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Siqueira JF, Silva WO, Romeiro K, Gominho LF, Alves FRF, Rôças IN. Apical root canal microbiome associated with primary and posttreatment apical periodontitis: A systematic review. Int Endod J 2024. [PMID: 38634795 DOI: 10.1111/iej.14071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/21/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Microorganisms colonizing the apical root canal system are conceivably the ones directly involved with the causation and maintenance of apical periodontitis. OBJECTIVES This article systematically reviews the reports on the microbiome occurring exclusively at the apical root canal of teeth with primary and posttreatment apical periodontitis. METHODS The electronic databases PubMed, Embase, Web of Science, Science Direct, and Proquest were searched up to August 2023. Clinical studies using culture and molecular microbiology methods to identify the microbial taxa present exclusively in the apical root canal segment of infected teeth with apical periodontitis were included. Studies were critically assessed using the Joanna Briggs Institute Critical Prevalence Assessment Checklist. RESULTS From 2277 articles initially detected, 52 were selected for full reading and 21 were eventually included in this review. Of these, molecular methods were used in 19 and culture in 2 studies. Ten studies evaluated primary infections, 8 evaluated posttreatment infections, and 3 included both. Cryopulverization of the apical root specimens was conducted in 11 studies. All studies evaluated the prevalence and diversity of bacteria, and only one also reported on fungi. Overall, the most frequent/abundant bacterial taxa found in the apical canal of primary infections were Pseudoramibacter alactolyticus, Olsenella uli, Fusobacterium species, Streptococcus species, Porphyromonas endodontalis, Prevotella species, Actinomyces species, Parvimonas micra, Treponema denticola, Synergistetes species, and an as-yet uncharacterized taxon. In posttreatment infections, the most prevalent/abundant bacterial taxa included species of Streptococcus, Enterococcus, Fusobacterium, Actinomyces, Pseudoramibacter, Pseudomonas, and Propionibacterium. At the phylum level, Firmicutes was the most represented. The average apical bacterial load ranged from 105 to 106 in primary infections and from 103 to 104 in posttreatment infections. DISCUSSION Microbial diversity in the apical part of the root canal system was examined encompassing data from both primary and posttreatment infections. Heterogeneity amongst the studies, especially in sample collection and microbial identification methods, is an important limitation that prevented a meta-analysis. CONCLUSIONS There is a pronounced bacterial diversity in the infected apical canal, with a high interindividual variability. Different microbiome compositions at the species/genus level are observed according to the infection type. REGISTRATION PROSPERO CRD42021275886.
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Affiliation(s)
- José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Warley O Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Kaline Romeiro
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Luciana F Gominho
- Department of Restorative Dentistry, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Ozdemir B, Ersahan S, Ozcelik F, Hepsenoglu YE, Sirin DA, Topbas C. Relationship of MMP-9 with the clinical course of apical periodontitis and the main bacterial species in the oral microbiota. Odontology 2024:10.1007/s10266-023-00895-w. [PMID: 38252232 DOI: 10.1007/s10266-023-00895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Bacterial products, host immune cells and cytokines have been reported to play an important role in the pathogenesis of apical periodontitis (AP). This study aimed to determine the main bacterial species in the microbiota as gram positive and negative and to compare the relationship between matrix metalloproteinase (MMP)-9 and tumor necrosis factor (TNF)-α with controlled patient groups. 60 patients with AP and extraction indication were included in the study. 30 systemically healthy volunteers without AP were selected as the control group. After access cavity preparation, an initial microbiologic sample (S1) was taken from the root canal. After atraumatic extraction of the tooth, a second microbial sample (S2) was taken from the extraradicular region. After bacterial DNA extraction, 16S rRNA gene primer was designed for sequence analysis. Bacterial community profiling was made by Sanger sequencing of the PCR products. In addition, serum MMP-9 and TNF-α levels were measured from all patients. TNF-α levels of the AP group were higher than the control group, while MMP-9 levels were found to be lower (p = 0.0264 and p = 0.0146, respectively). There was no difference in the main bacterial species isolated from the samples taken from the intracanal and extraradicular region of the tooth with AP (p = 0.714). The main bacterial species in the intracanal region of the tooth with AP are similar to the main bacterial species in the extraradicular region. The pathophysiology of the tooth with AP is associated with low MMP-9 and high TNF-α, independent of the bacterial species in the intracanal and extraradicular regions.
