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Arias-Moliz MT, Pérez-Carrasco V, Uroz-Torres D, Santana Ramos JD, García-Salcedo JA, Soriano M. Identification of keystone taxa in root canals and periapical lesions of post-treatment endodontic infections: Next generation microbiome research. Int Endod J 2024; 57:933-942. [PMID: 38357799 DOI: 10.1111/iej.14046] [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: 11/01/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
AIM The aim of this study was to analyse and compare the microbiome present in root canals and periapical lesions of teeth with post-treatment infections, and to identify the presence of keystone taxa in both habitats using next-generation sequencing analysis. METHODOLOGY Apices and periapical lesions of patients with post-treatment apical periodontitis were surgically extracted. Specimens were cryo-pulverized, bacterial DNA was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using the Illumina Miseq platform. Bioinformatic analysis was carried out with Mothur software, whilst diversity indices were obtained using operational taxonomic units (OTUs). The diversity indices were compared with the Kruskal-Wallis test, and community composition differences were explored with Permutational Multivariate Analysis of Variance (PERMANOVA). A bacterial functional study was performed with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Co-occurrence network analyses were performed using the Sparse Correlations for Compositional data (SparCC). Eigencentrality, clr-based abundance and ubiquitousness were applied to infer keystone taxa. P values <.05 were considered statistically significant. RESULTS Thirty-two apices and thirty-nine periapical lesions were sequenced and analysed. A similar alpha-diversity (p < .05) and community composition (p = .91) was observed for apices and lesion samples. The most abundant OTUs identified amongst all samples included Fusobacterium nucleatum, Prevotella loescheii, Streptococcus intermedius, Porphyromonas gingivalis, Parvimonas micra, Synergistetes bacterium, Tannerella forsythia and Peptostreptococcus stomatis. The metabolic pathways with >0.81% abundances included membrane transport, genetic information processing and metabolic pathways. F. nucleatum was identified as a keystone taxon as it showed ubiquitousness, an eigenvector centrality value of 0.83 and a clr-based abundance >4. CONCLUSIONS The microbiome in apices and periapical lesions of post-treatment endodontic infections showed a similar diversity and taxonomic composition. Co-occurrence network analyses at OTU level identified F. nucleatum as a keystone taxon candidate in these infections.
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Affiliation(s)
- Maria Teresa Arias-Moliz
- Department of Microbiology, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Virginia Pérez-Carrasco
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | | | - Jose Antonio García-Salcedo
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Soriano
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Center for Research in Mediterranean Intensive Agrosystems and Agri-Food Biotechnology (CIAIMBITAL), University of Almeria, Almería, Spain
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2
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Ordinola-Zapata R, Costalonga M, Dietz M, Lima BP, Staley C. The root canal microbiome diversity and function. A whole-metagenome shotgun analysis. Int Endod J 2024; 57:872-884. [PMID: 36861850 DOI: 10.1111/iej.13911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
AIM To evaluate the root canal microbiome composition and bacterial functional capability in cases of primary and secondary apical periodontitis utilizing whole-metagenome shotgun sequencing. METHODOLOGY Twenty-two samples from patients with primary root canal infections, and 18 samples obtained from previously treated teeth currently diagnosed with apical periodontitis were analysed with whole-metagenome shotgun sequencing at a depth of 20 M reads. Taxonomic and functional gene annotations were made using MetaPhlAn3 and HUMAnN3 software. The Shannon and Chao1 indices were utilized to measure alpha diversity. Differences in community composition were evaluated utilizing analysis of similarity (ANOSIM) using Bray-Curtis dissimilarities. The Wilcoxon rank sum test was used to compare differences in taxa and functional genes. RESULTS Microbial community variations within a community were significantly lower in secondary relative to primary infections (alpha diversity p = .001). Community composition was significantly different in primary versus secondary infection (R = .11, p = .005). The predominant taxa observed among samples (>2.5%) were Pseudopropionibacterium propionicum, Prevotella oris, Eubacterium infirmum, Tannerella forsythia, Atopobium rimae, Peptostreptococcus stomatis, Bacteroidetes bacterium oral taxon 272, Parvimonas micra, Olsenella profusa, Streptococcus anginosus, Lactobacillus rhamnosus, Porphyromonas endodontalis, Pseudoramibacter alactolyticus, Fusobacterium nucleatum, Eubacterium brachy and Solobacterium moorei. The Wilcoxon rank test revealed no significant differences in relative abundances of functional genes in both groups. Genes with greater relative abundances (top 25) were associated with genetic, signalling and cellular processes including the iron and peptide/nickel transport system. Numerous genes encoding toxins were identified: exfoliative toxin, haemolysins, thiol-activated cytolysin, phospholipase C, cAMP factor, sialidase, and hyaluronic glucosaminidase. CONCLUSIONS Despite taxonomic differences between primary and secondary apical periodontitis, the functional capability of the microbiomes was similar.
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Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Massimo Costalonga
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Matthew Dietz
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher Staley
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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3
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AlMogbel AA, Alasmary S, Alfarraj S, Alenazi R, Albuti R. Orthodontics and Endodontics Clinical Practice Correlation: A Narrative Review. Cureus 2024; 16:e56821. [PMID: 38654793 PMCID: PMC11037287 DOI: 10.7759/cureus.56821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Research on the connection between endodontic therapy and orthodontics is lacking. This overview of the literature synthesizes the findings from the fields of orthodontics and endodontics and explains how they are related. Beginning with the diagnosis, treating the patient at the appropriate time, moving endodontically treated teeth and traumatized teeth, resorbing roots by orthodontic mechanics, and managing traumatized teeth with orthodontic therapy. Multiple electronic databases were utilized including (PubMed, Scopus, Science Direct, and Web of Science) to perform manual literature searches. A total of 31 articles were reviewed and summarized in this paper in keywords like "Endodontically Treated Teeth and Orthodontic Treatment," "Endodontically Treated Tooth and Orthodontic Movement," "Orthodontic Treatment in RCT Teeth," "Root Canal Treatment with Orthodontic Movement," "Trauma with Orthodontic Movement," "Orthodontic and Endodontic." Orthodontic treatment of endodontically treated and traumatized teeth is a subject of controversy. The lack of research on the topic makes it a hard decision to make when to treat these teeth. Especially given that both orthodontic and endodontic treatments have multiple consequences on each other's outcomes. Thus, it is crucial for clinicians to understand how they integrate and have a guideline to refer to during decision-making. Successful orthodontic tooth movement could be carried out immediately after endodontic treatment. However, traumatized teeth need a follow-up period before initiating orthodontic movement, which ranges from three months to 12 months depending on the type of trauma and severity. Careful radiographic and clinical follow-up should be done during the healing period. Collaborative teamwork is important between orthodontists and endodontists for the success of treatment, and to achieve satisfactory outcomes.
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Affiliation(s)
- AbdulMajeed A AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, SAU
| | - Shatha Alasmary
- Department of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, College of Dentistry, Riyadh, SAU
| | - Shaden Alfarraj
- Department of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, College of Dentistry, Riyadh, SAU
| | - Raya Alenazi
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, SAU
| | - Rawan Albuti
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, SAU
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Teves-Cordova A, Coloma Calle L, Mejia Rojas P, Goncalves-Pereira J, Duarte MAH. Vital Pulp Therapy in Permanent Teeth Diagnosed with Symptomatic Irreversible Pulpitis: Reports with Long-Term Controls. Case Rep Dent 2023; 2023:2694388. [PMID: 38045017 PMCID: PMC10689073 DOI: 10.1155/2023/2694388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
The aim of this study was to describe the treatment of permanent teeth diagnosed with irreversible pulpitis, which can be effectively managed with partial or total pulpotomy. This alternative approach has shown great clinical and radiographic success in the long term compared to traditional pulpectomies. In this series of clinical cases, all the teeth exhibited symptoms of intense pain upon exposure to cold and at night. The clinical examination revealed extensive caries, while radiographic imaging showed radiolucent lesions in contact with the pulp chamber, indicating symptomatic irreversible pulpitis. The chosen treatment approach was either partial or total pulpotomy. The tooth was anesthetized, and the operative field was isolated and disinfected. After removing caries with a sterile round drill, the area was rinsed with sodium hypochlorite. In some cases, a portion of the pulp tissue was removed, while in others, the entire tissue of the pulp chamber was extracted using diamond burs. Hemostasis was achieved by applying sterile cotton pellets for 2 to 6 minutes. Following that, the tissue exhibited no signs of bleeding. Bioceramic cements were used, and the tooth was definitively restored. Periodic follow-up examinations were conducted, consistently showing positive pulp responses and no evidence of periradicular radiolucent lesions on radiographs.
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Affiliation(s)
- Abel Teves-Cordova
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo-USP, Bauru, Brazil
| | - Luis Coloma Calle
- Faculty of Dentistry of the Catholic University of Cuenca-Azogues, Ecuador
| | - Pierre Mejia Rojas
- Department of Endodontics, School of Dentistry, Cayetano Heredia Peruvian University, Lima, Peru
| | - Juan Goncalves-Pereira
- Department of Endodontics, School of Dentistry, Central University of Venezuela, Caracas, Venezuela
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo-USP, Bauru, Brazil
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Sathyanarayanan K, Ranjana NI, Bhavana M, R M, Sankar A, Mirnalini S. Asymptomatic Apical Periodontitis Lesions and Their Association With Systemic Inflammatory Burden: A Preliminary Prospective Clinical Study. Cureus 2023; 15:e46357. [PMID: 37920638 PMCID: PMC10619333 DOI: 10.7759/cureus.46357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background: Apical periodontitis (AP) is an inflammatory disorder of the periapical tissues caused by the persistence of a microbial infection within the root canal system of the affected tooth. Clinically, it is symptomatic or asymptomatic depending on several factors such as the type of microorganisms, bacterial load, immunological reaction, and local tissue mediators. Chronic or asymptomatic infections may initiate and modulate intravascular accumulation of inflammatory cells resulting in endothelial dysfunction which subsequently represents a possible systemic inflammatory burden. Aim: The present study aimed to evaluate the relationship between asymptomatic AP and systemic inflammatory burden by assessing the levels of chronic inflammatory cells. Methodology: A total of 25 patients diagnosed with asymptomatic AP who showed a negative response to the pulp sensitivity test with no history of any systemic diseases were included in this preliminary prospective observational study. Blood samples were collected at each phase of the study, and a complete hemogram was carried out. All hematological parameters were recorded before and after root canal therapy and they were analyzed for statistical significance at p <.05 using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Results: Evaluation of the mean total leukocyte count (TLC), lymphocyte, and eosinophil cell count showed a significant reduction in the number of cells before and after root canal therapy treatment respectively (p<.05). One-way analysis of variance also revealed statistical significance at p < .05 with a weak positive correlation between the TLC, lymphocyte, and eosinophil count before and after treatment. Conclusion: The present study showed that systemically healthy individuals with asymptomatic AP had increased inflammatory burden in the circulation, and thus, it is essential to identify and quantify the risk associated. It was evident that complete healing of the asymptomatic AP lesions results in an overall reduction of systemic inflammatory cells ultimately reducing the burden and risk of associated systemic inflammatory diseases.
