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Cantiga-Silva C, de Oliveira PHC, Faria FD, Justo MP, Sivieri-Araújo G, Ervolino E, Pinheiro TN, Segura-Egea JJ, Cintra LTA. Increase Toll-like receptors 2 and 4 in apical periodontitis of rats with chronic liver disease. Odontology 2024:10.1007/s10266-024-00974-6. [PMID: 38951301 DOI: 10.1007/s10266-024-00974-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/20/2024] [Indexed: 07/03/2024]
Abstract
The aim of this study was to evaluate the influence of liver fibrosis (LF) on the expression of Toll-like receptors (TLR) 2 and 4 in apical periodontitis (AP) in Wistar rats. Forty Wistar rats were allocated in the following groups (n = 10): C-control; AP-apical periodontitis; LF-liver fibrosis; AP + LF-rats with AP and LF. LF and AP were induced by established methodologies. Histological, bacteriological, and immunohistochemical analyses were performed according to pre-established scores. For comparisons between AP and AP + LF groups, the Mann-Whitney test was used (P < .05). The livers of the LF and AP + LF groups showed generalized portal inflammatory infiltrate and collagen fibers confirming the presence of LF. Histopathological analysis in the maxilla of the AP + LF group showed areas of necrosis comprising the entire dental pulp and periapical tissue surrounded by a more intense inflammatory infiltrate than observed in the AP group (P = 0.032). A significant number of specimens in the AP + LF group showed microorganisms beyond the apical foramen adhered to the extraradicular biofilm, demonstrating greater invasion compared to the AP group (P = .008). Immunohistochemical analysis showed a large number of cells immunoreactive for TLR2 and TLR4 in the AP + LF group, compared to the AP group (P < 0.05). Liver fibrosis favors the inflammation and contamination of microorganisms in apical periodontitis and triggers the expression of TLR2 and TLR4, modulating innate immunity response in periapical lesions.
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Affiliation(s)
- Cristiane Cantiga-Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Pedro Henrique Chaves de Oliveira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Flávio Duarte Faria
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Mariana Pagliusi Justo
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araújo
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Juan José Segura-Egea
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Seville, Spain
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
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Duarte Faria F, Cantiga-Silva C, Cardoso CDBM, da Silva Machado NE, de Oliveira PHC, Justo MP, Goto J, de Castilho Jacinto R, Sivieri-Araújo G, Cintra LTA. Influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis in Wistar rats. Odontology 2024:10.1007/s10266-024-00908-2. [PMID: 38457086 DOI: 10.1007/s10266-024-00908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024]
Abstract
The aim of this study was to investigate the influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis (AP) in Wistar rats. Fifty-six rats were submitted to pulp exposure of the lower left first molar for the induction of AP. On the same day, intraperitoneal antibiotic therapy was administered once a day, for 15 days, until euthanasia. The groups were formed according to the different treatments (n = 8): C-control; GEN-treated with gentamicin (10 mg/Kg); AC-treated with amoxicillin (100 mg/Kg); MZ-treated with metronidazole (40 mg/Kg); AMP-treated with ampicillin (100 mg/Kg); AMC group-treated with amoxicillin + clavulanic acid (100 mg/kg); CLI-treated with clindamycin (60 mg/kg). After euthanasia, the jaws were collected and processed for (1) histological and histometric analysis using hematoxylin and eosin staining, (2) analysis of collagen fibers using Picrosirius Red staining and (3) bacteriological analysis using Brown-Brenn staining. The data were analyzed statistically (p < 0.05). AP induction was confirmed in all groups. The AMC group had the lower intensity of inflammatory infiltrate (p = 0.028) and less periapical bone resorption compared to control (p = 0.006). Regarding collagen maturation, PSR staining revealed a predominance of mature collagen fibers in all groups. The AC and AMC groups had the lower amount of mature fibers and the highest amount of immature fibers, compared to all other groups (p < 0.001). All groups showed bacterial contamination; however, the AC and AMC groups showed a lower extent of bacterial contamination compared to the control (p < 0.001). It can be concluded that systemic antibiotic therapy influences the development and progression of induced AP.
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Affiliation(s)
- Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Pedro Henrique Chaves de Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Mariana Pagliusi Justo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Juliana Goto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Rogério de Castilho Jacinto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araújo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
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Vazão AR, Claudino L, Pimpinato PP, Sampaio LV, Fiais GA, de Freitas RN, Justo MP, Brito VGB, Oliveira SHP, Lima RR, Cintra LTÂ, Chaves-Neto AH. Experimental apical periodontitis alters salivary biochemical composition and induces local redox state disturbances in the salivary glands of male rats. Clin Oral Investig 2024; 28:154. [PMID: 38366095 DOI: 10.1007/s00784-024-05540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES The objective was to evaluate the effects of experimental apical periodontitis on the inflammatory, functional, biochemical, and redox parameters of the parotid and submandibular glands in rats. MATERIALS AND METHODS Twenty 12-week-old male Wistar rats were randomly divided into two groups (n = 10): a control group and apical periodontitis group. After 28 days, the saliva was collected for salivary flow rate and biochemistry composition. Both glands were sampled for quantification of the tumor necrosis factor-alpha (TNF-α) and biochemical analyses of redox state. RESULTS TNF-α concentrations were higher in both salivary glands adjacent to the periapical lesions in animals with apical periodontitis and also compared to the control group. The apical periodontitis group increased the salivary amylase, chloride, potassium, calcium, and phosphate. The total oxidant capacity increased in the parotid gland adjacent to the periapical lesions in the same rat and compared to the control group. Conversely, the total antioxidant capacity of the parotid glands on both sides in the apical periodontitis group was lower than that in the control group. Furthermore, glutathione peroxidase activity increased in the submandibular gland adjacent to the apical periodontitis group compared to the control group. CONCLUSIONS Experimental apical periodontitis alters salivary biochemical composition, in addition to increasing inflammatory marker and inducing local disturbances in the redox state in the parotid and submandibular glands of male rats. CLINICAL RELEVANCE Apical periodontitis could exacerbate the decline in oral health by triggering dysfunction in the salivary glands.