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Affiliation(s)
- Burcu Ozdemir
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Seyda Ersahan
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey.
| | - Fatih Ozcelik
- Department of Medical Biochemistry Department, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Yelda Erdem Hepsenoglu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Dursun Ali Sirin
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Turkey
| | - Celalettin Topbas
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Turkey
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Burian E, Feuerriegel G, Sollmann N, Burian G, Palla B, Griesbauer M, Bumm C, Probst M, Beer M, Folwaczny M. Visualization of clinically silent, odontogenic maxillary sinus mucositis originating from periapical inflammation using MRI: a feasibility study. Clin Oral Investig 2023:10.1007/s00784-023-04986-4. [PMID: 37039958 DOI: 10.1007/s00784-023-04986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the following clinical question: among patients with periapical inflammatory processes in the maxilla, does the use of magnetic resonance imaging (MRI), as compared to conventional periapical (AP) and panoramic radiography (OPT), improve diagnostic accuracy? METHODS Forty-two subjects with generalized periodontitis were scanned on a 3 T MRI. Sixteen asymptomatic subjects with mucosal swelling of the maxillary sinus were enrolled in the study. Periapical edema was assessed using short tau inversion recovery (STIR) sequence. Apical osteolysis and mucosal swelling were assessed by MRI, AP, and OPT imaging using the periapical index score (PAI). Comparisons between groups were performed with chi-squared tests with Yates' correction. Significance was set at p < 0.05. RESULTS Periapical lesions of maxillary premolars and molars were identified in 16 subjects, 21 sinuses, and 58 teeth. Bone edema and PAI scores were significantly higher using MRI as compared to OPT and AP (p < 0.05). Using the STIR sequence, a significant association of PAI score > 1 and the presence of mucosal swelling in the maxillary sinus was detected (p = 0.03). CONCLUSION Periapical inflammation and maxillary mucositis could be visualized using STIR imaging. The use of MRI may help detect early, subtle inflammatory changes in the periapical tissues surrounding maxillary dentition. Early detection could guide diagnostic criteria, as well as treatment and prevention.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, IL, USA
| | - Magdalena Griesbauer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caspar Bumm
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
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Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients. Int J Dent 2023; 2023:4961827. [PMID: 36819640 PMCID: PMC9937771 DOI: 10.1155/2023/4961827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/05/2022] [Accepted: 01/08/2023] [Indexed: 02/12/2023] Open
Abstract
Diabetes mellitus has been regarded as a condition capable of influencing the evolution of periapical lesions. Therefore, this study evaluated the immunoexpression of IL-1β, TNF-α, and IL-17 in apical periodontitis from type 2 diabetic patients through immunohistochemistry. Twenty-six periapical lesions were selected, and the images obtained through immunohistochemistry reactions were analyzed. The statistical significance was set at p < 0.05. IL-1β expression was considered focal (54%), weak to moderate (38%), and strong (8%) in diabetics, and focal (46%), weak to moderate (31%), and strong (23%), in controls. TNF-α was focal (85%) and weak to moderate (15%) in diabetics, and focal (92%) and weak to moderate (8%), in controls. IL-17 was focal (8%), weak to moderate (46%), and strong (46%) in diabetics, and focal (62%), weak to moderate (8%), and strong (30%), in controls. The quantitative analysis revealed greater expression of IL-17, with a significant difference between IL-17 × IL-1β × TNF-α(p=0.0009) in the diabetic group. The cytokines IL-1β and TNF-α did not express statistical differences between the tested groups. The IL-17 showed higher immunoexpression in the diabetic group (p=0.047), which may suggest higher bone resorption activity in chronic apical periodontitis in this group of patients.
