlorhexidine gel (Ca[OH]2 + CHX gel) (RCS3). Polymerase chain reaction (16S rDNA) was used for detection of the target bacteria, whereas limulus amebocyte lysate was used to measure endotoxin levels. Raw 264.7 macrophages were stimulated with AAA exudates from endodontic contents sampled in different moments of root canal treatment. Enzyme-linked immunosorbent assays were used to measure the levels of TNF-α and IL-1 beta. RESULTS Parvimonas micra, Porphyromonas endodontalis, Dialister pneumosintes, and Prevotella nigrescens were the most frequently detected species. Higher levels of endotoxins were found in samples from periapical exudates at RCS1 (P < .005). In fact, samples collected from periapical exudates showed a higher stimulation capacity at RCS1 (P < .05). A positive correlation was found between endotoxins from exudates with IL-1 beta (r = 0.97) and TNF-α (r = 0.88) production (P < .01). The significant reduction of endotoxins and bacterial species achieved by chemomechanical procedures (RCS2) resulted in a lower capacity of root canal contents to stimulate the cells compared with that at RCS1 (P < .05). The use of Ca(OH)2 + CHX gel as an intracanal medication (RCS3) improved the removal of endotoxins and bacteria from infected root canals (P < .05) whose contents induced a lower stimulation capacity against macrophages cells at RCS1, RCS2, and RCS3 (P < .05). CONCLUSIONS AAA exudates showed higher levels of endotoxins and showed a greater capacity of macrophage stimulation than the paired root canal samples. Moreover, the use of intracanal medication improved the removal of bacteria and endotoxins from infected root canals, which may have resulted in the reduction of the inflammatory potential of the root canal content.
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Affiliation(s)
- Ezilmara L R Sousa
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil; Department of Conservative Dentistry, Endodontics Division, Pelotas School of Dentistry
| | - Frederico C Martinho
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil; Department of Restorative Dentistry, Endodontics Division, São Jose dos Campos Dental School, State University of São Paulo, UNESP, São Jose dos Campos, São Paulo, Brazil
| | | | - Gustavo G Nascimento
- Pelotas School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil.
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Marinho ACS, Martinho FC, Zaia AA, Ferraz CCR, Gomes BPFDA. Monitoring the effectiveness of root canal procedures on endotoxin levels found in teeth with chronic apical periodontitis. J Appl Oral Sci 2014; 22:490-5. [PMID: 25075670 PMCID: PMC4307761 DOI: 10.1590/1678-775720130664] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 03/27/2014] [Indexed: 11/21/2022] Open
Abstract
Objective: The aim of this study was to monitor the effectiveness of root canal procedures by
using different irrigants and intracanal medication on endotoxin levels found in
root canals of teeth with chronic apical periodontitis. Material and Methods: Thirty root canals of teeth with pulpal necrosis associated with periapical
lesions were selected and randomly divided into groups according to the irrigants
used: GI - 2.5% NaOCl, GII - 2% chlorhexidine (CHX) gel, and GIII - saline
solution (SS) (all, n=10). Samples were collected with sterile/apyrogenic paper
points before (S1) and after root canal instrumentation (S2), after use of 17%
ethylenediaminetetraacetic acid (EDTA) (S3), and after 30 days of intracanal
medication (Ca(OH)2+SS) (S4). A turbidimetric kinetic Limulus Amebocyte
Lysate assay was used for endotoxin measurement. Results: Endotoxins were detected in 100% of the root canals investigated (30/30), with a
median value of 18.70 EU/mL. After S2, significant median percentage reduction was
observed in all groups, irrespective of the irrigant tested: 2.5% NaOCl (99.65%)
(GI), 2% CHX (94.27%) (GII), and SS (96.79%) (GIII) (all p<0.05). Root canal
rinse with 17% EDTA (S3) for a 3-minute period failed to decrease endotoxin levels
in GI and a slight decrease was observed in GII (59%) and GIII (61.1%) (all
p>0.05). Intracanal medication for 30 days was able to significantly reduce
residual endotoxins: 2.5% NaOCl (90%) (GI), 2% CHX (88.8%) (GII), and SS (85.7%)
(GIII, p<0.05). No differences were found in the endotoxin reduction when
comparing s2 and s4 treatment groups. Conclusion: Our findings demonstrated the effectiveness of the mechanical action of the
instruments along with the flow and backflow of irrigant enduring root canal
instrumentation for the endotoxin removal from root canals of teeth with chronic
apical periodontitis. Moreover, the use of intracanal medication for 30 days
contributed for an improvement of endotoxin reduction.