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Affiliation(s)
| | - N I Ranjana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Mohan Bhavana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Megavarnan R
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Aravinthan Sankar
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Selvakumar Mirnalini
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
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6
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Frazão DR, Santos Mendes PF, Baia-da-Silva DC, Mendonça de Moura JD, Neves dos Santos VR, Matos-Sousa JM, de Souza Balbinot G, Guimarães DM, Collares FM, Lima RR. Modulation of blood redox status by the progression of induced apical periodontitis in rats. Front Physiol 2023; 14:1214990. [PMID: 37731541 PMCID: PMC10508187 DOI: 10.3389/fphys.2023.1214990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/07/2023] [Indexed: 09/22/2023] Open
Abstract
This study aimed to investigate if apical periodontitis in different periods changes systemic levels of the antioxidant and pro-oxidant parameters in Wistar rats. Twenty-four rats were randomly allocated into healthy animals, apical periodontitis at 14 days (AP14) and apical periodontitis at 28 days (AP28). The first mandibular molars were accessed in the AP groups, and the pulp chamber was exposed to the oral environment, inducing the apical lesion. After 14 and 28 days, the animals were anesthetized, euthanized, and hemimandibles were collected for micro-computed tomography (micro-CT) analysis to measure lesion volume, bone volume (BV), percent of bone to total tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular space (Tb.Sp). A histological examination of the remaining bone was also performed. Finally, blood samples were collected for oxidative biochemistry analysis, investigating glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS). The lesion volume was greater at 28 than at 14 days, as shown by micro-CT. AP14 and AP28 had decreased BV and Tb.Th, but only AP28 showed a reduction in BV/TV. Tb.N and Tb. Sp were increased in apical periodontitis at 28 days. In the histopathological analysis, AP14 had focal regions of moderate mononuclear inflammatory infiltrate, and AP28 had an intense inflammatory infiltrate with bacterial colonies. In the biochemical evaluation, GSH, TEAC, and TBARS were increased after 14 days. However, GSH returned to control levels, TEAC was similar to AP14, and TBARS increased significantly after 28 days. Therefore, the oxidative biochemistry response was modulated according to the progression of periapical damage. After 14 days, the organism could still react to the injury. However, at 28 days, the antioxidant response decreased, associated with an increase in TBARS.
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Affiliation(s)
- Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - Paulo Fernando Santos Mendes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - Daiane Claydes Baia-da-Silva
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - João Daniel Mendonça de Moura
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - Vinicius Ruan Neves dos Santos
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - José Mario Matos-Sousa
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - Gabriela de Souza Balbinot
- Dental Material Laboratory, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Fabrício Mezzomo Collares
- Dental Material Laboratory, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, Brazil
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7
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Kotecha N, Shah NC, Doshi RJ, Kishan KV, Luke AM, Shetty KP, Mustafa M, Pawar AM. Microbiological Effectiveness of Sodium Hypochlorite Gel and Aqueous Solution When Implemented for Root Canal Disinfection in Multirooted Teeth: A Randomized Clinical Study. J Funct Biomater 2023; 14:jfb14050240. [PMID: 37233350 DOI: 10.3390/jfb14050240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/07/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)-canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)-canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro-Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann-Whitney U test which was used to compare the CFU difference (×105) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.
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Affiliation(s)
- Niral Kotecha
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Nimisha Chinmay Shah
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Rohan Jiteshkumar Doshi
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Karkala Venkappa Kishan
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Krishna Prasad Shetty
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
- Centre for Transdisciplinary Research, Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
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Martos R, Tar I, Nagy AC, Csősz É, Kiss C, Márton I. Hypercitrullination and anti-citrullinated protein antibodies in chronic apical periodontitis, a laboratory investigation. Does autoimmunity contribute to the pathogenesis? Int Endod J 2023; 56:584-592. [PMID: 36762960 DOI: 10.1111/iej.13903] [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: 12/06/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
AIM The presence of Gram-negative anaerobic bacteria, in particular, Porphyromonas gingivalis (P. gingivalis) in periapical granulomas predicts the generation of citrullinated proteins in the lesion. Citrullination of proteins may lead to the formation of anti-citrullinated autoantibodies (ACPA-s) initiating the formation of an autoimmune loop which may contribute to the perpetuation of inflammatory reactions and tissue damage in chronic apical periodontitis. The objective of this study was to demonstrate the formation of citrullinated proteins in chronic apical periodontitis and whether they can act as autoantigens. METHODOLOGY Twenty-five periapical granulomas (n = 25) were investigated in the study. Healthy periodontal tissue samples served as normal control tissue (n = 6). The peptidyl-citrulline level was determined with the dot blot method. ACPA levels were analysed using anti-citrullinated cyclic peptide (anti-CCP) EDIA kit. Differences between periapical granuloma and control samples were assessed using Mann-Whitney U tests. p Values <.05 were considered as statistically significant. RESULTS Protein concentrations, peptidyl-citrulline levels and anti-CCP ratios were compared between periapical granuloma and healthy control groups. Multiple linear regression analysis revealed significant (p = .042) hypercitrullination in periapical granuloma samples. Moreover, there was a significant difference in the ACPA ratios between periapical granuloma (2.03 ± 0.30) and healthy control (0.63 ± 0.17) groups (p = .01). Seventeen of 25 periapical granuloma samples (17/25; 68%), whereas one out of six control samples (1/6; 17%) were shown to be positive for the presence of ACPA. CONCLUSIONS This is the first study detecting the presence of citrullinated peptides and APCA in periapical granuloma, suggesting the contribution of autoimmune reactions in the pathogenesis and perpetuation of chronic apical periodontitis.
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Affiliation(s)
- Renáta Martos
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Ildikó Tar
- Department of Oral Medicine, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Éva Csősz
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csongor Kiss
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildikó Márton
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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9
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SANCAR B, TALAY GA. Treatment of Apical Periodontitis Induced BRONJ with Endodontic Treatment. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.972890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is one of the serious side effects of bisphosphonates, has an increasing clinical importance due to the widespread use of bisphosphonates in the treatment of many diseases such as osteoporosis, osteopenia, Paget's disease, osteogenesis imperfecta, and multiple myeloma. BRONJ can spontaneously develop in the jawbones. In addition, many factors such as tooth extraction, periodontal diseases, and local trauma can trigger BRONJ. In our case, it was detected that the lesion appearing like BRONJ in the left lower jaw of the 67-year-old female patient with a history of oral bisphosphonate use developed due to apical periodontitis resulting from the tooth numbered 34. Root canal treatment was administered to the relevant tooth of the patient, the fistula tract was closed after this treatment, and as a result of the CBCT examination, it was observed that the enlargement in the necrotic bone area stopped. In addition, the patient's complaints about the relevant tooth disappeared. As a result, endodontic treatment is an effective treatment approach in the treatment of BRONJ developing due to apical periodontitis. In order to avoid the risk of BRONJ, a detailed oral examination should be performed before starting the bisphosphonate treatment, and necessary endodontic, restorative and periodontal treatments should be followed.
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Affiliation(s)
- Bahadır SANCAR
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
| | - Gönen Aras TALAY
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
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10
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Ahmad MZ, Merdad KA, Sadaf D. An overview of systematic reviews on endotoxins in endodontic infections and the effectiveness of root canal therapy in its removal. Evid Based Dent 2022:10.1038/s41432-022-0826-x. [PMID: 36482195 DOI: 10.1038/s41432-022-0826-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/16/2022] [Indexed: 06/17/2023]
Abstract
Background The objective of this overview was to synthesise the current evidence on the role of endotoxins in endodontics infections and to evaluate the effectiveness of endodontic procedures in its removal using information from published systematic reviews.Methods Electronic databases Medline, Scopus, Embase, Cochrane Library and Google Scholar were searched for reviews published up to July 2021. Systematic reviews on endotoxins based on clinical and/or observational studies were included. The quality of systematic reviews was assessed with the AMSTAR2 tool.Results A total of five systematic reviews were selected, of which two reviews were of high quality. A significantly higher level of endotoxins were found in teeth with exudation, teeth with a previous episode of pain and pain on percussion. Chemomechanical preparation of root canals significantly reduce endotoxin levels. Calcium hydroxide intracanal medication in symptomatic teeth was significantly effective in endotoxin reduction (standardised mean difference -1.051 [95% confidence interval -2.039 to -0.063]; p <0.05; I2 = 83.3%; certainty of evidence = very low). Multiple session root canal treatment in teeth with symptomatic apical periodontitis was significantly more effective in endotoxins/lipopolysaccharides removal than single-session treatment.Conclusion Limited quality of evidence showed a significant association of endotoxins in infected teeth with clinical symptoms. Conventional chemomechanical preparation of root canals and intracanal medication were unable to eliminate endotoxins from the root canal system. Future evolution of effective disinfection therapies is warranted.
