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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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Ideo F, Niazi S, Chessa L, Miglianti M, Bardini G, Mannocci F, Cotti E. Prevalence of Apical Periodontitis in Patients with Autoimmune Liver Diseases on Immune Suppressants and Immune Modulators: A Cross-sectional Study. J Endod 2024; 50:784-791. [PMID: 38527610 DOI: 10.1016/j.joen.2024.02.026] [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: 09/05/2023] [Revised: 01/28/2024] [Accepted: 02/11/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION Autoimmune liver diseases (ALDs) are chronic conditions generated by an immune-mediated autoaggressive inflammatory reaction in genetically susceptible individuals. The purpose of this study was to evaluate the prevalence of apical periodontitis (AP) in patients suffering from ALDs undergoing treatment with the immune suppressants glucocorticoids, azathioprine, and/or ursodeoxycholic acid. METHODS The ALD group included 46 patients (11 men and 35 women, average age = 57.9 ± 11.8 years) and 1186 teeth. The control group included 50 healthy patients not taking any medications (15 men and 35 women, average age = 58.6 ± 10.4 years) and 1251 teeth. Demographic data and medical, pharmacologic, and dental history were recorded. Dental and radiographic examinations were performed. The presence of AP; the periapical index score; decayed, missing, and filled teeth; quality of restoration, and root canal treatment were evaluated. The influence of the medications the patients were taking on the prevalence of AP was also tested. RESULTS The prevalence of AP was significantly lower in ALDs than in the control group at the patient (P = .019) and tooth level (P = .014). Smoking and age were associated with a significant increase in AP in cases and controls (P = .045 and P = .001, respectively). In both groups, endodontically treated teeth showed a higher prevalence of AP. CONCLUSIONS Considering the limitations because of the observational nature of the study, the patients affected by ALDs liver diseases and undergoing treatment with immune suppressors (often associated with immune modulators) were found to exhibit a lower prevalence of AP.
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Affiliation(s)
- Francesca Ideo
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy.
| | - Sadia Niazi
- Department of Endodontology, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, Guy's Hospital, London, United Kingdom
| | - Luchino Chessa
- Liver Unit, Department of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - Michela Miglianti
- Liver Unit, Department of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - Giulia Bardini
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Francesco Mannocci
- Department of Endodontology, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, Guy's Hospital, London, United Kingdom
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
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Veiga Vasques AM, da Silva ACR, Bueno CRE, Duarte MAH, Ervolino E, Cintra LTA, Dezan Junior E. Bone Resorption in Apical Periodontitis Enhanced by Cigarette Smoke Inhalation: Histometric, Immunohistochemical, and Microtomographic Analysis in Rats. J Endod 2024; 50:493-498. [PMID: 38272443 DOI: 10.1016/j.joen.2024.01.005] [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: 10/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION This study evaluated the effects of cigarette smoke inhalation (CSI) on apical periodontitis (AP) induced in rats by histometric, immunohistochemical, and microtomographic analysis. METHODS A total of 32 male Wistar rats were divided into 4 experimental groups (n = 8): control, CSI, AP, and CSI + AP. Rats in the CSI and CSI + AP groups inhaled cigarette smoke by remaining inside a smoking chamber for 8 minutes 3 times a day for 50 days. After 20 days of smoke inhalation, rats in the AP and CSI + AP groups had the pulp of their first right lower molar exposed to induce AP. Blood was collected on day 50 to evaluate nicotine and serum cotinine levels. The animals' mandibles were removed for histologic processing to evaluate bone resorption by histometric, immunohistochemical (receptor activator of nuclear factor kappa B ligand/osteoprotegerin), and microtomographic analysis. The Student t test was applied. RESULTS Histometric analysis showed a larger area of bone resorption (P < .05) and microtomographic analysis found greater resorption volume (P < .001) for the CSI + AP group compared with the AP group. The CSI + AP group presented a high RANKL immunostaining pattern compared with the AP group (P < .001). CONCLUSIONS CSI increased bone resorption caused by AP.