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Affiliation(s)
- Arieli Raymundo Vazão
- Programa de Pós-Graduação em Ciências, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Lívia Claudino
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Pedro Penati Pimpinato
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Larissa Victorino Sampaio
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Gabriela Alice Fiais
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Rayara Nogueira de Freitas
- Programa de Pós-Graduação em Ciências, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Mariana Pagliusi Justo
- Programa de Pós-Graduação em Ciências, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Department of Preventive and Restorative Dentistry, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Victor Gustavo Balera Brito
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Sandra Helena Penha Oliveira
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Pará, Brazil
| | - Luciano Tavares Ângelo Cintra
- Programa de Pós-Graduação em Ciências, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
- Department of Preventive and Restorative Dentistry, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Antonio Hernandes Chaves-Neto
- Programa de Pós-Graduação em Ciências, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil.
- Department of Basic Sciences, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil.
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, School of Dentistry of Araçatuba-UNESP-Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil.
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Meyfarth SRS, Antunes LAA, da Silva Tavares J, Guimarães LDS, da Silva EAB, Baratto-Filho F, Küchler EC, Silva-Sousa AC, Sousa-Neto MD, Antunes LS. Single nucleotide polymorphisms in inducible nitric oxide synthase gene are not associated with persistent apical periodontitis. AUST ENDOD J 2023; 49:648-656. [PMID: 37724624 DOI: 10.1111/aej.12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
The aim of this study was to investigate whether there is an association between inducible in single nucleotide polymorphisms in nitric oxide synthase (rs2297518 and rs2779249) and persistent apical periodontitis. A total of 291 Brazilian subjects were included: 125 with signs/symptoms of persistent apical periodontitis and 166 with root canal-treated teeth exhibiting healthy perirradicular tissues. Endodontically treated patients were followed up after 1 year. The two single nucleotide polymorphisms in nitric oxide synthase were analysed using real-time polymerase chain reaction. Chi-square test and odds ratio with 95% confidence intervals were performed to compare genotype distributions between 'healed' and 'persistent apical periodontitis' groups (p < 0.05). Logistic regression analysis was used to evaluate SNP-SNP interactions. The allele and genotype distributions for the polymorphisms between the persistent apical periodontitis and healed groups were not statistically significant (p > 0.05). In the logistic regression analysis, the polymorphisms were not associated with persistent apical periodontitis and SNP-SNP interactions.
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Affiliation(s)
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Niterói, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
| | | | | | | | | | | | - Alice Corrêa Silva-Sousa
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Niterói, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
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La Rosa GRM, Pedullà E. Effectiveness of probiotics in apical periodontitis progression: A scoping review and implications for research. AUST ENDOD J 2023; 49 Suppl 1:528-536. [PMID: 36524834 DOI: 10.1111/aej.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
To synthesise the current knowledge on the effects of probiotics in apical periodontitis progression by a scoping review of animal and human studies. Reporting was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. The literature search and screening was performed on PubMed and Scopus databases by two independent reviewers selecting human and animal studies that evaluated the effectiveness of probiotics in reducing the severity of apical periodontitis. Two animal studies with 3 publications met the eligibility criteria for qualitative synthesis. The most common probiotics were Lactobacillus rhamnosus and Lactobacillus acidophilus orally administered for gavage in Wistar rats with induced apical periodontitis. Overall, probiotics significantly reduced inflammation and bone resorption with an improvement in the apical periodontitis progression. Although results in animal studies are promising, the use of probiotics in apical periodontitis progression requires caution due to the insufficient available evidence.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Bolat N, Erzurumlu Y, Aşcı H, Özmen Ö, Üreyen Kaya B. Selenium ameliorates inflammation by decreasing autophagic flux and mitogen-activated protein kinase signalling on experimentally induced rat periapical lesions. Int Endod J 2023; 56:227-244. [PMID: 36314140 DOI: 10.1111/iej.13861] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
AIM To reveal the molecular mechanisms that targets mitogen-activated protein kinase (MAPK) signalling and the autophagic flux and to investigate the possible effects of the systemic administration of selenium (Se) on experimentally induced rat periapical lesions. METHODOLOGY Thirty adult Sprague-Dawley rats were divided equally into negative control, positive control and Se groups. In the positive control and Se groups, the pulp chambers of their mandibular first molars were exposed to the oral environment to induce periapical lesions The Se group received daily intraperitoneal injections of Se at a dose of 0.1 mg kg-1 . After 28 days, the amount of bone destruction; severity of inflammation; penetration of microorganisms along the root canal; collagen degradation in periodontal ligament; interleukin (IL)-6, hypoxia-inducible factor-1 (HIF-1), cyclooxygenase-2 (COX-2) and caspase-3 expression; autophagic flux; and p38 MAPK signalling were evaluated using radiographic, histopathological, Gram staining, picrosirius red stain, immunohistochemical, quantitative real-time polymerase chain (qRT-PCR) and Western blot methods, respectively. These data were analysed through the Kruskal-Wallis and Dunnett's tests (p < .05). RESULTS The area of radiographic periapical bone loss, histopathological scores, the area of periapical bone loss and the scores for the bacteria localisation, the intensity of immunohistochemical staining for IL-6, HIF-1, COX-2 and caspase-3 in the Se group was significantly less than those of the positive control group (p < .01). The mRNA expression levels of Beclin-1, Atg3, Atg5, Atg7 and Atg16L1 were lower in the Se group than in the positive control group (p < .01). The protein expressions of Beclin-1, Atg5 and LC3-II, the phosphorylation ratio of the p38 MAPK and the ratios of LC3II/LC3I were significantly higher (p < .05) in the positive control and Se groups. On the contrary, the expression of the p62/SQSTM1 protein was significantly lower (p < .05) in the positive control and Se groups than in the negative control group. CONCLUSION The induction of periapical lesions in rats increased autophagic flux and activated p38 MAPK signal transduction processes. Se suppressed the inflammatory process, reduced bone destruction and both the autophagic flux and p38 MAPK activation.