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Affiliation(s)
- Muhammad Z Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Alrass, Saudi Arabia
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Durre Sadaf
- Department of Microbial Diseases, University College London, Eastman Dental Institute, London, United Kingdom.
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11
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Ferreira ML, Buligon MP, Sfreddo CS, Liedke GS, Morgental RD. Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis. Braz Oral Res 2022; 36:e112. [PMID: 35946740 DOI: 10.1590/1807-3107bor-2022.vol36.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/11/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.
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Affiliation(s)
- Monika Lamas Ferreira
- Universidade Federal de Pelotas - UFPel, Graduate Program in Dentistry , Pelotas , RS , Brazil
| | - Mônica Pagliarini Buligon
- Universidade Federal de Santa Maria - UFSM, Graduate Program in Dental Sciences , Santa Maria , RS , Brazil
| | - Camila Silveira Sfreddo
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Department of Semiology and Clinics , Pelotas , RS , Brazil
| | - Gabriela Salatino Liedke
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Stomatology , Santa Maria , RS , Brazil
| | - Renata Dornelles Morgental
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Stomatology , Santa Maria , RS , Brazil
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Pucinelli CM, Lima RB, Almeida LKY, Lucisano MP, Córdoba AZ, Marchesan JT, da Silva LAB, da Silva RAB. Interferon‐gamma inducible protein 16 and type I interferon receptors expression in experimental apical periodontitis induced in wild type mice. Int Endod J 2022; 55:1042-1052. [DOI: 10.1111/iej.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- C. M. Pucinelli
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - R. B. Lima
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - L. K. Y. Almeida
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - M. P. Lucisano
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - A. Z. Córdoba
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - J. T. Marchesan
- Department of Periodontology ‐ University of North Carolina at Chapel Hill School of Dentistry Chapel Hill NC EUA
| | - L. A. B. da Silva
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
| | - R. A. B. da Silva
- Department of Pediatric Dentistry ‐ University of São Paulo School of Dentistry of Ribeirão Preto Ribeirão Preto SP Brazil
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Alnowailaty Y, Alghamdi F. Prevalence of Endodontically Treated Premolars and Molars With Untreated Canals and Their Association With Apical Periodontitis Using Cone-Beam Computed Tomography. Cureus 2022; 14:e25619. [PMID: 35795507 PMCID: PMC9250691 DOI: 10.7759/cureus.25619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/05/2022] Open
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do Nascimento IV, Rodrigues MIQ, Isaias PHC, Barros‐Silva PG, Sousa FB, Nunes Alves APN, Mota MRL. Chronic systemic corticosteroid therapy influences the development of pulp necrosis and experimental apical periodontitis, exacerbating the inflammatory process and bone resorption in rats. Int Endod J 2022; 55:646-659. [DOI: 10.1111/iej.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Isabelly Vidal do Nascimento
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Maria Imaculada Queiroz Rodrigues
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Pedro Henrique Chaves Isaias
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Paulo Goberlânio Barros‐Silva
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Fabricio Bitu Sousa
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Ana Paula Negreiros Nunes Alves
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Mário Rogério Lima Mota
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
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15
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Radicular canal disinfection using Photodynamic therapy and Sodium Hypochlorite following three chelating agents’ green tea extract, grape extract, and Ethylenediaminetetraacetic acid on the push-out bond strength of epoxy resin-based sealer. Photodiagnosis Photodyn Ther 2022; 38:102809. [DOI: 10.1016/j.pdpdt.2022.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/23/2022]
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Hussein H, Kishen A. Application of Proteomics in Apical Periodontitis. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.814603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Apical periodontitis is an inflammatory reaction of the periradicular tissues as a consequence of multispecies microbial communities organized as biofilms within the root canal system. Periradicular tissue changes at the molecular level initiate and orchestrate the inflammatory process and precede the presentation of clinical symptoms. Inflammatory mediators have been studied at either the proteomic, metabolomic, or transcriptomic levels. Analysis at the protein level is the most common approach used to identify and quantify analytes from diseased periradicular tissues during root canal treatment, since it is more representative of definitive and active periradicular inflammatory mediator than its transcript expression level. In disease, proteins expressed in an altered manner could be utilized as biomarkers. Biomarker proteins in periradicular tissues have been qualitatively and quantitatively assessed using antibodies (immunoassays and immunostaining) or mass spectrometry-based approaches. Herein, we aim to provide a comprehensive understanding of biomarker proteins identified in clinical studies investigating periradicular lesions and pulp tissue associated with apical periodontitis using proteomics. The high throughput mass spectrometry-based proteomics has the potential to improve the current methods of monitoring inflammation while distinguishing between progressive, stable, and healing lesions for the identification of new diagnostic and therapeutic targets. This method would provide more objective tools to (a) discover biomarkers related to biological processes for better clinical case selection, and (b) determine tissue response to novel therapeutic interventions for more predictable outcomes in endodontic treatment.
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Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. FRONTIERS IN ORAL HEALTH 2022; 2:672887. [PMID: 35048015 PMCID: PMC8757850 DOI: 10.3389/froh.2021.672887] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is the habitat of several hundreds of microbial taxa that have evolved to coexist in multispecies communities in this unique ecosystem. By contrast, the internal tissue of the tooth, i.e., the dental pulp, is a physiologically sterile connective tissue in which any microbial invasion is a pathological sign. It results in inflammation of the pulp tissue and eventually to pulp death and spread of inflammation/infection to the periradicular tissues. Over the past few decades, substantial emphasis has been placed on understanding the pathobiology of root canal infections, including the microbial composition, biofilm biology and host responses to infections. To develop clinically effective treatment regimens as well as preventive therapies, such extensive understanding is necessary. Rather surprisingly, despite the definitive realization that root canal infections are biofilm mediated, clinical strategies have been focused more on preparing canals to radiographically impeccable levels, while much is left desired on the debridement of these complex root canal systems. Hence, solely focusing on "canal shaping" largely misses the point of endodontic treatment as the current understanding of the microbial aetiopathogenesis of apical periodontitis calls for the emphasis to be placed on "canal cleaning" and chemo-mechanical disinfection. In this review, we dissect in great detail, the current knowledge on the root canal microbiome, both in terms of its composition and functional characteristics. We also describe the challenges in root canal disinfection and the novel strategies that attempt to address this challenge. Finally, we provide some critical pointers for areas of future research, which will serve as an important area for consideration in Frontiers in Oral Health.
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Affiliation(s)
- Jasmine Wong
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Peggy Näsman
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Abdeta A, Bitew A, Fentaw S, Tsige E, Assefa D, Lejisa T, Kefyalew Y, Tigabu E, Evans M. Phenotypic characterization of carbapenem non-susceptible gram-negative bacilli isolated from clinical specimens. PLoS One 2021; 16:e0256556. [PMID: 34855767 PMCID: PMC8638961 DOI: 10.1371/journal.pone.0256556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023] Open
Abstract
Background Multidrug resistant, extremely drug-resistant, pan-drug resistant, carbapenem-resistant, and carbapenemase-producing gram-negative bacteria are becoming more common in health care settings and are posing a growing threat to public health. Objective The study was aimed to detect and phenotypically characterize carbapenem no- susceptible gram-negative bacilli at the Ethiopian Public Health Institute. Materials and methods A prospective cross-sectional study was conducted from June 30, 2019, to May 30, 2020, at the national reference laboratory of the Ethiopian Public Health Institute. Clinical samples were collected, inoculated, and incubated for each sample in accordance with standard protocol. Antimicrobial susceptibility testing was conducted using Kirby-Bauer disk diffusion method. Identification was done using the traditional biochemical method. Multidrug-resistant and extensively drug-resistant isolates were classified using a standardized definition established by the European Centre for Disease Prevention and Control and the United States Centers for Disease Prevention and Control. Gram-negative organisms with reduced susceptibility to carbapenem antibiotics were considered candidate carbapenemase producers and subjected to modified carbapenem inactivation and simplified carbapenem inactivation methods. Meropenem with EDTA was used to differentiate metallo-β-lactamase (MBL) from serine carbapenemase. Meropenem (MRP)/meropenem + phenylboronic acid (MBO) were used to differentiate Klebsiella pneumoniae carbapenemase (KPC) from other serine carbapenemase producing gram-negative organisms. Results A total of 1,337 clinical specimens were analyzed, of which 429 gram-negative bacterial isolates were recovered. Out of 429 isolates, 319, 74, and 36 were Enterobacterales, Acinetobacter species, and Pseudomonas aeruginosa respectively. In our study, the prevalence of multidrug-resistant, extensively drug-resistant, carbapenemase-producing, and carbapenem nonsusceptible gram-negative bacilli were 45.2%, 7.7%, 5.4%, and 15.4% respectively. Out of 429 isolates, 66 demonstrated reduced susceptibility to the antibiotics meropenem and imipenem. These isolates were tested for carbapenemase production of which 34.8% (23/66) were carbapenemase producers. Out of 23 carbapenemase positive gram-negative bacteria, ten (10) and thirteen (13) were metallo-beta-lactamase and serine carbapenemase respectively. Three of 13 serine carbapenemase positive organisms were Klebsiella pneumoniae carbapenemase. Conclusion This study revealed an alarming level of antimicrobial resistance (AMR), with a high prevalence of multidrug-resistant (MDR) and extremely drug-resistant, carbapenemase-producing gram-negative bacteria, particularly among intensive care unit patients at the health facility level. These findings point to a scenario in which clinical management of infected patients becomes increasingly difficult and necessitates the use of “last-resort” antimicrobials likely exacerbating the magnitude of the global AMR crisis. This mandates robust AMR monitoring and an infection prevention and control program.