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Affiliation(s)
- Ana Maria Veiga Vasques
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Ana Claudia Rodrigues da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Carlos Roberto Emerenciano Bueno
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Eloi Dezan Junior
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba, 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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da Silva ACR, Vasques AMV, Bueno CRE, Ervolino E, Cintra LTÂ, Biguetti CC, Matsumoto MA, Dezan-Junior E. Effects of cigarette smoke inhalation on the immune-inflammatory profile of experimental apical periodontitis in rats. Int Endod J 2023; 56:1559-1570. [PMID: 37787896 DOI: 10.1111/iej.13981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE To evaluate the effects of cigarette smoke inhalation on the immune-inflammatory profile of experimental apical periodontitis in rats. METHODOLOGY In total, 32 male Wistar rats were divided into four groups (n = 8): AP-induced apical periodontitis; S-cigarette smoke inhalation; APS-induced AP and cigarette smoke inhalation; and C (control)-neither AP nor cigarette smoke inhalation. To induce cigarette smoke inhalation, the animals were kept in a chamber filled with tobacco smoke for 8 min thrice a day for 50 days. AP was induced 20 days after inhalation initiation by exposing their coronary pulp to their oral environment for 30 days. After animals were euthanized, their right hemimaxillae were removed for histopathological, semi-quantitative and immunohistochemical (F4/80, CD206 and iNOS) analyses. RESULTS Quantitative data showed a moderate number of inflammatory infiltrates in AP and an intense number in APS (p < .05). Comparing F4/80+ cells showed no statistically significant differences among groups, but we found more CD206+ cells in AP than in C and S (p > .05). INOS+ immunostaining showed a significant increase in AP and APS, when compared with C and S (p < .05). APS had more iNOS+ cells than AP (p < .05). CONCLUSION Cigarette smoke inhalation worsened AP, leading to a predominantly pro- inflammatory profile in our experimental model.
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Affiliation(s)
- Ana Claudia Rodrigues da Silva
- Departamento de Odontologia Preventiva e Restauradora, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Araçatuba, Brazil
| | - Ana Maria Veiga Vasques
- Departamento de Odontologia Preventiva e Restauradora, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Araçatuba, Brazil
| | - Carlos Roberto Emerenciano Bueno
- Departamento de Odontologia Preventiva e Restauradora, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Araçatuba, Brazil
| | - Edilson Ervolino
- Departamento de Ciências Básicas, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
| | - Luciano Tavares Ângelo Cintra
- Departamento de Odontologia Preventiva e Restauradora, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Araçatuba, Brazil
| | - Claudia Cristina Biguetti
- Regenerative Medicine Research Laboratory, Department of Surgery and Biomechanics, School of Podiatric Medicine, University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Mariza Akemi Matsumoto
- Departamento de Ciências Básicas, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
| | - Eloi Dezan-Junior
- Departamento de Odontologia Preventiva e Restauradora, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Araçatuba, Brazil
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Agger AE, Reseland JE, Hjelkrem E, Lian AM, Hals EKB, Zandi H, Sunde PT. Are comorbidities associated with the cytokine/chemokine profile of persistent apical periodontitis? Clin Oral Investig 2023; 27:5203-5215. [PMID: 37434075 PMCID: PMC10492720 DOI: 10.1007/s00784-023-05139-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 07/02/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES This study aimed to identify disease-related markers in persistent apical periodontitis (PAP) biopsies and examine whether these were associated with comorbidities like rheumatoid arthritis (RA) and cardiovascular diseases (CVD). MATERIALS AND METHOD The levels of the cytokines/chemokines GM-CSF, IFN-γ, IL-2, IL-6, IL-9, IL-10, IL-13, IL-15, IL-17E/IL-25, IL-21, IL-23, IL-27, IL-28A/IFN -λ2, IL-33, MIP-3α/CCL20, and TNF-α were determined in lesions from patients with PAP (n = 20) and compared to healthy bone samples (n = 20). RESULTS We identified eleven cytokines to be differently expressed, and among them, IL-2, IL-6, IL-17E, IL-21, and IL-27 appeared to drive the discrepancy between the disease and healthy groups. The levels of T follicular helper (Tfh) cell promoting cytokines (IL-21, IL-6, IL-27) were enhanced while T helper (Th) 1 cell promoting cytokine (IL-2), Th2 cell promoting cytokine (IL-13), and Th17 cell promoting cytokine (IL-17E) were reduced in the PAP group. The data also indicate that Tfh cell differentiation (IL-21), along with Th1 (GM-CSF, IFNγ), Th2 (IL-13), and Th17 (GM-CSF) cell differentiation, might be increased in the subpopulation of patients suffering from RA, whereas no differences were found in patients with CVD. CONCLUSIONS Levels of cytokines/chemokines in PAP were identified, and cluster analyzes indicated that these markers may be associated with the differentiation of different T cell populations. Patients with PAP and RA comorbidities showed elevated levels of markers reinforcing this association. CLINICAL RELEVANCE Molecular analyses of PAP may result in identification of prognostic markers.