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Affiliation(s)
- Nergiz Bolat
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Yalçin Erzurumlu
- Department of Biochemistry, Faculty of Pharmacy, Suleyman Demirel University, Isparta, Turkey
| | - Halil Aşcı
- Department of Pharmacology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Özlem Özmen
- Department of Pathology, Faculty of Veterinary, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Justo MP, Cardoso CBM, Cantiga-Silva C, Oliveira PHC, Sivieri-Araújo G, Azuma MM, Ervolino E, Cintra LTA. Curcumin reduces inflammation in rat apical periodontitis. Int Endod J 2022; 55:1241-1251. [PMID: 36004614 DOI: 10.1111/iej.13819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the effect of systemic curcumin administration on the severity of apical periodontitis (AP). METHODOLOGY Forty male Wistar rats weighing 250-280g each, age 2.5 months, were distributed into four groups (n=10): control untreated rats (C), control rats treated with curcumin (CUR), rats with pulp exposure-induced apical periodontitis (AP), and rats with pulp exposure-induced apical periodontitis treated with curcumin (AP-CUR). Curcumin treatment was administered orally once daily for 15 days before pulp exposure and continued for 30 days after pulp exposure. The rats were sacrificed at 30 days, and the jaws were collected and reconstructed in a program specific for micro-CT. The jaws were processed for analysis of the inflammatory process using Haemotoxylin and Eosin staining and immunohistochemical assays for interleukin tumour necrosis factor alpha (TNF-α), interleukin (Il)-6, and Il-1β. Tartrate-resistant acid phosphatase (TRAP) and osteocalcin (OCN) staining were used to analyze the resorptive process on the bone surface of periapical area. Kruskal-Wallis with Dunn's test was performed for nonparametric data, and ANOVA with Tukey's test for parametric data, p < .05. RESULTS Micro-CT revealed no statistically significant differences in bone resorption between the AP and AP-CUR groups (p > .05). The levels of inflammatory cell infiltration and immunoreactivity for the proinflammatory cytokines TNF-α, Il-6, and Il-1β were significantly higher in the periapical lesions of the AP group than in the AP-CUR group (p < .05). The number of TRAP-positive multinucleated cells was higher in the AP group than in the AP-CUR group (p < .05). In OCN-positive cells, no differences were observed between the AP and AP-CUR groups (p > .05). CONCLUSIONS Oral supplementation with curcumin had a significant effect on the AP severity in rats, suggesting an anti-inflammatory effect of curcumin on AP development.
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Affiliation(s)
- M P Justo
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - C B M Cardoso
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - C Cantiga-Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - P H C Oliveira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - G Sivieri-Araújo
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - M M Azuma
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - L T A Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil.,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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Rossetti BR, Lemos AF, Só BB, Weissheimer T, Martins MD, Só MVR. Effects of estrogen deficiency on the progression of apical periodontitis. A systematic review of preclinical studies. Arch Oral Biol 2022; 142:105496. [DOI: 10.1016/j.archoralbio.2022.105496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/02/2022]
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Dal-Fabbro R, Cosme-Silva L, Rezende Silva Martins de Oliveira F, Capalbo LC, Plazza FA, Ervolino E, Cintra LTA, Gomes-Filho JE. Effect of red wine or its polyphenols on induced apical periodontitis in rats. Int Endod J 2021; 54:2276-2289. [PMID: 34534374 DOI: 10.1111/iej.13633] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/14/2021] [Indexed: 01/25/2023]
Abstract
AIM To evaluate the effect of red wine consumption or its polyphenols on the inflammation/resorption processes associated with apical periodontitis in rats. METHODOLOGY Thirty-two three-month-old Wistar rats had apical periodontitis induced in four first molars and were then arranged into four groups: control (C)-rats with apical periodontitis; wine (W)-rats with apical periodontitis receiving 4.28 ml/kg of red wine; resveratrol+quercetin (R+Q)-rats with apical periodontitis receiving 4.28 ml/kg of a solution containing 1.00 mg/L of quercetin and 0.86 mg/L of resveratrol and alcohol (ALC)-rats with apical periodontitis receiving the alcoholic dose contained in the wine. The oral gavage treatments were administered daily, from day 0 to day 45. On the 15th day, apical periodontitis was induced, and on the 45th day, the animals were euthanized. Histological, immunohistochemical (RANKL, OPG, TRAP, IL-10, TNF-⍺ and IL-1β) and micro-computed tomography for bone resorption analysis were performed in the jaws. The Kruskal-Wallis with Dunn's test was performed for nonparametric data, and the anova with Tukey's test for parametric data, p < .05. RESULTS The median score of the inflammatory process was significantly lower in the R+Q group (1) compared to the C (2) (p = .0305) and ALC (3) (p = .0003) groups, and not different from the W (1.5) group. The immunolabeling for OPG was significantly higher in the R+Q group (p = .0054) compared to all groups; the same was observed for IL-10 (p = .0185), different from groups C and ALC. The R+Q group had the lowest TRAP cell count (p < .0001), followed by the W group, both inferior to C and ALC groups. The lowest bone resorption value was in the R+Q group (0.50mm3 ± 0.21mm3 ), significantly lower (p = .0292) than the C group (0.88mm3 ± 0.10mm3 ). The W group (0.60 mm3 ± 0.25 mm3 ) and R+Q group had less bone resorption compared to the ALC group (0.97 mm3 ± 0.22 mm3 ), p = .0297 and p = .0042, respectively. CONCLUSION Red wine administration to rats for 15 days before induction of apical periodontitis decreased inflammation, TRAP marking and periapical bone resorption compared to alcohol. Resveratrol-quercetin administration reduced the inflammatory process in apical periodontitis, periapical bone resorption, and altered the OPG, IL-10 and TRAP expression compared to C and ALC groups.