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Affiliation(s)
- Abera Abdeta
- National Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail:
| | - Adane Bitew
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Surafel Fentaw
- National Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Estifanos Tsige
- National Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dawit Assefa
- National Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tadesse Lejisa
- National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yordanos Kefyalew
- Department of Applied Biology, School of Applied Natural Science, Adama Science and Technology University, Adama, Ethiopia
| | - Eyasu Tigabu
- Global One Health initiative, The Ohio State University, East African Regional Office, Addis Ababa, Ethiopia
| | - Martin Evans
- Laboratory Director and Microbiology Consultant, New York, New York, United States of America
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Ali NT, El-Boghdadi RM, Ibrahim AM, Amin SAW. Clinical and microbiological effects of ultrasonically activated irrigation versus syringe irrigation during endodontic treatment: a systematic review and meta-analysis of randomized clinical trials. Odontology 2021; 110:419-433. [PMID: 34729673 DOI: 10.1007/s10266-021-00671-8] [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: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
This study aimed to systematically review clinical and microbiology-related effects of ultrasonically activated irrigation (UAI) compared to syringe irrigation (SI) during endodontic treatment. Electronic databases searching and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing UAI to SI. The RoB 2.0 Cochrane tool was used for risk-of-bias (RoB) assessment. The main outcomes were postoperative pain, treatment failure, and microbiology-related outcomes. Qualitative and quantitative analyses, wherever applicable, were performed. Risk ratios (RR) and [standardized] mean differences {[S]MD} were calculated for dichotomous and continuous outcomes, respectively. Certainty of evidence (CoE) was assessed using GRADE tool. Ten RCTs were included. UAI reduced pain incidence within the first 24 h (RR 0.50, 95% CI 0.35-0.71, 308 teeth) and microbial counts (SMDpooled - 0.40, 95% CI [- 0.78, - 0.02], I2 = 0%, 126 teeth) than SI in non-vital teeth with apical periodontitis (AP). Both groups, however, had similar effects regarding pain intensity, lipopolysaccharide amounts, and the incidence of rescue-analgesic intake, treatment failure, and microbial presence (p > 0.05). CoE ranged from low to very low. Very limited evidence suggests that UAI could reduce postoperative-pain risk within the first 24 h and microbial counts for non-vital teeth with AP compared to SI. Most meta-analyses, however, are based on very few studies, mostly low-powered, with an overall very-low-to-low CoE. Further well-designed, larger RCTs are, thus, required.
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Affiliation(s)
- Noha Tawfik Ali
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Randa Mohamed El-Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Ahmed Mohamed Ibrahim
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Suzan Abdul Wanees Amin
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt.
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Ricucci D, Siqueira JF, Abdelsayed RA, Lio SG, Rôças IN. Bacterial Invasion of Pulp Blood Vessels in Teeth with Symptomatic Irreversible Pulpitis. J Endod 2021; 47:1854-1864. [PMID: 34597722 DOI: 10.1016/j.joen.2021.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study described the degenerative changes and infection patterns of the pulp tissue associated with symptomatic irreversible pulpitis. METHODS The material consisted of 32 extracted teeth with untreated deep caries that were clinically and histologically diagnosed with irreversible pulpitis and were part of the histopathologic collection of 1 of the authors. The controls consisted of intact teeth with normal uninflamed pulps and teeth with reversible pulpitis. Teeth were processed for histopathologic and histobacteriologic analyses. RESULTS All teeth with irreversible pulpitis showed areas of severe acute inflammation, necrosis, microabscesses, and bacterial infection in the pulp chamber. These areas were surrounded by a chronic inflammatory infiltrate, and, at the distance, the pulp tissue was often uninflamed. Bacteria were also observed in the areas surrounding the necrotic foci, both as scattered cells through the extravascular space and at varying numbers within the blood vessel lumen. The number of bacteria and the density of the intravascular bacterial aggregations varied considerably. In one third of the cases, bacteria occurred in the lumen of venules in areas at a considerable distance from the necrotic focus in the coronal third of the root. No intravascular bacteria were noted in the middle and apical segments of the canal. No bacteria were found in the pulps of any of the control specimens. CONCLUSIONS Bacterial invasion and colonization of necrotic areas were observed in the pulp of all teeth with caries exposure and symptomatic irreversible pulpitis. Bacterial penetration of blood vessels occurred in all cases, suggesting that this may be an important mechanism of spread of bacterial infection through the pulp tissue in an endodontic infection.
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Affiliation(s)
| | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics and Dental Research, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Rafik A Abdelsayed
- Department of Oral Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, Augusta, Georgia
| | | | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics and Dental Research, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
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Does an interim dressing with calcium hydroxide reduce endotoxins between endodontic appointments? Evid Based Dent 2021; 22:96-97. [PMID: 34561657 DOI: 10.1038/s41432-021-0199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Data sources PubMed, Cochrane Library, LILACS/Biblioteca Brasileira de Odontologica, Web of Science, Embase, Scopus, grey literature.Study selection Randomised and non-randomised clinical studies, experimental studies. Population: human studies with permanent dentition; Intervention: evaluation of lipopolysaccharide (LPS) after dressing with calcium hydroxide (CH); Comparison: evaluation of LPS before dressing with CH; Outcome: antimicrobial efficacy against LPS.Data extraction and synthesis A modified Cochrane Risk of Bias (RoB) tool was used to evaluate internal validity of randomised controlled trials, Robins-1 tool for non-randomised controlled trials, and the 'Before and After' tool for experimental studies. Meta-analyses were conducted by subgrouping according to CH use, chemo-mechanical preparation (CMP), antimicrobial substance (AS), and irrigant. Further analyses explored incidence of LPS reduction. All subgroups were assessed for heterogeneity through I2 test and the random-effect model was applied. Sensitivity analysis was performed to evaluate the influence of studies with RoB in effect significance.Results Nine studies were included for qualitative assessment, of which seven were included for meta-analysis. Three studies were assessed as low RoB, one was medium risk, with two having a high RoB. Three studies presented with 'some concerns'. After dressing with CH, no AS resulted in 61.7% of teeth with reduction in LPS (95% CI: 37.7%-82.9%, I2 = 96.7%), compared to AS where 98.9% of teeth showed an LPS reduction (95% CI: 97.4%-99.8%, I2 = 38.6%). Where mean reductions in LPS were compared, CH with or without AS, reduced mean LPSs before (standardised mean difference [SMD] = 21.087 [CI: 21.453 to 20.721], P = 0.001, I2 = 58.7%) and after CMP (SMD = 20.919 [CI: 21.156 to 20.682], P = 0.001, I2 = 24.7%) using a CH dressing. Considering the irrigant solutions, the overall results showed a reduction before (SMD = 21.053 [CI: 21.311 to 20.795], P = 0.001, I2 = 58.7%) and after CMP (SMD = 20.938 [CI: 21.147 to 20.729], P = 0.001, I2 = 24.6%) using a CH dressing. There was a reduction in mean LPS over time, up to 30 days. All analyses presented a very low certainty of evidence.Conclusions An interim dressing with CH reduces LPS levels below those achieved with CMP and AS, but does not eliminate LPS completely. No evidence is presented on improved clinical outcomes following multiple-visit treatment with CH dressing.
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Sinha N, Asthana G, Parmar G, Langaliya A, Shah J, Kumbhar A, Singh B. Evaluation of Ozone Therapy in Endodontic Treatment of Teeth with Necrotic Pulp and Apical Periodontitis: A Randomized Clinical Trial. J Endod 2021; 47:1820-1828. [PMID: 34562501 DOI: 10.1016/j.joen.2021.09.006] [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: 08/02/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The aim of this study was to compare the effect of different application techniques of ozone on the prevalence of postendodontic pain in patients undergoing single-visit root canal treatment. METHODS hundred eight patients with necrotic pulp in single-rooted teeth and apical periodontitis participated in the trial. A standard single-visit endodontics protocol was followed with 5.25% sodium hypochlorite and rotary nickel-titanium files. After shaping and cleaning, patients were randomly allocated into the following groups: group 1 (n = 21), ozone treatment with no activation (NA); group 2 (n = 22), ozone treatment with manual dynamic activation (MDA); group 3, (n = 21), ozone treatment with passive ultrasonic activation (PUA); group 4 (n = 23), ozone treatment with sonic activation (SA); and group 5 (n = 21), no ozone treatment (the control group). Patient levels of discomfort were recorded at 6 different time intervals using the visual analog scale (VAS). Comparison of the mean difference between the groups and time intervals was performed using 2-way analysis of variance followed by a post hoc Bonferroni test. The level of significance was set at 5%. RESULTS VAS scores were highest for the control > NA > MDA > SA > PUA groups. A statistically significant reduction in VAS scores was observed in the PUA and SA groups in comparison with the NA, control, and MDA groups. Timewise comparison showed a highly significant decline in VAS scores at all time intervals (P < .001). CONCLUSIONS Ultrasonic and sonic activation of ozone resulted in less pain in patients undergoing single-visit endodontics compared with no ozone treatment.
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Affiliation(s)
- Nidhi Sinha
- Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India.
| | - Geeta Asthana
- Department of Conservative Dentistry and Endodontics, Government Dental College, Ahmedabad, Gujarat, India
| | - Girish Parmar
- Department of Conservative Dentistry and Endodontics, Government Dental College, Ahmedabad, Gujarat, India
| | - Akshayraj Langaliya
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Jinali Shah
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Aravind Kumbhar
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Bijay Singh
- Department of Prosthodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
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Samoilova EM, Yusubalieva GM, Belopasov VV, Ekusheva EV, Baklaushev VP. [Infections and inflammation in the development of stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:11-21. [PMID: 34553576 DOI: 10.17116/jnevro202112108211] [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] [Indexed: 12/30/2022]
Abstract
The review systematizes data on the role of infectious diseases and systemic inflammation in the pathogenesis of stroke. Various risk factors for stroke associated with pro-inflammatory reactions and their contribution to the pathogenesis of cerebrovascular pathology are analyzed. The interaction of systemic inflammation with hemostasis disturbances and clots formation, activation of autoreactive clones of cytotoxic lymphocytes, the progression of endothelial damage, and other processes is shown. Along with infection, these factors increase the risk of stroke. The key mechanisms of the pathogenesis from the development of acute or chronic inflammation to the preconditions of stroke are presented. The mechanisms of the acting of the infectious process as a trigger factor and/or medium-term or long-term risk factors of stroke are described. A separate section is devoted to the mechanisms of developing cerebrovascular diseases after COVID-19. Identifying an increased risk of stroke due to infection can be of great preventive value. Understanding of this risk by specialists followed by correction of drug therapy and rehabilitation measures can reduce the incidence of cerebrovascular complications in infectious patients.