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Endo MS, Ferraz CCR, Zaia AA, Almeida JFA, Gomes BPFA. Quantitative and qualitative analysis of microorganisms in root-filled teeth with persistent infection: Monitoring of the endodontic retreatment. Eur J Dent 2014; 7:302-309. [PMID: 24926210 PMCID: PMC4053619 DOI: 10.4103/1305-7456.115414] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim of this study was to investigate in vivo microorganisms detected in root-filled teeth with post-treatment apical periodontitis and quantify colony-forming units (CFU) during endodontic retreatment. Materials and Methods: Fifteen root-filled teeth had their previous gutta-percha removed and were randomly instrumented before being divided into three groups and medicated with either [Ca(OH)2 + 2% CHX gel], [Ca(OH)2 + 0.9% NaCl] or 2% CHX gel. Samples were taken after removal of gutta-percha (S1), after chemomechanical preparation using 2% CHX gel (S2), and after inter-appointment dressing (S3) for 7 or 14 days later. Cultivable bacteria recovered from infected root canals at the three stages were counted and identified by means of culture and PCR assay (16S rDNA). Quantitative data were statistically analyzed by using Mann-Whitney test in which pairs of groups were compared (P < 0.05). Results: CFU counts decreased significantly from S1 to S2 (P < 0.05). No significant difference was found between S2 and S3 (P = 0.3093) for all three experimental groups. Chemomechanical preparation and intra-canal dressing promoted significant median reductions of 99.61% and 99.57%, respectively, in the number of bacteria compared to S1 samples. A total of 110 cultivable isolates were recovered by culture technique from 32 different species and 7 different genera. Out of the 13 target species-specific primer of bacteria analyzed, 11 were detected during endodontic retreatment. Conclusion: The great majority of taxa found in post-treatment samples were Gram-positive bacteria, although Gram-negative bacteria were found by molecular methods. Moreover, our results showed that gutta-percha removal and chemomechanical preparation are effective for root canal disinfection, whereas additional intra-canal dressing did not improve disinfection.
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Affiliation(s)
- Marcos S Endo
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School - State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Caio C R Ferraz
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School - State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Alexandre A Zaia
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School - State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Jose F A Almeida
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School - State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School - State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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Martinho FC, Leite FR, Chiesa WM, Nascimento GG, Feres M, Gomes BP. Signaling Pathways Activation by Primary Endodontic Infectious Contents and Production of Inflammatory Mediators. J Endod 2014; 40:484-9. [DOI: 10.1016/j.joen.2013.10.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 10/11/2013] [Accepted: 10/18/2013] [Indexed: 11/29/2022]
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Clinical investigation of bacterial species and endotoxin in endodontic infection and evaluation of root canal content activity against macrophages by cytokine production. Clin Oral Investig 2014; 18:2095-102. [PMID: 24535073 DOI: 10.1007/s00784-014-1198-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION This study investigated the presence of different Gram-negative bacterial species and the levels of endotoxins found in primary endodontic infection (PEI), determining their stimulation ability against macrophages through the levels of interleukin (IL)-1, IL-6, IL-10, and tumor necrosis factor alpha (TNF-α), and evaluated their relationship with clinical and radiographic findings. MATERIAL AND METHODS Samples were taken from 21 root canals with primary endodontic infection with apical periodontitis (PEIAP). Molecular techniques were used for bacterial detection. Limulus amebocyte lysate assay was used to measure endotoxins. Pro-inflammatory cytokines were measured by ELISA assay. RESULTS All samples were positive for bacterial DNA (21/21). Prevotella nigrescens (57.2 %) was the most frequent species. Higher levels of endotoxins were found in teeth with pain on palpation and exudation (all p < 0.05). Positive correlations were found between endotoxins and the levels of TNF-α and IL-1β, whereas a negative correlation was found between endotoxin and the amount of IL-10 (p < 0.05). Endotoxin levels were found to be a risk factor for exudation and increased the number of Gram-negative bacterial species for the presence of a larger area of bone destruction (all p < 0.05). CONCLUSION A wide variety of Gram-negative bacterial species are involved in primary endodontic infection, with participation of different Treponema species. Thus, the levels of endotoxins and the number of Gram-negative bacteria species present in root canals were considered risk factors for the severity of endodontic infection. CLINICAL RELEVANCE The present study revealed that Gram-negative bacterial species and endotoxins play an important role in the development of signs/symptoms and the severity of bone destruction, this knowledge is essential for the establishment of an effective therapy.