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Affiliation(s)
- Renan Dal-Fabbro
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan, Ann Arbor, Michigan, USA
| | - Leopoldo Cosme-Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Alagoas (UFAL), Alagoas, Brazil
| | | | - Letícia Cabrera Capalbo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Flávia Alfredo Plazza
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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10
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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11
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Dal-Fabbro R, Cosme-Silva L, Capalbo LC, Chaves-Neto AH, Ervolino E, Cintra LTA, Gomes-Filho JE. Excessive caffeine intake increases bone resorption associated with periapical periodontitis in rats. Int Endod J 2021; 54:1861-1870. [PMID: 34037986 DOI: 10.1111/iej.13578] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/31/2022]
Abstract
AIM To evaluate the effect of excessive caffeine intake on the inflammation/resorption processes associated with periapical periodontitis (PP) in rats. METHODOLOGY Sixteen Wistar rats were used. Periapical periodontitis was induced in the four first molars in each animal. The animals were arranged into two groups: control (C)-rats with periapical periodontitis; and caffeine (CAF)-rats with periapical periodontitis under caffeine administration protocol. The CAF animals received 10 mg/100 g of body weight/day of caffeine via gavage starting fifteen days before PP induction and continuing for thirty more days until euthanasia. On the 30th day, the animals were euthanized and the jaws removed for microcomputed tomography, histological and immunohistochemical analysis for RANKL, OPG, TRAP, IL-10, TNF-⍺ and IL-1β. The Mann-Whitney test was performed for nonparametric data, and Student's t test was performed for parametric data, using p < .05. RESULTS There was no significant difference in the weight change between the groups. The median score of the inflammatory process was significantly greater in the CAF group (3) compared with the C group (2), p = .0256. Bone resorption was greater in the group consuming caffeine (1.08 ± 0.15 mm3 ) compared with the C group (0.88 ± 0.10 mm3 ), p = .0346. The immunolabelling for RANKL, TRAP and IL-1β was significantly higher in the CAF group when compared to the control, p < .05. No differences were found for the OPG, IL-10 and TNF-⍺ immunolabelling. CONCLUSION Excessive caffeine exposure via gavage in rats was able to exacerbate the volume of periapical bone destruction, and the inflammatory pattern deriving from periapical periodontitis altering the expression of RANKL, IL-1β and TRAP.
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Affiliation(s)
- Renan Dal-Fabbro
- Department of Preventive and Restorative Dentistry, Araçatuba, Brazil
| | - Leopoldo Cosme-Silva
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Federal University of Alagoas (UFAL), Alagoas, Brazil
| | | | | | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
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12
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Aubeux D, Peters OA, Hosseinpour S, Tessier S, Geoffroy V, Pérez F, Gaudin A. Specialized pro-resolving lipid mediators in endodontics: a narrative review. BMC Oral Health 2021; 21:276. [PMID: 34030680 PMCID: PMC8142493 DOI: 10.1186/s12903-021-01619-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/09/2021] [Indexed: 02/06/2023] Open
Abstract
Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is a highly dynamic tissue equipped with a network of resident immunocompetent cells that play major roles in the defense against pathogens and during tissue injury. However, the efficiency of these mechanisms during dental pulp inflammation (pulpitis) varies due to anatomical and physiological restrictions. Uncontrolled, excessive, or unresolved inflammation can lead to pulp tissue necrosis and subsequent bone infections called apical periodontitis. In most cases, pulpitis treatment consists of total pulp removal. Although this strategy has a good success rate, this treatment has some drawbacks (lack of defense mechanisms, loss of healing capacities, incomplete formation of the root in young patients). In a sizeable number of clinical situations, the decision to perform pulp extirpation and endodontic treatment is justifiable by the lack of therapeutic tools that could otherwise limit the immune/inflammatory process. In the past few decades, many studies have demonstrated that the resolution of acute inflammation is necessary to avoid the development of chronic inflammation and to promote repair or regeneration. This active process is orchestrated by Specialized Pro-resolving lipid Mediators (SPMs), including lipoxins, resolvins, protectins and maresins. Interestingly, SPMs do not have direct anti-inflammatory effects by inhibiting or directly blocking this process but can actively reduce neutrophil infiltration into inflamed tissues, enhance efferocytosis and bacterial phagocytosis by monocytes and macrophages and simultaneously inhibit inflammatory cytokine production. Experimental clinical application of SPMs has shown promising result in a wide range of inflammatory diseases, such as renal fibrosis, cerebral ischemia, marginal periodontitis, and cancer; the potential of SPMs in endodontic therapy has recently been explored. In this review, our objective was to analyze the involvement and potential use of SPMs in endodontic therapies with an emphasis on SPM delivery systems to effectively administer SPMs into the dental pulp space.