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Affiliation(s)
- E M Samoilova
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - G M Yusubalieva
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - V V Belopasov
- Astrakhan State Medical University, Astrakhan, Russia
| | - E V Ekusheva
- Academy of Postgraduate Education of the Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies FMBA of Russia, Moscow, Russia.,Belgorod State National Research University, Belgorod, Russia
| | - V P Baklaushev
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
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Pereira JA, Polaquini CR, Dos Santos V, Caiaffa KS, Rabelo RL, Theodoro RDS, Theodoro LH, Regasini LO, Duque C. Antibiofilm and cytotoxic effect of 3,3'-dihydroxycurcumin (DHC) as photosensitizer agent in antimicrobial photodynamic therapy for endodontic purposes. Photodiagnosis Photodyn Ther 2021; 36:102534. [PMID: 34520879 DOI: 10.1016/j.pdpdt.2021.102534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 08/28/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Curcuminoids have been designed not only to improve chemical and metabolic stability of curcumin (CUR), but also to increase its antimicrobial activity, without effecting its ability as photosensitizer agent in antimicrobial photodynamic therapy (aPDT) with light emitting diode (LED). This study evaluated the antimicrobial and antibiofilm action of curcumin analog DHC (or 3,3'-dihydroxycurcumin), submitted or not to LED irradiation, on microorganisms of endodontic importance and its influence on fibroblasts viability. METHODS DHC was synthetized by modified Pablon's methodology and the experiments were conducted under irradiation or not with indium gallium nitride-based LED (440-480nm, 100 mW/cm2, 0.78 cm2,60 s). The antimicrobial activity of CUR and DHC were determined by the Minimum Inhibitory and Bactericidal Concentration assays against Gram-positive and Gram-negative bacteria and the effect of both compounds on fibroblast viability was tested using colorimetric assays. They were also evaluated on 72h and 7days single-species biofilms and on 14 days multispecies biofilms formed inside dentin tubules by bacterial colonies counts and confocal microscopy, respectively. Data were analyzed statistically considering p<0.05. RESULTS DHC had bactericidal effect against all bacteria tested higher than CUR, in planktonic conditions. CUR and DHC (at 39 and 19 μg/mL, respectively) were cytocompatible and LED irradiation reduced fibroblast viability, regardless of compound. CUR and DHC reduced the growth of single-species biofilms and the effect of aPDT was bacteria dependent. DHC reduced more than 70% of microorganisms from multispecies biofilms, superior to CUR effect. CONCLUSIONS DHC showed low cytotoxicity and antibiofilm effect similar to curcumin, when submitted or not to aPDT, and could be further explored as a bioactive compound for endodontic purposes.
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Affiliation(s)
- Jesse Augusto Pereira
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, São Paulo, Brazil
| | - Carlos Roberto Polaquini
- São Paulo State University (UNESP), Institute of Biosciences, Humanities and Exact Sciences (IBILCE), Department of Chemistry and Environmental Sciences, São José do Rio Preto, São Paulo, Brazil
| | - VanessaRodrigues Dos Santos
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, São Paulo, Brazil
| | - Karina Sampaio Caiaffa
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, São Paulo, Brazil
| | - Rafaela Laruzo Rabelo
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, São Paulo, Brazil
| | - Reinaldo Dos Santos Theodoro
- São Paulo State University (UNESP), Institute of Biosciences, Humanities and Exact Sciences (IBILCE), Department of Chemistry and Environmental Sciences, São José do Rio Preto, São Paulo, Brazil
| | - Letícia Helena Theodoro
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Diagnosis and Surgery, Araçatuba, São Paulo, Brazil.
| | - Luis Octavio Regasini
- São Paulo State University (UNESP), Institute of Biosciences, Humanities and Exact Sciences (IBILCE), Department of Chemistry and Environmental Sciences, São José do Rio Preto, São Paulo, Brazil.
| | - Cristiane Duque
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba, São Paulo, Brazil.
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Gomes BP, Francisco PA, Godoi Jr EP, Endo MS, Barbosa-Ribeiro M, Delboni MG, Pecorari VG. Identification of Culturable and Nonculturable Microorganisms, Lipopolysaccharides, and Lipoteichoic Acids From Root Canals of Teeth With Endodontic Failure. J Endod 2021; 47:1075-1086. [DOI: 10.1016/j.joen.2021.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/20/2022]
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Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation. BMC Oral Health 2021; 21:124. [PMID: 33731077 PMCID: PMC7968314 DOI: 10.1186/s12903-021-01491-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/07/2021] [Indexed: 12/16/2022] Open
Abstract
Background The present study aimed at investigating the prevalence of Apical periodontitis in a Moroccan Adult subpopulation with a non-surgical root canal treatment and to assess associated risk factors including endodontic treatment quality, periodontal health status, coronal restoration cavity design and quality.
Methods A total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan subpopulation according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression. Results The present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% CI 1.08–3.91, OR 2.05, p = 0.02), inadequate coronal restoration (95% CI 1.16–4.04, OR 2.16, p = 0.01), inadequate root canal filling length and homogeneity (95% CI 1.24–3.01, OR 1.93, P = 0.004), (95% CI 1.41–4.44, OR 2.50, p = 0.002) respectively. Conclusions The present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth. Prevalence of Apical periodontitis in the present study was 72.1%.
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Francisco PA, Fagundes PIDG, Lemes-Junior JC, Lima AR, Passini MRZ, Gomes BPFA. Pathogenic potential of Enterococcus faecalis strains isolated from root canals after unsuccessful endodontic treatment. Clin Oral Investig 2021; 25:5171-5179. [PMID: 33559751 DOI: 10.1007/s00784-021-03823-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate strains of Enterococcus faecalis isolated from endodontic failures cases for (a) presence of virulence genes, namely, gelatinase production (gelE), surface protein (esp), collagen-binding adhesin (ace), cytolysin activator (cylA), E. faecalis antigen A (efaA) and aggregation substance (asa), all by using PCR; (b) biofilm formation capacity; and (c) activity of gelatinase and β-lactamase. MATERIALS AND METHODS Twenty-five strains of E. faecalis were tested. The DNA extracted from these strains was used for identification of virulence genes by PCR and 1% agarose gel. Biofilm formation was performed on polystyrene microplates by using the violet crystal staining method. For assessment of the gelatinase activity, inoculum of pure cultures was deposited in tubes containing gelatin and a nutrient broth, whereas nitrocefin disks were used to assess the β-lactamase action. RESULTS The virulence genes efaA and cylA were detected in 100% of the strains, whereas gelE was present in 84%, ace in 68%, esp in 56% and asa in 48%. Four strains had no biofilm formation, 17 had poor formation and four had moderate formation. Gelatinase production was observed in three strains and β-lactamase resistance in five strains of E. faecalis. TOPIC Diverse patterns of virulence gene detection were observed among the E. faecalis strains, with predominance of those capable of forming biofilm. A few strains have been found to hydrolyze gelatin proteins, whereas β-lactamase resistance was detected in different isolates. CLINICAL RELEVANCE To understand the influence of virulence factors in E. faecalis on the host heath status.
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Affiliation(s)
- Priscila Amanda Francisco
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil
| | - Pedro Ivo da Graça Fagundes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil
| | - João Carlos Lemes-Junior
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil
| | - Augusto Rodrigues Lima
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil
| | - Maicon Ricardo Zieberg Passini
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Av Limeira 901, Bairro Areiao, Piracicaba, São Paulo, Brazil.
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MASSUNARI L, RABELO RL, LEITE ML, SOARES DG, ANOVAZZI G, COSTA CAS, DUQUE C. Dose- and time-dependent effects of taxifolin on viability and mineralization markers of osteoblast-like cells. Braz Oral Res 2021; 35:e140. [DOI: 10.1590/1807-3107bor-2021.vol35.0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/13/2021] [Indexed: 11/22/2022] Open
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Poornima L, Ravishankar P, Abbott PV, Subbiya A, PradeepKumar AR. Impact of root canal treatment on high-sensitivity C-reactive protein levels in systemically healthy adults with apical periodontitis - a preliminary prospective, longitudinal interventional study. Int Endod J 2020; 54:501-508. [PMID: 33185278 DOI: 10.1111/iej.13444] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022]
Abstract
AIM To assess the influence of root canal treatment on serum high-sensitivity C-reactive protein (hsCRP) levels in systemically healthy human adults. METHODOLOGY Fifteen individuals aged 20-40 years diagnosed with apical periodontitis [Periapical Index (PAI) score ≥3] who were otherwise healthy took part in this prospective interventional study. Patients with moderate to severe periodontitis, systemic diseases and traditional cardiac risk factors (hypertension, diabetes, dyslipidemia and smoking) were excluded. Root canal treatment was completed in two visits with an inter-appointment calcium hydroxide intracanal medicament. After 6 months, healing of apical periodontitis was evaluated clinically and radiographically, and serum hsCRP levels were recorded. A paired sample T-test was used to compare the mean hsCRP values between the pre- and post-treatment groups. The Mann-Whitney U test was used to compare hsCRP values between patients with PAI scores of 3 and 4, and the Wilcoxon signed-rank test was used to compare pre- and postoperative PAI scores. RESULTS The mean preoperative baseline serum hsCRP level was 2.88 ± 1.06 mg L-1 which can be associated with a moderate risk for cardiovascular disease (CVD). Based on the preoperative hsCRP levels, eight of the 15 patients were categorized as high risk (hsCRP > 3 mg L-1 ) and the other seven as medium risk (hsCRP 1-3 mg L-1 ) for CVD. The mean preoperative hsCRP value of patients with a PAI score of 3 was 2.88 ± 1.19 mg L-1 , and the mean preoperative hsCRP of patients with a PAI score of 4 was 2.87 ± 0.15 mg L-1 , which was not significantly different (P = 0.942). Six months after root canal treatment, the mean PAI score had significantly reduced from 3.2 ± 0.42 to 1.4 ± 0.69 (P = 0.003). The PAI score had reduced to ≤2 in 87% of the patients, and the mean serum hsCRP levels had significantly reduced to 1.34 ± 0.52 mg L-1 (P < 0.001). Ten of the 15 patients had a reduction in their CVD risk status. CONCLUSIONS This study suggests that root canal treatment can reduce serum hsCRP levels in systemically healthy individuals with apical periodontitis.