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Luo X, Wan Q, Cheng L, Xu R. Mechanisms of bone remodeling and therapeutic strategies in chronic apical periodontitis. Front Cell Infect Microbiol 2022; 12:908859. [PMID: 35937695 PMCID: PMC9353524 DOI: 10.3389/fcimb.2022.908859] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 12/19/2022] Open
Abstract
Chronic periapical periodontitis (CAP) is a typical oral disease in which periodontal inflammation caused by an odontogenic infection eventually leads to bone loss. Uncontrolled infections often lead to extensive bone loss around the root tip, which ultimately leads to tooth loss. The main clinical issue in the treatment of periapical periodontitis is the repair of jawbone defects, and infection control is the first priority. However, the oral cavity is an open environment, and the distribution of microorganisms through the mouth in jawbone defects is inevitable. The subversion of host cell metabolism by oral microorganisms initiates disease. The presence of microorganisms stimulates a series of immune responses, which in turn stimulates bone healing. Given the above background, we intended to examine the paradoxes and connections between microorganisms and jaw defect repair in anticipation of new ideas for jaw defect repair. To this end, we reviewed the microbial factors, human signaling pathways, immune cells, and cytokines involved in the development of CAP, as well as concentrated growth factor (CGF) and stem cells in bone defect repair, with the aim of understanding the impact of microbial factors on host cell metabolism to inform the etiology and clinical management of CAP.
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Affiliation(s)
| | | | - Lei Cheng
- *Correspondence: Lei Cheng, ; Ruoshi Xu,
| | - Ruoshi Xu
- *Correspondence: Lei Cheng, ; Ruoshi Xu,
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Sun X, Yang Z, Nie Y, Hou B. Microbial Communities in the Extraradicular and Intraradicular Infections Associated With Persistent Apical Periodontitis. Front Cell Infect Microbiol 2022; 11:798367. [PMID: 35096647 PMCID: PMC8791237 DOI: 10.3389/fcimb.2021.798367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/17/2021] [Indexed: 12/26/2022] Open
Abstract
Microorganisms in the complex root canal system and the extraradicular regions, including the periapical lesions and extraradicular biofilm may cause root canal treatment failures. However, few studies described the difference between the intraradicular and extraradicular infections from the same tooth associated with persistent apical periodontitis. This study aimed to characterize the microbiome present in the root canal, extraradicular biofilm, and periapical lesions associated with persistent apical periodontitis. The microbial communities in the root canal, extraradicular biofilm, and periapical lesions were investigated by Illumina high-throughput sequencing using Illumina Hiseq 2500 platform. The dominant phyla in the extraradicular and intraradicular infections associated with persistent apical periodontitis were Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria, and the genera Fusobacterium, Morganella, Porphyromonas, Streptococcus, and Bifidobacterium dominated across all samples. Although extraradicular infection sites showed higher OTU richness and β-diversity compared to intraradicular samples, the occurrence of sinus tract rather than the sampling sites demarcated the microbial communities in the infections associated with persistent apical periodontitis. PERMANOVA analysis confirmed that the samples with or without sinus tracts contained significantly different microbial communities. Porphyromonas, Eubacterium, Treponema, and Phocaeicola were found in significantly higher levels with sinus tracts, whilst Microbacterium and Enterococcus were more abundant in samples without sinus tracts. In conclusion, diverse bacteria were detected in both intraradicular and extraradicular infections associated with persistent apical periodontitis, which might be influenced by the occurrence of the sinus tract. The results may provide new insight into the pathogenesis of persistent apical periodontitis.
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Affiliation(s)
- Xiaoqiang Sun
- The Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Zi Yang
- The Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Yong Nie
- College of Engineering, Peking University, Beijing, China
| | - Benxiang Hou
- The Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Tan XL, Chen X, Fu YJ, Ye L, Zhang L, Huang DM. Diverse microbiota in palatal radicular groove analyzed by Illumina sequencing: Four case reports. World J Clin Cases 2021; 9:6846-6857. [PMID: 34447834 PMCID: PMC8362521 DOI: 10.12998/wjcc.v9.i23.6846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/24/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A palatal radicular groove is an unusual developmental deformity of the tooth, which may serve as a channel linking the periodontal and periapical inflammation, and yet no literature could be obtained analyzing microbiota within the palatal radicular grooves.
CASE SUMMARY Four patients diagnosed with palatal radicular groove and concomitant periodontal-endodontic deformity in permanent maxillary lateral incisors were enrolled in this work. Twelve bacterial samples from 4 patients were collected from different parts of the palatal radicular groove during intentional replantation surgery. Illumina sequencing was performed to analyze the taxonomical composition and microbiome structure inside the palatal grooves, and 1162 operational taxonomic units were obtained. The phyla of Firmicutes and Proteobacteria predominated in most of the samples. An unknown genus from the Bacillaceae family, Lactococcus, and Porphyromonas were the most abundant genera identified. There was no difference in the microbiota richness and diversity in three sections of the groove.