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Affiliation(s)
- Davy Aubeux
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France.,Université de Nantes, UFR Odontologie, 44042, Nantes, France
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | | | - Solène Tessier
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France.,Université de Nantes, UFR Odontologie, 44042, Nantes, France
| | - Valérie Geoffroy
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France.,Université de Nantes, UFR Odontologie, 44042, Nantes, France
| | - Fabienne Pérez
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France.,Université de Nantes, UFR Odontologie, 44042, Nantes, France.,CHU Nantes, PHU4 OTONN44093, Nantes, France
| | - Alexis Gaudin
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France. .,Université de Nantes, UFR Odontologie, 44042, Nantes, France. .,CHU Nantes, PHU4 OTONN44093, Nantes, France.
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13
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Minhoto GB, Khoury RD, Orozco EIF, Prado RF, Valera MC. Effect of chronic unpredictable stress on the progression of experimental apical periodontitis in rats. Int Endod J 2021; 54:1342-1352. [PMID: 33724486 DOI: 10.1111/iej.13515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
AIM To establish an experimental model combining chronic stress and apical periodontitis by assessing the development of periapical lesions in rats in three different time points. METHODOLOGY Forty-eight male Wistar rats were randomly assigned into two equal groups: Apical periodontitis (AP) and AP + Stress (AP + S). The animals of the AP group were not exposed to stressful conditions whereas the AP + S group were exposed to a variety of stressors on a daily basis until the end of the experiment. After three weeks of chronic unpredictable stress, apical periodontitis was induced in both groups by exposing the pulpal tissue of the mandibular first molar to the oral environment. Each group was further subdivided into three subgroups according to the euthanasia period: 14, 21 and 28 days after pulp exposure. The animals were weighed, and the blood was collected for corticosterone serum dosage by radioimmunoassay. The mandibles were removed and submitted to histopathological and microtomography analyses to assess the inflammatory response and the progression of periapical lesions. Comparisons between the AP and AP + S groups were performed using Student's t-test and Mann-Whitney U-test for parametric and nonparametric data, respectively. The one-way anova test followed by Tukey's test (parametric data) and Kruskal-Wallis followed by Dunn's test (nonparametric data) were used for comparisons between the three time points within the same group (P < 0.05). RESULTS The AP + S group had a significantly lower average percentage of weight gain at 14 days and 21 days after AP induction (P < 0.05). Significantly higher levels of corticosterone were found in the AP + S group at 21 days (P < 0.05). The AP + S group had a significantly greater intensity and extension of inflammatory infiltrate with larger areas of bone loss compared to the AP groups at 21 days (P < 0.05). The volume of the periapical lesions in the AP + S group was significantly larger than that of the AP group 21 days following pulp exposure (P < 0.05). CONCLUSIONS The chronic unpredictable stress model applied for 6 weeks exacerbated the inflammatory response and increased bone loss associated with AP, especially 21 days after its induction. This model appears to be suitable for investigating the bidirectional relationship between apical periodontitis and chronic stress.
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Affiliation(s)
- G B Minhoto
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - R D Khoury
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - E I F Orozco
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - R F Prado
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - M C Valera
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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14
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Cosme-Silva L, Dal-Fabbro R, Cintra LTA, Ervolino E, Prado ASD, Oliveira DPD, Marcelos PGCLD, Gomes-Filho JE. Dietary supplementation with multi-strain formula of probiotics modulates inflammatory and immunological markers in apical periodontitis. J Appl Oral Sci 2021; 29:e20210483. [PMID: 33503222 PMCID: PMC7837670 DOI: 10.1590/1678-7757-2020-0483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of this study was to evaluate whether probiotics multi-strain formula affects the development of apical periodontitis (AP) induced in rats. Methodology 16 Wistar rats were divided in two groups (n=8): rats with AP fed with regular diet (Control-C (CG)); rats with AP, fed with regular diet and supplemented with multi-strain formula (one billion colony-forming units (CFU)): GNC Probiotic Complex (PCG) (
Lactobacillus acidophilus, Lactobacillus salivaris, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium animalis
subs. lactis and
Streptococcus thermofilus
). AP was induced in the upper and lower first molars by dental pulp exposure to the oral environment. PCG was administered orally through gavage for 30 days during the AP development. After this period the animals were euthanized and the mandibles were removed and processed for histologic analysis, and immunochemical assays for interleukin (IL)-6, IL-10, IL-1β, RANKL, OPG, and TRAP. The Mann–Whitney U test and Student’s t test were performed (P<.05). Results The CG showed more intense inflammatory infiltrate than the PCG group (P<.05). IL-1β, IL 6 and RANKL decreased in the PCG group compared with CG (P<.05). The IL-10 level increased in the PCG group (P<.05). The OPG level was similar in both groups (P>.05). The number of mature osteoclasts (TRAP-positive multinucleated cells) was lower in PCG group when compared to the CG (P<.05). Conclusion Probiotic Complex modulates inflammation and bone resorption in apical periodontitis.
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Affiliation(s)
- Leopoldo Cosme-Silva
- Universidade Federal de Alagoas (UFAL), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Maceió, Brasil
| | - Renan Dal-Fabbro
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, Brasil
| | - Edilson Ervolino
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araraquara, Brasil
| | - Alana Sant'Ana do Prado
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, Brasil
| | - Daniel Pinto de Oliveira
- Universidade Federal de Alagoas (UFAL), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Maceió, Brasil
| | | | - João Eduardo Gomes-Filho
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, Brasil
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15
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Cosme-Silva L, Santos AFD, Lopes CS, Dal-Fabbro R, Benetti F, Gomes-Filho JE, Queiroz IODA, Ervolino E, Viola NV. Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1β and TNF-α promoted by a new bioceramic cement. J Appl Oral Sci 2020; 28:e20200033. [PMID: 32785523 PMCID: PMC7406194 DOI: 10.1590/1678-7757-2020-0033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/17/2020] [Indexed: 11/21/2022] Open
Abstract
Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA. Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1β and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in μm2 and semiquantitative immunolabeling analyses of IL-1β and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level. Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1β and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05). Conclusion BIO-C PULPO was biocompatible and induced mineralization similar to MTA.