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Affiliation(s)
- L Poornima
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
| | - P Ravishankar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
| | - P V Abbott
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - A Subbiya
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A R PradeepKumar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
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Effects of different pulp-capping materials on cell death signaling pathways of lipoteichoic acid-stimulated human dental pulp stem cells. Odontology 2020; 109:547-559. [PMID: 33206337 DOI: 10.1007/s10266-020-00571-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed to evaluate the response of dental pulp stem cells (DPSCs) cultured with and without lipoteichoic acid (LTA) to different pulp-capping materials. METHODS The cells were cultured and seeded in 6-well plates and exposed to 1% LTA solution. Dycal, ProRoot MTA and Biodentine materials were applied on cells and all groups were evaluated by cell proliferation, viability, cell cycle and cell death signaling pathways for 24 and 72 h. RESULTS LTA + Dycal treatment significantly inhibited the proliferation of DPSCs and increased the apoptosis rate of cells more than the other groups at 72 h. Compared to other groups, LTA + Dycal treatment significantly increased the levels of Caspase-3 and AKT and decreased the levels of p-AKT. CONCLUSIONS The results of this study revealed that all tested materials caused apoptosis in DPSCs via an extrinsic apoptotic pathway. The DPSCs showed an early apoptosis response to the Dycal and a late apoptosis response to the ProRoot MTA and Biodentine treatments. LTA led autophagy and inhibited the proliferation of DPSCs. ProRoot MTA and Biodentin eliminated the LTA's bioactivity with higher efficiency than Dycal.
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Analysis of second mesiobuccal root canal instrumentation in maxillary first molars with three nickel-titanium rotary instruments: a micro-computed tomographic study. Odontology 2020; 109:496-505. [PMID: 33175279 DOI: 10.1007/s10266-020-00564-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to evaluate the shaping characteristics of Protaper Universal (PTU; Dentsply Tulsa Dental Specialties, Johnson City, TN), Hero Shaper (HS; MicroMega, Besacon, France) and Hyflex CM (HCM; Coltene-Whaledent, Allstetten, Switzerland) nickel-titanium systems with various apical sizes and tapers in second mesiobuccal (MB2) canal instrumentation using micro-computed tomographic imaging. A total of 27 maxillary first molars with independent patent MB2 canals were selected and randomly assigned to three groups according to the 3-dimensional morphologic aspects obtained from preoperative micro-computed tomographic scans. Canals were first negotiated with a size 8 K-file and finally prepared to F1, F2, and F3 with PTU and to sizes 20.04 taper, 25.04 taper, and 30.04 taper with HS and HCM. Postoperative scans were performed after each instrumentation with the same parameters used in the initial scan. The canal volume, canal transportation, untouched canal surface and wall thickness were measured and calculated using Mimics 10.01 software (Image Works, Materialise, Belgium). Statistical analysis was performed using one-way analysis of variance post hoc LSD tests. PTU removed more dentin than HS and HCM in all sections when instrumented to the same apical size (P < 0.05). HS and HCM presented a lower mean value of canal transportation than PTU in all measured sizes and sections. PTU presented a lower mean value of distal wall thickness than HS and HCM at the level of 1 and 2 mm below the furcation region in all measured sizes. In conclusion, for MB2 canal instrumentation, HS and HCM of 0.04 taper are safer than PTU.
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Proteomic analysis of human dental pulp in different clinical diagnosis. Clin Oral Investig 2020; 25:3285-3295. [PMID: 33159586 DOI: 10.1007/s00784-020-03660-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/27/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The present study aimed to identify proteins obtained from pulp tissue and correlate with each clinical diagnosis (healthy pulp, inflamed pulp, and necrotic pulp). MATERIALS AND METHODS A total of forty-five molars were used. Three biological replicas were evaluated. Lysis and sonication were used for protein extraction. Protein quantification was assessed by using the Bradford technique, and shotgun proteome analysis was performed by nanoUPLC-MSE using a Synapt G2 mass spectrometer. Mass spectra data were processed using the Waters PLGS software, and protein identification was done using the human Uniprot database appended to the PLGS search engine. RESULTS A total of 123 different proteins were identified in all evaluated pulp conditions. Among these, 66 proteins were observed for healthy pulp, 66 for inflamed pulp, and 91 for necrotic pulp. Most protein identification was related to immune response, multi-organism process, platelet activation, and stress in inflamed pulp samples compared to healthy pulp. Proteins related to cellular component organization or biogenesis, developmental process, growth, immune response, multi-organism process, response to stimulus, signaling, stress, and transport were identified in cases of apical periodontitis compared to inflamed pulp. CONCLUSIONS The progression of the disease to inflamed pulp promoted a high abundance of proteins related to the immune system and stress. Comparing the necrotic pulp with inflamed pulp conditions, a high abundance of proteins was noticed related to metabolism, transport, and response between organisms. CLINICAL RELEVANCE This finding may assist in future studies of new markers, understanding of tissue engineering, and development of future products.
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Fehrmann C, Dörfer CE, Fawzy El-Sayed KM. Toll-like Receptor Expression Profile of Human Stem/Progenitor Cells Form the Apical Papilla. J Endod 2020; 46:1623-1630. [PMID: 32827509 DOI: 10.1016/j.joen.2020.08.017] [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: 04/30/2020] [Revised: 07/28/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Stem/progenitor cells from the apical papilla (SCAPs) demonstrate remarkable regenerative and immunomodulatory properties. During their regenerative events, SCAPs, similar to other stem/progenitor cells, could interact with their local inflammatory microenvironment via their expressed toll-like receptors (TLRs). The present study aimed to describe for the first time the unique TLR expression profile of SCAPs. METHODS Cells were isolated from the apical papilla of extracted wisdom teeth (n = 8), STRO-1 immunomagnetically sorted, and cultured to obtain single colony-forming units. The expression of CD14, 34, 45, 73, 90, and 105 were characterized on the SCAPs, and their multilineage differentiation potential was examined to prove their multipotent aptitude. After their incubation in basic or inflammatory medium (25 ng/mL interleukin 1 beta, 103 U/mL interferon gamma, 50 ng/mL tumor necrosis factor alpha, and 3 × 103 U/mL interferon alpha), a TLR expression profile for SCAPs under uninflamed as well as inflamed conditions was respectively generated. RESULTS SCAPs demonstrated all predefined stem/progenitor cell characteristics. In basic medium, SCAPs expressed TLRs 1-10. The inflammatory microenvironment up-regulated the expression of TLR1, TLR2, TLR4, TLR5, TLR6, and TLR9 and down-regulated the expression of TLR3, TLR7, TLR8, and TLR10 in SCAPs under the inflamed condition. CONCLUSIONS The present study defines for the first time a distinctive TLR expression profile for SCAPs under uninflamed and inflamed conditions. This profile could greatly impact SCAP responsiveness to their inflammatory microenvironmental agents under regenerative conditions in vivo.
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Affiliation(s)
- Christian Fehrmann
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts University, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts University, Kiel, Germany
| | - Karim M Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts University, Kiel, Germany; Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
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Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Czumbel LM, Sang-ngoen T, Garami A, Mikó A, Varga G, Lohinai Z. Antimicrobial Efficacy of Chlorhexidine and Sodium Hypochlorite in Root Canal Disinfection: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod 2020; 46:1032-1041.e7. [PMID: 32413440 DOI: 10.1016/j.joen.2020.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/20/2020] [Accepted: 05/05/2020] [Indexed: 02/02/2023]
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Nesari R, Kratchman S, Saad M, Kohli MR. Selective Curettage: A Conservative Microsurgical Approach to Treating Large and Complicated Lesions. J Endod 2020; 46:1782-1790. [PMID: 32738339 DOI: 10.1016/j.joen.2020.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/19/2020] [Indexed: 11/26/2022]
Abstract
Endodontic microsurgery is a predictable and successful procedure when using techniques that have been developed over the past several years. One of the steps during surgery involves curettage of the entire lesion. However, there are cases in which the lesion has advanced to invade anatomic structures like the nasal fossa, maxillary sinus, mandibular canal, neighboring vital teeth, or through and through to the palate. These lesions make endodontic microsurgery difficult for the operator to execute and have inherent risks to the patient. Selective curettage is a conservative approach to treat such cases by removing approximately 50%-70% of the granulomatous tissue while avoiding complications and damage to the neighboring structures. Three-dimensional cone-beam computed tomographic imaging, 2-dimensional periapical radiographs, and clinical follow-ups of the selective curettage lesions showed complete or incomplete (scar tissue) healing in all cases with no untoward results.
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Affiliation(s)
- Roy Nesari
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Samuel Kratchman
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Mina Saad
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Meetu R Kohli
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania.