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Sousa EL, Martinho FC, Nascimento GG, Leite FR, Gomes BP. Quantification of Endotoxins in Infected Root Canals and Acute Apical Abscess Exudates: Monitoring the Effectiveness of Root Canal Procedures in the Reduction of Endotoxins. J Endod 2014; 40:177-81. [DOI: 10.1016/j.joen.2013.10.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/06/2013] [Accepted: 10/07/2013] [Indexed: 10/25/2022]
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One-Visit Versus Two-Visit Root Canal Treatment: Effectiveness in the Removal of Endotoxins and Cultivable Bacteria. J Endod 2013; 39:959-64. [DOI: 10.1016/j.joen.2013.04.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 03/06/2013] [Accepted: 04/03/2013] [Indexed: 11/22/2022]
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Marinho ACS, Martinho FC, Zaia AA, Ferraz CCR, Gomes BPFDA. Influence of the apical enlargement size on the endotoxin level reduction of dental root canals. J Appl Oral Sci 2013; 20:661-6. [PMID: 23329249 PMCID: PMC3881856 DOI: 10.1590/s1678-77572012000600012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 09/17/2012] [Indexed: 11/22/2022] Open
Abstract
Gram-negative bacteria play an essential role in endodontic infections because they
have virulence factors such as endotoxin. Due to its potential cytotoxic activity,
special attention has been given to the removal/neutralization of this endotoxin in
the root canal system.
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Affiliation(s)
- Ariane Cassia Salustiano Marinho
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
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Elevated Tumor Necrosis Factor-alpha Expression in Periapical Lesions Infected by Epstein-Barr Virus. J Endod 2013; 39:456-60. [DOI: 10.1016/j.joen.2012.12.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/13/2012] [Accepted: 12/30/2012] [Indexed: 11/22/2022]
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Gomes BPFA, Endo MS, Martinho FC. Comparison of endotoxin levels found in primary and secondary endodontic infections. J Endod 2013; 38:1082-6. [PMID: 22794210 DOI: 10.1016/j.joen.2012.04.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/12/2012] [Accepted: 04/24/2012] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This clinical study was conducted to compare the levels of endotoxins (lipopolysaccharides [LPSs]) found in primary and secondary endodontic infections with apical periodontitis by correlating LPS contents with clinical/radiographic findings. In addition, the presence of target gram-negative anaerobic bacteria was also investigated. METHODS Samples were taken from 15 root canals with primary infections and 15 with secondary infections by using paper points. The limulus amebocyte lysate assay was used to quantify endotoxins, and the polymerase chain reaction technique (16S rDNA) was used for bacterial investigation. RESULTS Endotoxins were detected in 100% of the root canal samples collected from primary (15/15) and secondary (15/15) infections with median values of 7.49 EU/mL and 3.96 EU/mL, respectively (P < .05). The median value of endotoxins found in the presence of clinical symptoms was significantly higher than in asymptomatic teeth with primary infections (P < .05). A positive correlation was found between endotoxin contents and a larger size of the radiolucent area (>3 mm) (P < .05). Prevotella nigrescens (10/15, 4/15), Fusobacterium nucleatum (5/15, 1/15), Treponema denticola (3/15, 1/15), and Treponema socranskii (5/15, 1/15) were detected in teeth with primary and secondary infections, respectively. P. endodontalis was present only in teeth with primary infections (5/15). CONCLUSIONS Teeth with primary endodontic infections had higher contents of endotoxins and a more complex gram-negative bacterial community than teeth with secondary infections. Moreover, the levels of endotoxins were related to the severity of bone destruction in periapical tissues as well as the development of clinical features in teeth with primary infections.
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Affiliation(s)
- Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, São Paulo, SP, Brazil.