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Affiliation(s)
- Leopoldo Cosme-Silva
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Federal de Alagoas, Maceió, Alagoas, Brasil
| | - Amanda Ferreira Dos Santos
- Departamento de Clínica e Cirurgia, Faculdade de Odontologia, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brasil
| | - Camila Soares Lopes
- Departamento de Clínica e Cirurgia, Faculdade de Odontologia, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brasil
| | - Renan Dal-Fabbro
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Estadual Paulista, Araçatuba, São Paulo, Brasil
| | - Francine Benetti
- Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - João Eduardo Gomes-Filho
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Estadual Paulista, Araçatuba, São Paulo, Brasil
| | | | - Edilson Ervolino
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Estadual Paulista, Araçatuba, São Paulo, Brasil
| | - Naiana Viana Viola
- Departamento de Endodontia, Faculdade de Odontologia, Universidade Federal de Alagoas, Maceió, Alagoas, Brasil
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16
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Pinto KP, Ferreira CMA, Guimarães AFC, Lima CO, Pires FR, Sassone LM, Silva EJNL. Effects of alcohol and nicotine consumption on the development of apical periodontitis in rats: a correlative micro-computed tomographic, histological and immunohistochemical study. Int Endod J 2020; 53:1238-1252. [PMID: 32516436 DOI: 10.1111/iej.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022]
Abstract
AIM To evaluate the effects of alcohol and nicotine, when used alone or simultaneously, in the development of apical periodontitis induced in rats, using a correlative analytic approach with micro-CT, histological and immunohistochemical analysis. METHODOLOGY Twenty-eight male Wistar rats were arranged into four groups: Control, Nicotine, Alcohol and Alcohol + Nicotine. The alcohol groups were exposed to self-administration of a 25% alcohol solution, whilst the other groups drunk only filtered water. The nicotine groups received daily intraperitoneal injections of a solution with 0.19 μL of nicotine per mL, whilst the other groups received saline solution. The pulps of the left mandibular first molars were exposed for 28 days to induce periapical lesions. Throughout the experiment, drug administration was maintained, and the animals had their weight and solid and liquid consumption measured. After euthanasia, the mandibles were removed and the area, volume and major diameter of the periapical lesions were measured using micro-computed tomography images. The samples were submitted to histopathological evaluation and immunohistochemistry for RANKL and PTHrP. Statistical analysis was undertaken with a significance level of 5%. Nonparametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, whilst one-way anova followed by Tukey's test was performed for parametric data. RESULTS The alcohol groups had lower solid and liquid consumption and gained less weight when compared to the nonalcohol groups (P < 0.05). The Alcohol + Nicotine group had lesions with significantly larger volume and area when compared to the other groups (P < 0.05), whilst the Alcohol or Nicotine groups had significantly larger lesions than the control group (P < 0.05). There was no significant difference in the largest diameter of the lesions amongst groups (P > 0.05). The experimental groups had greater inflammatory response scores than the control group (P < 0.05), and the representative samples had more pronounced immunoreaction against RANKL and PTHrP antibodies. CONCLUSIONS Alcohol and nicotine consumption exacerbated the inflammatory response and the development of periradicular lesions in rats. The association of both substances enhanced their harmful effects.
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Affiliation(s)
- K P Pinto
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C M A Ferreira
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - A F C Guimarães
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C O Lima
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - F R Pires
- Department of Oral Pathology, School of Dentistry, Estácio de Sá University (UNESA), Rio de Janeiro, Brazil
| | - L M Sassone
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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Cosme-Silva L, Dal-Fabbro R, Cintra LTA, Ervolino E, Plazza F, Mogami Bomfim S, Duarte PCT, Junior VEDS, Gomes-Filho JE. Reduced bone resorption and inflammation in apical periodontitis evoked by dietary supplementation with probiotics in rats. Int Endod J 2020; 53:1084-1092. [PMID: 32436602 DOI: 10.1111/iej.13311] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 04/21/2020] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the relationship between systemic administration of probiotics and inflammation/resorption processes associated with apical periodontitis (AP) in a rat model. METHODOLOGY Twenty-four male Wistar rats were used. AP was induced in the mandibular left/right first molars. The animals were arranged into three groups: Control, Lactobacillus rhamnosus and L. acidophilus. Probiotics were orally administered via gavage (109 colony-forming units (CFU) diluted in 5 mL of water) for 30 days during the development of AP. On the 30th day, blood was collected to analyse the calcium, phosphorus and alkaline phosphatase concentrations in plasma. Then, the animals were euthanized and the jaws removed for micro-computed tomography and immune-histopathological analysis for receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG) and tartrate-resistant acid phosphatase (TRAP). After the Shapiro-Wilk test of normality, the Kruskal-Wallis followed by Dunn's test was performed for nonparametric data, and analysis of variance followed by the Tukey test was performed for parametric data (P < 0.05). RESULTS There was no significant difference in the calcium and phosphorus levels in plasma amongst the groups (P > 0.05). The level of alkaline phosphatase was significantly higher in the groups that consumed probiotics (P < 0.05). A significantly lower volume of bone resorption was observed in groups that consumed probiotics (P < 0.05). The inflammatory infiltrates and the immunolabelling for RANKL and TRAP were significantly lower in probiotic groups when compared to the control (P < 0.05). Also, the OPG was significantly more immunolabelled in the L. acidophilus group than in the L. rhamnosus and control groups (P < 0.05). CONCLUSION Probiotic supplementation through gavage (L. rhamnosus and L. acidophilus) had a significant effect on the reduction of inflammation and bone resorption in apical periodontitis development in rats.