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Affiliation(s)
- Anne Eriksson Agger
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Janne Elin Reseland
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Erik Hjelkrem
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Aina-Mari Lian
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Else K Breivik Hals
- TAKO-Centre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Homan Zandi
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Pia Titterud Sunde
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Postboks 1109 Blindern, N-0317, Oslo, Norway.
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Pinheiro TN, Desideri Vieira AJ, Salino AV, de Oliveira Aranha Ribeiro E, Felipe do Vale H, de Souza Leitão R, Carlos R, Tavares Ângelo Cintra L. Multiple oral sinus tract and trismus leading to a surprising diagnosis of osteopetrosis: Case report. SPECIAL CARE IN DENTISTRY 2023; 43:671-678. [PMID: 36316790 DOI: 10.1111/scd.12798] [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: 08/02/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
AIMS We report a rare case of late diagnosis of malignant osteopetrosis in a 36-year-old male patient due to multiple intraoral sinus tracts and trismus. CASE REPORT The patient reported a history of facial scars that could not be attributed to the older external fistulas that were present and various complicated dental extractions since infancy. In addition, the patient had not been previously diagnosed with any other significant diseases other than blindness since infancy. Computed tomography revealed a marble-like sclerotic pattern of all cranial bones, a thickened parietal bone, and a narrowing of the encephalic space and the optic canal. Further laboratory and imaging studies revealed complete sclerosed bone of the chest and pelvis, anemia, reticulocitosis, extramedular hematopoiesis, altered dehydrogenasis lactate, and acid phosphatasis. An interdisciplinary treatment was initiated with medical and dental care monitoring. The patient is still receiving attention after 4 years of follow-up. CONCLUSIONS The outcome of this case represents the daily challenges faced by interdisciplinary care providers and reveals pearls and pitfalls that can serve as a reference for professional practice in such cases.
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Affiliation(s)
- Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School, of Amazonas State University, Manaus, Amazonas, Brazil
| | - Ana Julia Desideri Vieira
- Undergraduate Dentistry Student, Dental School of Amazonas State University, Manaus, Amazonas, Brazil
| | - Alessandra Valle Salino
- Department Special Care Dentistry, Dental School of Amazonas State University, Manaus, Amazonas, Brazil
| | | | - Hugo Felipe do Vale
- Department of Periodontics, Dental School of Amazonas State University, Manaus, Amazonas, Brazil
| | | | - Roman Carlos
- Oral and Maxillofacial Pathology, Hospital Herrera-Llerandi, Guatemala City, Guatemala
| | - Luciano Tavares Ângelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Santos RMD, Machado NEDS, Cantiga-Silva C, Belardi BE, Tsosura TVS, Chiba FY, Tessarin GWL, Mattera MSDLC, Nobumoto ACTY, Ervolino E, Cintra LTA, Matsushita DH. Modulatory influence of melatonin on apical periodontitis in Wistar rats fed a high-fat diet. Arch Oral Biol 2023; 153:105749. [PMID: 37320884 DOI: 10.1016/j.archoralbio.2023.105749] [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: 03/29/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to evaluate the influence of high-fat diet (HFD) and melatonin (MEL) treatment on the progression of inflammation and alveolar bone resorption (ABR) in rats with AP. DESIGN Forty male Wistar rats were divided into four groups: apical periodontitis (AP), HFDAP, APMEL and HFDAPMEL. The animals were fed an HFD or standard diet for 107 days. On the 7th day, the rats were subjected to AP, and after 70 days, the rats in the MEL groups were treated with MEL for 30 days. Post treatment, the animals were euthanized, and their jaws were retrieved for evaluation of bone resorption, intensity of the inflammatory response, and immunohistochemical analysis including tartrate-resistant acid phosphatase (TRAP) and interleukin-1β (IL-1β) levels and tumor necrosis factor (TNF)-α expression. RESULTS The APMEL group showed reduction in the inflammatory infiltrate and IL-1β expression relation to HFDAP, while the TNF-α levels did not differ among the groups. The HFDAP group showed an increase in the ABR. MEL reduced the TRAP levels in the APMEL and HFDAPMEL groups. CONCLUSIONS while MEL could reduce TRAP levels in the APMEL and HFDAPMEL groups, the reduction in the HFDAPMEL group was smaller than that in the APMEL group, demonstrating that the interaction between AP and HFD decreased the anti-resorptive effects of MEL.