CONCLUSION The unique ecological niches inside the palatal grooves harbored bacterial communities that shared some component features of both the endodontic and periodontal infections. The existence of palatal groove may play an interaction bridge between the root apex and tooth cervix and thus impair the outcome of traditional therapeutic methods such as root canal treatment and periodontal management.
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Affiliation(s)
- Xue-Lian Tan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Jie Fu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ding-Ming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
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Teixeira FFC, Cardoso FGR, Ferreira NS, Gomes APM, Corazza BJM, Valera MC, Martinho FC. Clinical influence of calcium hydroxide intracanal medications on matrix metalloproteinases and tissue inhibitors of metalloproteinases in apical periodontitis. Clin Oral Investig 2021; 26:643-650. [PMID: 34255199 DOI: 10.1007/s00784-021-04042-z] [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: 01/21/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study investigated the influence of calcium hydroxide intracanal medications on the levels of metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in apical periodontitis (AP). MATERIALS AND METHODS Twenty primarily infected root canals with AP were randomly divided into two groups: Ca(OH)2 + sterile saline solution (SSL) group and Ca(OH)2 + 2% chlorhexidine gel (CHX gel) group. We collected samples from the periradicular tissue fluid (PTF) before (s1) and after 14 days of intracanal medication (s2). MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were measured by ELISA assay. RESULTS MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were detected in all PTF samples at s1 and s2 (20/20). At s1, MMP-2 and MMP-9 were detected at higher levels than MMP-1 (p < .05). Higher levels of TIMP-1 than TIMP-2 were found in AP (p < .05). Additionally, we detected higher MMP-1, MMP-2, and MMP-9 over TIMP-1 and TIMP-2 levels in AP (p < .05). At s2, Ca(OH)2 + SSL was as effective as Ca(OH)2 + 2% CHX gel in lowering the levels of MMP-1, MMP-2, and MMP-9 after 14 days of intracanal medication, with no significant difference between them (p > .05). Both Ca(OH) 2 intracanal medications had no significant impact on the levels of TIMP-1 and TIMP-2 (both p > .05). At s2, TIMP-1 levels were higher than TIMP-2 (p < .05). Moreover, there were positive correlations between the levels of MMP-1 and TIMP-1 and MMP-1 and TIMP-2 (p < .05). CONCLUSIONS Calcium hydroxide medications effectively lowered the levels of MMP-1, MMP-2, and MMP-9 in periapical tissues after 14 days of treatment, with no difference between them. Moreover, the calcium hydroxide intracanal medications tested here had no impact in TIMP-1 and TIMP-2 in periapical tissues. CLINICAL RELEVANCE MMPs and TIMPs play an essential role in the degradation of the extracellular matrix. The imbalance MMPs and TIMPs can cause periapical tissue destruction. Therefore, the reestablishment of the balance between activated MMPs and TIMPs with root canal therapy is essential to restore tissue homeostasis.
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Affiliation(s)
- Flavia F C Teixeira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Flavia G R Cardoso
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Nadia S Ferreira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Ana P M Gomes
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
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Liu J, Wang J, Ren J, Yang Q, Zhan W, Wang M, Hao L, Yue Y. Inhibition of receptor-interacting protein kinase-3 in the necroptosis pathway attenuates inflammatory bone loss in experimental apical periodontitis in Balb/c mice. Int Endod J 2021; 54:1538-1547. [PMID: 33896018 DOI: 10.1111/iej.13534] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/18/2021] [Indexed: 02/05/2023]
Abstract
AIM To explore the role of necroptosis in apical periodontitis (AP), this study investigated necroptosis in a Fusobacterium nucleatum (Fn)-induced AP model of Balb/c mice and explored related intracellular signalling pathways in L929 cells affected by Fn. METHODOLOGY For the in vivo experiments, expression of receptor-interacting protein kinase-3 (RIP3) was inhibited using an adeno-associated virus and then the Balb/c mice model of AP was established by injecting Fn into the root canal of the first mandibular molars. Bone loss and number of osteoclasts were measured via micro-computed tomography and tartrate-resistant acid phosphatase staining, respectively; expression of RIP3 and phosphorylated mixed lineage kinase domain-like protein (pMLKL) was detected by immunohistochemistry and western blotting; expression of mRNA of inflammatory cytokines was evaluated using quantitative real-time polymerase chain reaction (qRT-PCR). For the in vitro experiments, L929 cells transfected with RIP3-Mus-siRNA or negative control siRNA were co-cultured with Fn; thereafter, western blotting, detection of cell death and viability and qRT-PCR analyses were performed to assess the activation of necroptosis pathway and expression of mRNA of inflammatory cytokines. Data were analysed with unpaired t-test and one-way analysis of variance with significance set at p < .05. RESULTS The Fn-induced apical lesions were associated with apical bone loss, an increased number of osteoclasts, enhanced expression of pMLKL and increased mRNA levels of inflammatory cytokines(IL-1α and IL-1β); all these effects were alleviated by RIP3 inhibition (p < .05). L929 cells infected with Fn displayed increased expression of pMLKL and increased cell death (p < .05), together with decreased cell viability (p < .05), whilst transfection with RIP3-Mus-siRNA decreased the mRNA expression of inflammatory cytokines(TNF-α and IL-6, p < .05). CONCLUSIONS Necroptosis may be involved in AP progression. RIP3 inhibition ameliorated the expression of inflammatory cytokines and bone resorption in Fn-induced AP lesions in Balb/c mice.