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Louzada LM, Arruda-Vasconcelos R, Duque TM, Casarin RC, Feres M, Gomes BP. Clinical Investigation of Microbial Profile and Levels of Endotoxins and Lipoteichoic Acid at Different Phases of the Endodontic Treatment in Teeth with Vital Pulp and Associated Periodontal Disease. J Endod 2020; 46:736-747. [DOI: 10.1016/j.joen.2020.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/13/2022]
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Zargar N, Ashraf H, Marashi SMA, Sabeti M, Aziz A. Identification of microorganisms in irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings. Clin Oral Investig 2020; 24:2099-2108. [PMID: 32377864 DOI: 10.1007/s00784-019-03075-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the composition of microbiota of irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings by performing cultures and 16s rDNA sequencing in Iranian patients. MATERIAL AND METHODS In this prospective cross-sectional study, samples were collected from 41 root canals for 4 main groups of patients. Bacterial identification was performed by the polymerase chain reaction (PCR) and 16s rDNA sequencing of aerobic and anaerobic cultivable colonies taken from patients' culture plates. Additionally, the presence of 13 bacterial species and 3 nonbacterial species was also explored using PCR and species-specific primers. RESULTS Sixteen microbial species, 1 fungus (Candida albicans), and 1 virus (Herpes simplex virus) were discovered and isolated. Species with the highest prevalence were Dialister invisus (68.3%), Porphyromonas gingivalis (58.8%), Streptococcus salivarius (58.5%), and Treponema denticola (56.1%). Lysinibacillus fusiformis (19.1%) was detected in the root canals for the first time. Candida albicans was seen in 11 cases (26.8%). Herpes simplex virus (HSV) was seen in 4 patients (9.8%). CONCLUSIONS Our results suggest that Gram-negative anaerobic oral bacteria are the majority of the microbes in primary endodontic infections. Various combinations of bacterial species were related to different clinical and radiographic conditions. Lysinibacillus fusiformis was detected for the first time in primary endodontic infections. CLINICAL RELEVANCE The results of this investigation might help clinicians choose to identify suspected endodontic pathogens in the etiology of each form of pulpal and periradicular diseases to determine the best therapeutic measures.
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Affiliation(s)
- Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - Hengameh Ashraf
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - S M Amin Marashi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Sabeti
- UCSF School of Dentistry, 707 Parnassus Ave. Room-D 3226, San Francisco, CA, 94143-0758, USA
| | - Alireza Aziz
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Evin Avenue, Chamran Highway, Tehran, 1983963113, Iran.
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Lei S, Liu XM, Liu Y, Bi J, Zhu S, Chen X. Lipopolysaccharide Downregulates the Osteo-/Odontogenic Differentiation of Stem Cells From Apical Papilla by Inducing Autophagy. J Endod 2020; 46:502-508. [DOI: 10.1016/j.joen.2020.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/09/2019] [Accepted: 01/06/2020] [Indexed: 12/12/2022]
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Moraes RRD, Morel LL, Correa MB, Lima GDS. A Bibliometric Analysis of Articles Published in Brazilian Dental Journal over 30 years. Braz Dent J 2020; 31:10-18. [PMID: 32159699 DOI: 10.1590/0103-6440202004550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/09/2020] [Indexed: 11/22/2022] Open
Abstract
This study assessed bibliometric characteristics of all articles published in Brazilian Dental Journal (BDJ) in its 30 years of existence (1990-2019) and factors associated with citation rates. A document search was carried out in Scopus in December, 2019 and information about the articles were exported, including citations. Type of study and main subject in each article were categorized. Number of citations was categorized in tertiles. Logistic regression models were used to assess the association between variables related to articles' characteristics and number of citations. In 30 years, 1705 articles were published and 18507 citations received, with average 57 articles and 334 pages published yearly and 10.9 cites/doc. The most frequent types of study were laboratorial (63%), clinical (18.5%), and case reports (11%); the main subjects were dental materials (21.6%), endodontics (19.3%), and oral pathology/stomatology (13.1%). Most articles had origin in Brazil (90%), followed by USA (4.6%) and UK (1.5%). Aside from BDJ, Journal of Endodontics (3.5%) and International Endodontic Journal (2.2%) were journals that most often cited BDJ. Main origins of citations were Brazil (36.7%), USA (10.6%), and India (9%). Older articles had higher odds to be highly cited (12% increase/year), longer articles had lower odds (9% decrease/page). Narrative reviews and epidemiological studies were associated with more citations and systematic reviews with less citations. In conclusion, BDJ covered many subjects and study types in 30 years, showing increased growth in international audience. The journal may be regarded as one of the leading Brazilian journals in dentistry published in English.
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Affiliation(s)
- Rafael Ratto de Moraes
- School of Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Laura Lourenço Morel
- School of Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Marcos Britto Correa
- School of Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Giana da Silveira Lima
- School of Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Estrela C, Pécora JD, Sousa-Neto MD. The Contribution of the Brazilian Dental Journal to the Brazilian Scientific Research over 30 Years. Braz Dent J 2020; 31:3-9. [PMID: 32159702 DOI: 10.1590/0103-6440202004551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/03/2020] [Indexed: 11/22/2022] Open
Abstract
The Brazilian Dental Journal (BDJ) was officially launched in 1990, stimulated by the courage and boldness of researchers dedicated to teaching and research in dentistry. The journal was conceived in a worldwide coverage and universal language to allow publication of the results of Brazilian studies, which otherwise would not be accessible to the scientific dental community. In the year we celebrate the thirtieth anniversary of BDJ, this article presents a brief overview of Brazilian dental research and a bibliometric analysis of the articles published in this journal as a contribution to our readers and fellow researchers. The purpose was to identify the mot frequent categories of study, the most published areas of dentistry and BDJ's top 50 most-cited articles in the Scopus and Google Scholar databases. A search was performed on all BDJ online issues published from 1990 to 2019. In this period, BDJ published 1,710 articles. Based on their distribution by category of study, 557 articles were in the basic research/dental materials area, 527 in the basic research/biology area and 280 in the clinical research area. Eight articles were cited more than 100 times in the Scopus database and 266 times in the Google Scholar database. Endodontics was the most published area. This overview of BDJ production over those 30 years allows establishing a profile of the characteristics, impact and trends of the published studies, as well as the journal's contribution to the top 50 most-cited articles in the Scopus and Google Scholar databases.
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Affiliation(s)
- Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, UFG - Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Jesus Djalma Pécora
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. Clin Oral Investig 2020; 24:3169-3179. [PMID: 31933111 DOI: 10.1007/s00784-019-03191-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/27/2019] [Indexed: 12/18/2022]
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Kaur K, Sculley D, Wallace J, Turner A, Ferraris C, Veysey M, Lucock M, Beckett EL. Micronutrients and bioactive compounds in oral inflammatory diseases. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2019.100105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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43
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Silva EJNL, Prado MC, Soares DN, Hecksher F, Martins JNR, Fidalgo TKS. The effect of ozone therapy in root canal disinfection: a systematic review. Int Endod J 2019; 53:317-332. [PMID: 31587303 DOI: 10.1111/iej.13229] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/01/2019] [Indexed: 12/15/2022]
Abstract
AIM To answer the following focused question: 'As regards microorganism load reduction for patients undergoing root canal treatment, is the use of ozone therapy comparable to conventional chemomechanical techniques using sodium hypochlorite (NaOCl)?' DATA SOURCES A systematic review was conducted using controlled vocabulary and free-text key words in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey until 2 November 2018. Additional studies were sought through hand searching of endodontic journals. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS The inclusion criteria comprised studies that compared microbial reduction in root canals after treatments with ozone and NaOCl in extracted mature human teeth or randomized clinical trials. STUDY APPRAISAL AND SYNTHESIS METHODS The quality assessment of included laboratory studies was performed with the following parameters: (i) sample size calculation, (ii) samples with similar dimensions, (iii) control group, (iv) standardization of procedures, (v) statistical analysis and (vi) other risk of bias. For randomized clinical trials, the qualitative analysis of the studies was performed from the bias risk assessment using the tool 'Bias Risk Assessment of Randomized Controlled Studies' Cochrane Handbook 5.0.2. RESULTS The search resulted in 180 published studies. After removal of duplicate studies and full-text analysis, eight studies were selected and seven were considered low risk of bias (seven ex vivo studies and one random clinical trial). Overall, the results demonstrated that ozone therapy provides significantly less microbial load reduction than NaOCl. As an adjunct in chemomechanical preparation, ozone was ineffective in increasing the antimicrobial effect of NaOCl. Ozone performance was strongly associated with the application protocol used: it is dose, time and bacterial strain dependent, besides the correlation with the use of complementary disinfection sources. LIMITATIONS A restricted number of randomized clinical trial was found, and the difference amongst the methodology of the studies did not allow a meta-analysis to be performed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Although the selected studies had limitations, this review reached a satisfactory methodological and moderate evidence quality contributing to important preliminary information regarding ozone therapy. As regards load reduction of microorganisms for patients undergoing root canal treatment, ozone is not indicated neither to replace nor to complement the antimicrobial action of NaOCl.
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Affiliation(s)
- E J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - M C Prado
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - D N Soares
- Preventive and Community Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - F Hecksher
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - J N R Martins
- Instituto de Implantologia, Lisboa, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - T K S Fidalgo
- Preventive and Community Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
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44
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Systemic inflammation linking chronic periodontitis to cognitive decline. Brain Behav Immun 2019; 81:63-73. [PMID: 31279681 DOI: 10.1016/j.bbi.2019.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022] Open
Abstract
Persistent inflammation in the systemic immune system can impose detrimental effects on the central nervous system (CNS). Neuroinflammation might be a result of this to accelerate the progressive deterioration of neuronal functions during aging. In this regard, controlling inflammation through delaying and/or preventing chronic inflammatory diseases may be a potential strategy to prevent or modify the progression of Alzheimer's Disease (AD). Periodontitis is a chronic inflammatory disease of the oral cavity that is common among the elderly, especially for those who have decline in cognitive functions. While epidemiological findings support the association of chronic periodontitis and cognitive decline, whether they have causal relationship remains unclear. Nonetheless, the possibility that periodontopathogens, systemic immune cells and inflammatory cytokines could reach the CNS should not be overlooked. The impacts of periodontitis on CNS homeostasis and inflammation as a pathophysiological factor concerning the association between periodontitis and AD will be discussed in this review. Future work should elucidate the pathological pathways involved in periodontitis-induced cerebral infections and inflammation, and define the role of the latter in AD progression.