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Affiliation(s)
- Rodrigo Martins Dos Santos
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Nathalia Evelyn da Silva Machado
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brazil
| | - Cristiane Cantiga-Silva
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brazil
| | - Bianca Elvira Belardi
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Thais Verônica Saori Tsosura
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Fernando Yamamoto Chiba
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brazil
| | - Gestter Willian Lattari Tessarin
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; North University Center of São Paulo, Unorte, São José do Rio Preto, SP, Brazil.
| | - Maria Sara de Lima Coutinho Mattera
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ana Carla Thalez Ywabuchi Nobumoto
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Edilson Ervolino
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brazil
| | - Doris Hissako Matsushita
- São Paulo State University (UNESP), School of Dentistry, Araçatuba Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP) Araçatuba, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF)/Sociedade Brasileira de Fisiologia (SBFis), School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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9
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Vasques AMV, da Silva ACR, Bueno CRE, Cury MTS, Ervolino E, Cintra LTA, Dezan Junior E. Inflammatory profile of apical periodontitis exacerbated by cigarette smoke inhalation: Histological and immunohistochemical analysis in rats. Int Endod J 2023; 56:465-474. [PMID: 36585248 DOI: 10.1111/iej.13883] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023]
Abstract
AIM The aim of this study was to evaluate the effects of cigarette smoke inhalation (CSI) on inflammation, pro-inflammatory mediators and haematological parameters in rats with induced apical periodontitis (AP). METHODOLOGY Thirty-two 3-month-old male Wistar rats were divided into four experimental groups (n = 8): C-Control; S-rats with CSI; AP-rats with AP; and SAP-rats with CSI + AP. Animals in groups S and SAP inhaled cigarette smoke by remaining inside a smoking chamber for 8 min, three times daily, for 50 days. After 20 days of smoke inhalation, animals in AP and SAP groups had the pulps of the lower right first molar exposed to oral environment for 30 days to induce AP. In these subsequent 30 days, animals in group S and SAP continued with CSI. On Day 50, animals were euthanized and mandibles were histologically processed to assess inflammatory infiltrate, immunohistochemical interleukins (IL-1β, IL-6 and TNF-α), and blood samples collected for laboratory analysis. The Mann-Whitney test was performed for non-parametric data and the pairwise analyses of Student's t-test for parametric data, with a significance level of p < .050. RESULTS Inflammatory infiltrate was moderate in AP group and more severe in the SAP (p = .010). The interleukins IL-6, IL-1β and TNF-α were higher in SAP group (p < .001) when compared to the AP group. A greater number of red blood cells (p = .010), haemoglobin (p = .007) and neutrophils (p = .014) were observed in the SAP group in comparison with the AP group. CONCLUSION Cigarette smoke inhalation induced a more severe inflammatory infiltrate, with increased levels of pro-inflammatory cytokines and changes in haematological parameters in rats with induced AP. Thus, CSI aggravated AP, exacerbating the inflammatory response.
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Affiliation(s)
- Ana Maria Veiga Vasques
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ana Claudia Rodrigues da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Carlos Roberto Emerenciano Bueno
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Marina Tolomei Sandoval Cury
- Endodontic Section, 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, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Eloi Dezan Junior
- Endodontic Section, 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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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: 8] [Impact Index Per Article: 4.0] [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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11
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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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