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Immunomodulatory Effects of Endodontic Sealers: A Systematic Review. Dent J (Basel) 2023; 11:dj11020054. [PMID: 36826199 PMCID: PMC9955805 DOI: 10.3390/dj11020054] [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: 12/09/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Inflammation is a crucial step prior to healing, and the regulatory effects of endodontic materials on the immune response can influence tissue repair. This review aimed to answer whether endodontic sealers can modulate the immune cells and inflammation. An electronic search in Scopus, Web of Science, PubMed, and Google Scholar databases were performed. This systematic review was mainly based on PRISMA guidelines, and the risk of bias was evaluated by SYRCLEs and the Modified CONSORT checklist for in vivo and in vitro studies, respectively. In total, 28 articles: 22 in vitro studies, and six in vivo studies were included in this systematic review. AH Plus and AH 26 can down-regulate iNOS mRNA, while S-PRG sealers can down-regulate p65 of NF-κB pathways to inhibit the production of TNF-α, IL-1, and IL-6. In vitro and in vivo studies suggested that various endodontic sealers exhibited immunomodulatory impact in macrophages polarization and inflammatory cytokine production, which could promote healing, tissue repair, and inhibit inflammation. Since the paradigm change from immune inert biomaterials to bioactive materials, endodontic materials, particularly sealers, are required to have modulatory effects in clinical conditions. New generations of endodontic sealers could hamper detrimental inflammatory responses and maintain periodontal tissue, which represent a breakthrough in biocompatibility and functionality of endodontic biomaterials.
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Benetti F, Ferreira LL, Dos Reis-Prado AH, Faria FD, Ervolino E, Berbert FLCV, Leonardo RDT, Dias J, Gomes-Filho JE, Cintra LTA. Interleukin-6, tumor necrosis factor-α, and CD5 immunolabeling of new experimental endodontic sealer and repair material. Odontology 2023; 111:93-104. [PMID: 35751826 DOI: 10.1007/s10266-022-00723-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/07/2022] [Indexed: 01/06/2023]
Abstract
The aim of this study was to evaluate the biocompatibility and immunoinflammatory response of the Sealepox and Sealepox-RP, based on interleukin (IL)-6, tumor necrosis factor (TNF)-α, and CD5 immunolabelling. The ProRoot MTA (PRMTA) was used for comparison. Polyethylene tubes (1.0-mm internal, 1.6-mm external diameter, and 10.0-mm length; ISO 10993) with or without (control) materials were randomly implanted in the dorsum of 35 rats (4 per rat). After 7, 15, 30, 60, and 90 days (n = 7), the tubes were removed for histological and immunohistochemical analysis. The Kruskal-Wallis and Dunn's test for non-parametric data and, ANOVA and Tukey test for parametric data were used (P < 0.05). Hematoxylin and eosin staining revealed that the concentration of inflammatory cells decreased over time with no differences between groups in all periods (P > 0.05). Regarding IL-6 immunostaining, there was no difference at 7 days (P > 0.05); all groups decreased over time, being faster for the PRMTA group and also, with no differences between groups in the last period (P > 0.05). For TNF-α, at 7 days there was no difference between groups (P > 0.05); there was an increase at 15 days for PRMTA and, at 30 and 60 days, for PRMTA and Sealepox compared to the control (P < 0.05). At 90 days, Sealepox RP showed the lowest immunostaining being similar to the control (P > 0.05). Regarding CD5 cells, at 7 days, there was high immunostaining for PRMTA compared to the control (P < 0.05); and significant reduction over time with difference for all groups at 30 and 60 days. (P < 0.05); Sealepox was similar to the control in all periods (P > 0.05). Sealepox RP showed the highest immunostaining at 15 days, being different from the control and PRMTA (P < 0.05); in the other periods it was similar to the control (P > 0.05). It can be concluded that Sealepox and Sealepox-RP were biocompatible and demonstrated similar immunoinflammatory response regarding IL-6, TNF-α, and CD5 compared to PRMTA.