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Souza LC, Crozeta BM, Guajardo L, Brasil da Costa FH, Sousa-Neto MD, Letra A, Silva RM. Potential role of TP63 in apical periodontitis development. Int Endod J 2019; 52:1344-1353. [PMID: 31025362 DOI: 10.1111/iej.13133] [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: 11/30/2018] [Accepted: 04/23/2019] [Indexed: 12/25/2022]
Abstract
AIM To investigate the expression of TP63 in apical periodontitis (AP) tissues and the association of single nucleotide polymorphisms (SNPs) in the TP63 gene with AP using a case-control dataset. METHODOLOGY Expression of TP63 in human AP lesions (apical abscess, radicular cyst, periapical granuloma) was evaluated using immunohistochemistry. A case-control association study was performed to assess the association of TP63 polymorphisms in individuals having AP with or without associated pain. Cases were defined as subjects with deep caries and AP (n = 151) and subjects with symptomatic apical periodontitis or acute apical abscess (n = 124). Subjects without AP (n = 169) and asymptomatic (n = 196) were used as controls, respectively. Saliva samples were collected as source of genomic DNA. Twelve SNPs in the TP63 gene were selected for genotyping using Taqman chemistry in real-time PCR. Data analysis was performed using PLINK software. The Bonferroni method was applied to correct for multiple testing; α ≤ 0.004 indicates significant differences between groups. RESULTS TP63 expression was evident in apical abscesses and radicular cysts, while weaker expression was observed in periapical granulomas. Positive expression was observed in mononuclear cells in the granulation tissues of all AP lesions. Regarding the presence of AP, a trend for allelic association was observed for rs16864812 and rs9810322 (P = 0.04) and rs9810322 genotypes were also nominally associated with AP under a dominant model (P = 0.04). When considering the presence of periapical pain, a trend for allelic and genotypic association was observed for rs10155037 (P = 0.03). Haplotypes were also associated with AP and periapical pain (P ≤ 0.05). CONCLUSIONS Apical periodontitis is a complex multifactorial condition and it is likely that multiple genes and environmental effects may influence its susceptibility, progression or both. TP63 variants may play a role in AP pathogenesis and susceptibility, individually or interactively with other genes. Additional studies in other populations and functional studies are needed to improve understanding of the role of TP63 in AP.
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Affiliation(s)
- L C Souza
- Department of Endodontics, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston.,Center for Craniofacial Research, University of Texas School of Dentistry at Houston, Houston, TX, USA
| | - B M Crozeta
- Department of Endodontics, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston.,Department of Endodontics, University of São Paulo, Ribeirão Preto, Brazil
| | - L Guajardo
- Department of Endodontics, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston
| | | | - M D Sousa-Neto
- Department of Endodontics, University of São Paulo, Ribeirão Preto, Brazil
| | - A Letra
- Department of Endodontics, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston.,Center for Craniofacial Research, University of Texas School of Dentistry at Houston, Houston, TX, USA.,Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R M Silva
- Department of Endodontics, School of Dentistry at Houston, University of Texas Health Science Center at Houston, Houston.,Center for Craniofacial Research, University of Texas School of Dentistry at Houston, Houston, TX, USA
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Sehirli AÖ, Aksoy U, Kermeoglu F, Kalender A, Savtekin G, Ozkayalar H, Sayiner S. Protective effect of alpha-lipoic acid against apical periodontitis-induced cardiac injury in rats. Eur J Oral Sci 2019; 127:333-339. [PMID: 30995351 DOI: 10.1111/eos.12618] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study was designed to assess the possible protective effect of alpha-lipoic acid (ALA) on apical periodontitis (AP)-induced cardiac injury. Wistar albino rats were randomized into four groups: control; ALA; AP; and ALA + AP. Rats of the control and ALA groups were not endodontically treated, but saline and ALA (100 mg kg-1 ) were administered. In rats of the AP and ALA + AP groups, the pulp chambers of mandibular first molar teeth were exposed and left open for 30 d to induce AP. Saline and ALA (100 mg kg-1 ) were administered intraperitoneally every 24 h during the experiment. At the end of the experiment, the rats were killed. Establishment of AP was verified by radiographic and histopathological evaluation. Serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatine kinase (CK), and superoxide dismutase (SOD) activities were determined using an automated biochemical analyzer, and the structural cardiac injury was assessed pathologically. Serum ALP, LDH, and CK activities were elevated, and SOD activities were decreased, in the AP group. The changed enzyme activities were significantly normalized by treatment with ALA. We conclude that ALA administration alleviated the AP-induced heart injury and improved cardiac structure and function, and therefore this agent may be of potential therapeutic value in protecting cardiac tissue from systemic injury caused by AP.
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Affiliation(s)
- Ahmet Ö Sehirli
- Department of Pharmacology, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Fatma Kermeoglu
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Atakan Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Gokce Savtekin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Hanife Ozkayalar
- Department of Medical Pathology, Faculty of Medicine, Near East University, Nicosia, Mersin 10, Turkey
| | - Serkan Sayiner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Nicosia, Mersin 10, Turkey
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Fawzy El-Sayed KM, Elahmady M, Adawi Z, Aboushadi N, Elnaggar A, Eid M, Hamdy N, Sanaa D, Dörfer CE. The periodontal stem/progenitor cell inflammatory-regenerative cross talk: A new perspective. J Periodontal Res 2019; 54:81-94. [PMID: 30295324 DOI: 10.1111/jre.12616] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/24/2018] [Accepted: 08/31/2018] [Indexed: 12/13/2022]
Abstract
Adult multipotent stem/progenitor cells, with remarkable regenerative potential, have been isolated from various components of the human periodontium. These multipotent stem/progenitor cells include the periodontal ligament stem/progenitor cells (PDLSCs), stem cells from the apical papilla (SCAP), the gingival mesenchymal stem/progenitor cells (G-MSCs), and the alveolar bone proper stem/progenitor cells (AB-MSCs). Whereas inflammation is regarded as the reason for tissue damage, it also remains a fundamental step of any early healing process. In performing their periodontal tissue regenerative/reparative activity, periodontal stem/progenitor cells interact with their surrounding inflammatory micro-environmental, through their expressed receptors, which could influence their fate and the outcome of any periodontal stem/progenitor cell-mediated reparative/regenerative activity. The present review discusses the current understanding about the interaction of periodontal stem/progenitor cells with their surrounding inflammatory micro-environment, elaborates on the inflammatory factors influencing their stemness, proliferation, migration/homing, differentiation, and immunomodulatory attributes, the possible underlying intracellular mechanisms, as well as their proposed relationship to the canonical and noncanonical Wnt pathways.
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Affiliation(s)
- Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
| | | | - Zeina Adawi
- Faculty of Dentistry, New Giza University, Giza, Egypt
| | | | - Ali Elnaggar
- Faculty of Dentistry, New Giza University, Giza, Egypt
| | - Maryam Eid
- Faculty of Dentistry, New Giza University, Giza, Egypt
| | - Nayera Hamdy
- Faculty of Dentistry, New Giza University, Giza, Egypt
| | - Dalia Sanaa
- Faculty of Dentistry, New Giza University, Giza, Egypt
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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TEODORA PREOTEASA CRISTINA, PREOTEASA ELENA, POPA MARCELA, (PIRCALABIORU) GRADISTEANU GRATIELA, GRIGORE RALUCA, MARUTESCU LUMINITA. In vitro characterization of microbial biofilm on soft materials used in overdentures retained by mini implants. ROMANIAN BIOTECHNOLOGICAL LETTERS 2019. [DOI: 10.25083/rbl/24.1/10.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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49
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Chen S, Lei H, Luo Y, Jiang S, Zhang M, Lv H, Cai Z, Huang X. Micro‐
CT
analysis of chronic apical periodontitis induced by several specific pathogens. Int Endod J 2019; 52:1028-1039. [PMID: 30734930 DOI: 10.1111/iej.13095] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/05/2019] [Indexed: 12/11/2022]
Affiliation(s)
- S. Chen
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Key Laboratory of Stomatology Fujian Province University Fuzhou China
| | - H. Lei
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Fujian Biological Materials Engineering and Technology Center of Stomatology Fuzhou China
| | - Y. Luo
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Fujian Biological Materials Engineering and Technology Center of Stomatology Fuzhou China
| | - S. Jiang
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Key Laboratory of Stomatology Fujian Province University Fuzhou China
| | - M. Zhang
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
| | - H. Lv
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Fujian Biological Materials Engineering and Technology Center of Stomatology Fuzhou China
| | - Z. Cai
- Department of Stomatology Fujian Medical University Union Hospital Fuzhou China
| | - X. Huang
- School and Hospital of Stomatology Fujian Medical University Fuzhou China
- Key Laboratory of Stomatology Fujian Province University Fuzhou China
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Marashdeh MQ, Gitalis R, Lévesque C, Finer Y. Endodontic pathogens possess collagenolytic properties that degrade human dentine collagen matrix. Int Endod J 2018; 52:416-423. [DOI: 10.1111/iej.13018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/18/2018] [Indexed: 01/12/2023]
Affiliation(s)
- M. Q. Marashdeh
- Faculty of Dentistry; University of Toronto; Toronto Canada
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto Canada
| | - R. Gitalis
- Faculty of Dentistry; University of Toronto; Toronto Canada
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto Canada
| | - C. Lévesque
- Faculty of Dentistry; University of Toronto; Toronto Canada
| | - Y. Finer
- Faculty of Dentistry; University of Toronto; Toronto Canada
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto Canada
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