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de Oliveira LD, Carvalho CAT, Carvalho AS, de Souza Alves J, Valera MC, Jorge AOC. Efficacy of Endodontic Treatment for Endotoxin Reduction in Primarily Infected Root Canals and Evaluation of Cytotoxic Effects. J Endod 2012; 38:1053-7. [DOI: 10.1016/j.joen.2012.04.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 04/13/2012] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
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Endo MS, Martinho FC, Zaia AA, Ferraz CCR, Almeida JFA, Gomes BPFA. Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation. Eur J Clin Microbiol Infect Dis 2012; 31:2575-83. [DOI: 10.1007/s10096-012-1598-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
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Wagner C, Barth VC, de Oliveira SD, Campos MM. Effectiveness of the proton pump inhibitor omeprazole associated with calcium hydroxide as intracanal medication: an in vivo study. J Endod 2011; 37:1253-7. [PMID: 21846542 DOI: 10.1016/j.joen.2011.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/02/2011] [Accepted: 06/03/2011] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the efficacy of the association of a proton pump inhibitor (omeprazole) with Ca(OH)(2) as intracanal medication in a rat model of periapical lesions. METHODS Periapical lesions were induced on the first right mandibular molar tooth of 36 male Wistar rats (6 per group). After 28 days, the distal canal of each tooth was prepared, filled with the respective dressing (negative control group, PEG 400; positive control group, Ca(OH)(2) + PEG400; test group, Ca(OH)(2) + omeprazole + PEG 400), and sealed with amalgam for 15 or 28 days. Microbiological samples were taken in 3 periods: S1, after 28 days of lesion induction; S2, after the biomechanical preparation; and S3, after the medication (15 and 28 days). RESULTS The radiographic and histologic analysis revealed that either Ca(OH)(2) or Ca(OH)(2) plus omeprazole dressings produced a reduction of periapical lesions at 28 days, when compared with the negative control group. The reduction of periapical lesions and inflammatory cell infiltration was visibly improved by associating omeprazole with Ca(OH)(2), with an increase of reparative bone areas. The microbiological assessment showed a significant decrease of colony-forming units count from S1 to S2 or S3 collecting times, but no differences were observed between the S2 and the S3 time-periods or among the experimental groups within the S3 period. Further bacterial characterization showed a possible selective activity of the medications. CONCLUSIONS Our data showed that association of omeprazole with Ca(OH)(2) favored a superior repair of rat periapical lesions and seemed to display different selective activity over endodontic microbiota, in comparison with the conventional Ca(OH)(2) dressing.
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Affiliation(s)
- Cláudia Wagner
- Postgraduate Program of Dental College, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Segura-Egea JJ, Castellanos-Cosano L, Velasco-Ortega E, Ríos-Santos JV, Llamas-Carreras JM, Machuca G, López-Frías FJ. Relationship between Smoking and Endodontic Variables in Hypertensive Patients. J Endod 2011; 37:764-7. [DOI: 10.1016/j.joen.2011.03.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 03/17/2011] [Accepted: 03/17/2011] [Indexed: 11/26/2022]
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50
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Martinho FC, Chiesa WMM, Zaia AA, Ferraz CCR, Almeida JFA, Souza-Filho FJ, Gomes BPFA. Comparison of endotoxin levels in previous studies on primary endodontic infections. J Endod 2011; 37:163-7. [PMID: 21238796 DOI: 10.1016/j.joen.2010.11.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 11/11/2010] [Accepted: 11/12/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study was performed to determine which of the quantitative methods, namely, chromogenic endpoint, chromogenic kinetic, and turbidimetric kinetic ones, best fit for the analysis of primary endodontic infections. METHODS Twenty-one root canals with apical periodontitis were sampled with paper points. The same sample was analyzed by means of the endpoint chromogenic Limulus amebocyte lysate (LAL) assay (QCL), quantitative kinetic chromogenic LAL assay (KQCL), and kinetic turbidimetric LAL assay (Turbidimetric). RESULTS All three LAL methods were effective in the recovery of endotoxin from root canal infection. Regardless of the method tested, endotoxin was detected in 100% of the root canals (21/21). The KQCL assay yielded a median value of endotoxin of 7.49 EU/mL, close to and not significantly different from those for the turbidimetric test (9.19 EU/mL) (both kinetic methods) (p > 0.05). In contrast, the endpoint QCL showed a median value of 34.20 EU/mL (p < 0.05). The comparison of the three methods revealed that both turbidimetric and KQCL methods were more precise, with best reproducibility (the coefficient variation between analysis of the root canal and its duplicate was lower than 10%). The inhibition/enhancement assay indicated a good interaction between the root canal samples with the turbidimetric method. CONCLUSION This study has revealed that quantitative kinetic-turbidimetric and kinetic-chromogenic LAL methods are best fitted for the analysis of endotoxins in root canal infection, both being more precise and allowing better reproducibility compared with the endpoint-QCL assay.
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Affiliation(s)
- Frederico C Martinho
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Sao Paulo, SP, Brazil
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