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Affiliation(s)
- Francine Benetti
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Luciana Louzada Ferreira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Alexandre Henrique Dos Reis-Prado
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Flávio Duarte Faria
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil
| | - João Dias
- University Institute Egas Moniz (IUEM), Monte de Caparica, Almada, Portugal
| | - João Eduardo Gomes-Filho
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil. .,School of Dentistry, Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), Araçatuba, SP, Brazil.
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de Morais Sampaio GA, de Meneses IHC, Vieira RA, Pithon MM, Alves PM, Lacerda-Santos R. Influence of chlorhexidine digluconate on biocompatibility of cements: Morphological and immunohistochemistry analysis. Microsc Res Tech 2022; 85:2438-2445. [PMID: 35244313 DOI: 10.1002/jemt.24099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/31/2021] [Accepted: 02/24/2022] [Indexed: 11/09/2022]
Abstract
In this study, the in vivo biocompatibility was evaluated by using conventional ionomer cements modified with Chlorhexidine (CHX) in different time intervals. In total, 105 male Wistar rats were randomized into seven groups: control, groups M, M10, M18 and groups RL, RL10, RL18 (M-Meron and RL-RivaLuting, and added CHX-10% and CHX-18%, respectively). Histological analyses of inflammatory infiltrate and collagen fibers, and immunohistochemistry of CD68+ for macrophages (MOs) and multinucleated giant cells (MGCs) were performed. Data were analyzed using the Kruskal-Wallis and Dunn (p < .05) tests. Intense inflammatory infiltrate was demonstrated in Group Riva CHX-18% within 7 and 15 days (p < .05), without differences after 30 days. For collagenization, healing of the groups was compatible with that of control in 15 and 30 days (p > .05). Immunomarking of CD68+ was more significant in the groups with higher concentration of CHX. There was significant difference in quantity of MGCs in groups with 18% CHX, Meron (p = .001) in 7 days, and in Riva at 30 days (p = .001). Significant difference was also found in quantities of MOs in Groups Meron and Riva in 7 days (p = .001), and only in Riva at 15 and 30 days (p = .001). The cements with addition of CHX demonstrated biocompatibility with tissues. Riva CHX-18% had the most effect on cells of the inflammatory process but showed satisfactory tissue repair.
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Affiliation(s)
| | | | - Rayssa Amaral Vieira
- Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, State University of the Southwest of Bahia, Jequié, Bahia, Brazil
| | - Polliana Muniz Alves
- Department of Pathology, Dental School, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
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Almeida Mesquita J, Lacerda-Santos R, Pina Godoy G, Franscisco Weege Nonaka C, Muniz Alves P. Morphological and immunohistochemical analysis of the biocompatibility of resin-modified cements. Microsc Res Tech 2016; 80:504-510. [DOI: 10.1002/jemt.22822] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/15/2016] [Accepted: 11/28/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Janaina Almeida Mesquita
- Department of Oral Pathology; Dental School State University of Paraíba-UEPB; Rua Baraunas, 351, Bodocongo Campina Grande Paraíba 58429-500 Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry; Dental School, Federal University of Juiz de Fora - UFJF; Av. Doutor Raimundo Monteiro Rezende, 330, Centro Governador Valadares Minas Gerais 35010-177 Brazil
| | - Gustavo Pina Godoy
- Department of Oral Pathology; Dental School State University of Paraíba-UEPB; Rua Baraunas, 351, Bodocongo Campina Grande Paraíba 58429-500 Brazil
| | - Cassiano Franscisco Weege Nonaka
- Department of Oral Pathology; Dental School State University of Paraíba-UEPB; Rua Baraunas, 351, Bodocongo Campina Grande Paraíba 58429-500 Brazil
| | - Pollianna Muniz Alves
- Department of Oral Pathology; Dental School State University of Paraíba-UEPB; Rua Baraunas, 351, Bodocongo Campina Grande Paraíba 58429-500 Brazil
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