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Affiliation(s)
- L Cosme-Silva
- Department of Endodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.,Department of Odontology, School of Dentistry, Federal University of Alagoas (UFAL), Maceio, Alagoas, Brazil
| | - R Dal-Fabbro
- Department of Endodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - L T A Cintra
- Department of Endodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - E Ervolino
- Department of Basic Sciences, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - F Plazza
- Department of Endodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - S Mogami Bomfim
- Department of Clinic and Surgery and Animal Reproduction, Araçatuba Veterinary Medicine, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - P C T Duarte
- Department Health, Feira de Santana State University (UEFS), Feira de Santana, Bahia, Brazil
| | - V E D S Junior
- Department of Odontology, School of Dentistry, Federal University of Alagoas (UFAL), Maceio, Alagoas, Brazil
| | - J E Gomes-Filho
- Department of Endodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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The influence of adrenergic blockade in rats with apical periodontitis under chronic stress conditions. Arch Oral Biol 2019; 110:104590. [PMID: 31743801 DOI: 10.1016/j.archoralbio.2019.104590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/11/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the influence of chronic stress and adrenergic blockade in a rat model of apical periodontitis. METHODS Thirty-two Wistar rats were submitted to an animal model of periapical lesion and randomly divided into 4 groups (n = 8): no stress (NS); stress + saline solution (SS); stress + β-adrenergic blocker (Sβ); stress + α-adrenergic blocker (Sα). The SS, Sβ and Sα groups were submitted to an animal model of chronic stress for 28 days and received daily injections of saline solution, propranolol (β adrenergic blocker) and phentolamine (α adrenergic blocker), respectively. After 28 days the animals were euthanized and the following analyses were carried out: a) serum corticosterone levels through Radioimmunoassay; b) measurement of serum levels of IL-1B, IL-6, IL-10 and IL-17 by enzyme-linked immunosorbent assay (ELISA); c) volume of periapical bone resorption by micro-computed tomography; d) histomorphometric analysis by staining with hematoxylin and eosin; e) expression of β-AR, α-AR, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) by immunohistochemistry; f) tartrate-resistant acid phosphatase (TRAP) staining; g) ex-vivo cytokine release followed by the stimulation with LPS in superfusion system, by ELISA. RESULTS SS group displayed significantly higher corticosterone levels than NS group (non-stressed). Higher IL-1β serum level was observed in the NS group (p < .05); compared to all stressed groups. Other cytokines were present in similar amounts in the serum of all groups. All groups presented similar periapical lesions. All groups presented moderate inflammatory infiltrate, without statistically significant differences between them. No differences were observed regarding β-AR, α-AR, Rank-L and OPG expression. The number of TRAP-positive cells was significantly decreased in the groups that received daily injections of adrenergic blockers. The IL-1β release followed LPS stimulation was significantly suppressed when the superfusion media contained propranolol (p < .05). Perfusion containing phentolamine induced a greater release of IL-10. TGF-β was significantly suppressed by phentolamine perfusion in the NS group (p < .05). CONCLUSIONS Chronic stress can significantly change the inflammatory cytokines release. Rank-L/OPG system and periapical lesion volume were not affected following the current method applied. The administration of adrenergic blockers was not able to modulate the inflammatory response but presented effectivity in reducing the number of osteoclasts in the periapical region.
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Dal-Fabbro R, Marques-de-Almeida M, Cosme-Silva L, Capalbo LC, Ervolino E, Cintra LTA, Gomes-Filho JE. Effects of different alcohol concentrations on the development of apical periodontitis in rats. Arch Oral Biol 2019; 108:104538. [PMID: 31476521 DOI: 10.1016/j.archoralbio.2019.104538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/21/2022]
Abstract
AIM To investigate the effect of different alcohol concentrations on the development of apical periodontitis (AP) in rats. METHODS Forty Wistar rats were arranged into five groups: (C) - control rats receiving sterile water as the only liquid; (G5) - animals receiving an alcohol solution at 5%, (G10) - alcohol solution at 10%, (G15) - alcohol solution at 15%, and (G20) - alcohol solution at 20%. The alcoholic solution or water was given to the groups as the sole source of hydration throughout the 30 days of the experiment. AP was induced in the mandibular molars on the first day. In the end, the animals were euthanized for histopathological and IL-1b, RANKL, OPG, and TRAP analyses. The Kruskal-Wallis test was used for nonparametric data, and ANOVA followed by the Tukey test were performed for parametric data, p < 0.05. RESULTS G15 and G20 had a greater chronic inflammatory infiltrate (Score 3) and AP size bigger (1.59 ± 0.41 and 1.83 ± 0.38, respectively) than the C, G5 and G10 (p < 0.05). No significant difference was found in the IL-1b analyses. The G15 and G20 showed the highest immunolabeling pattern for RANKL and the lowest for OPG. The G20 had greater TRAP cells per mm (4.70 ± 0.99) compared to the C, G5, and G10 (p < 0.05). Furthermore, G15 presented 3.92 ± 0.64 TRAP cells/mm, higher than C (p < 0.05). CONCLUSIONS G5 and G10 did not exert a protective or aggravating effect on the AP development. However, G15 and G20 had a significant effect on the AP severity, exacerbating the inflammation and osteoclast markers.
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Affiliation(s)
- Renan Dal-Fabbro
- Department of Endodontics, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil.
| | - Melyna Marques-de-Almeida
- Department of Endodontics, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil
| | - Leopoldo Cosme-Silva
- Department of Endodontics, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil; Department of Restorative Dentistry, Endodontics, School of Dentistry, Federal University of Alagoas, Alagoas, Brazil (UFAL)
| | - Letícia Cabrera Capalbo
- Department of Endodontics, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil
| | | | - João Eduardo Gomes-Filho
- Department of Endodontics, São Paulo State University (Unesp) - School of Dentistry, Araçatuba, Brazil.
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Cosme-Silva L, Dal-Fabbro R, Cintra LTA, Dos Santos VR, Duque C, Ervolino E, Mogami Bomfim S, Gomes-Filho JE. Systemic administration of probiotics reduces the severity of apical periodontitis. Int Endod J 2019; 52:1738-1749. [PMID: 31356689 DOI: 10.1111/iej.13192] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/24/2019] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the effect of systemic administration of probiotics on the severity of apical periodontitis (AP). METHODOLOGY Twenty-four male Wistar rats were used. AP was induced in the maxillary left/right first molars. The animals were arranged into groups: Control, Lactobacillus rhamnosus, and Lactobacillus acidophilus. Probiotics were administered orally for gavage (109 colony-forming units diluted in 5 mL of water for 30 days) during the development of AP. After 30 days, cardiac puncture was performed to analyse the complete blood count. Moreover, microbiological analysis of the root canal contents and saliva was performed. Then, the animals were euthanized and the jaw removed for histopathological and IL-10, IL-1β and IL-6 immunolabeling analyses. After the Shapiro-Wilk test of normality, the Kruskal-Wallis followed by Dunn's test was performed for nonparametric data, and analysis of variance followed by the Tukey test was performed for parametric data (P < 0.05). RESULTS No significance difference was observed in the blood profiles and in the counts of microorganisms from the saliva samples among the groups (P > 0.05). Total microorganism counts in the root canal, the inflammatory infiltrate and the immunostaining for IL-1β and IL-6 in AP were significantly lower in the probiotic groups when compared with the control group (P < 0.05). IL-10 was significantly more immunolabled in the probiotic groups than in the control group (P < 0.05). CONCLUSION Supplementation with probiotics (Lactobacillus rhamnosus and Lactobacillus acidophilus) had a significant effect on the severity of apical periodontitis in rats, demonstrating the anti-inflammatory effect of probiotics on the development of apical periodontitis.
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Affiliation(s)
| | | | | | | | - C Duque
- Department of Paediatric and Social Dentistry
| | - E Ervolino
- Department of Basic Sciences, Araçatuba Dental School
| | - S Mogami Bomfim
- Department of Clinic and Surgery and Animal Reproduction, Araçatuba Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, Sao Paulo, Brazil
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Cintra LTA, Estrela C, Azuma MM, Queiroz ÍODA, Kawai T, Gomes-Filho JE. Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials. Braz Oral Res 2018; 32:e68. [DOI: 10.1590/1807-3107bor-2018.vol32.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
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Dal‐Fabbro R, Marques‐de‐Almeida M, Cosme‐Silva L, Ervolino E, Cintra LTA, Gomes‐Filho JE. Chronic alcohol consumption increases inflammation and osteoclastogenesis in apical periodontitis. Int Endod J 2018; 52:329-336. [DOI: 10.1111/iej.13014] [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: 09/07/2018] [Indexed: 12/11/2022]
Affiliation(s)
- R. Dal‐Fabbro
- Department of EndodonticsSão Paulo State University (UNESP) School of Dentistry AraçatubaBrazil
| | - M. Marques‐de‐Almeida
- Department of EndodonticsSão Paulo State University (UNESP) School of Dentistry AraçatubaBrazil
| | - L. Cosme‐Silva
- Department of EndodonticsSão Paulo State University (UNESP) School of Dentistry AraçatubaBrazil
| | - E. Ervolino
- Department of Basic Sciences São Paulo State University (UNESP) School of Dentistry Araçatuba Brazil
| | - L. T. A. Cintra
- Department of EndodonticsSão Paulo State University (UNESP) School of Dentistry AraçatubaBrazil
| | - J. E. Gomes‐Filho
- Department of EndodonticsSão Paulo State University (UNESP) School of Dentistry AraçatubaBrazil
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Holland R, Gomes JE, Cintra LTA, Queiroz ÍODA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017; 25:465-476. [PMID: 29069143 PMCID: PMC5804382 DOI: 10.1590/1678-7757-2016-0464] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/11/2017] [Indexed: 12/20/2022] Open
Abstract
Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.
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Affiliation(s)
- Roberto Holland
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - João Eduardo Gomes
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Índia Olinta de Azevedo Queiroz
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil
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Multiple Apical Periodontitis Influences Serum Levels of Cytokines and Nitric Oxide. J Endod 2016; 42:747-51. [DOI: 10.1016/j.joen.2016.01.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/13/2016] [Accepted: 01/30/2016] [Indexed: 12/14/2022]
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Wayama MT, Yoshimura H, Ohba S, Yoshida H, Matsuda S, Kobayashi J, Kobayashi M, Gomes Filho JE, Sano K. Diminished Progression of Periapical Lesions with Zoledronic Acid in Ovariectomized Rats. J Endod 2015; 41:2002-7. [DOI: 10.1016/j.joen.2015.08.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/09/2015] [Accepted: 08/29/2015] [Indexed: 11/27/2022]
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