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Affiliation(s)
- Jie Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jiajia Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jie Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Qin Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Weicheng Zhan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Min Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Liang Hao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yuan Yue
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
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Thuller KABR, Armada L, Valente MI, Pires FR, Vilaça CMM, Gomes CC. Immunoexpression of Interleukin 17, 6, and 1 Beta in Primary Chronic Apical Periodontitis in Smokers and Nonsmokers. J Endod 2021; 47:755-761. [PMID: 33548327 DOI: 10.1016/j.joen.2021.01.010] [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: 10/20/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The purpose of this study was to compare the immunoexpression of biomarkers interleukin (IL)-17, IL-6, and IL-1β in primary chronic apical periodontitis in smokers and nonsmokers. METHODS Teeth with primary chronic apical periodontitis indicated for extraction in 16 cigarette smokers and 16 nonsmokers were selected. Silanized sections of tissue were used for immunohistochemical analysis after being stained with hematoxylin-eosin for histopathologic categorization. Subsequently, the images were analyzed with an optical microscope, and each slide was subdivided into 5 high-magnification fields, with scores (0-2) being assigned according to the amount of staining for each antibody. RESULTS The qualitative analysis of IL-17 cytokine expression showed no focal expression in 5.8%, weak to moderate expression in 17.6%, and strong expression in 76.4% of the smokers and no focal expression in 78.5% and weak to moderate expression in 21.4% of the nonsmokers. IL-6 expression was negative to focal in 13.3%, weak to moderate in 53.3%, and strong in 33.3% of the smokers and negative to focal in 33.3%, weak to moderate in 25%, and strong in 41.6% of the nonsmokers. IL-1β expression was weak to moderate in 87.5% and negative to focal expression in 12.5% of the smokers and negative to focal expression in 100% of the nonsmokers. Quantitative evaluation of the data using the Mann-Whitney U test showed a significant difference in the immunoexpression of IL-17 (P < .0001) and IL-1β (P < .0001) and no significant difference in the immunoexpression of IL-6 (P = .46) between the 2 groups (P < .05). CONCLUSIONS The cytokines IL-17 and IL-1β were more highly expressed in smokers than nonsmokers, whereas IL-6 expression was similar in the 2 groups.
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Affiliation(s)
- Katherine A B R Thuller
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Luciana Armada
- Postgraduate Program, School of Dentistry, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Isabel Valente
- Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Fábio Ramoa Pires
- Postgraduate Program, School of Dentistry, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiano M M Vilaça
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Cinthya Cristina Gomes
- Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil.
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12
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Paula-Silva FWG, Arnez MFM, de Campos Chaves Lamarque G, Petille R, Ribeiro-Santos FR, de Sena MF, Nelson-Filho P, da Silva LAB. Osteoclast formation, inflammation, and matrix metalloproteinase-9 are downregulated in bone repair following root canal treatment in dogs teeth. Clin Oral Investig 2021; 25:4699-4707. [PMID: 33449195 DOI: 10.1007/s00784-021-03784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/06/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the inflammatory infiltrate, osteoclast formation, and expression of MMP-9 during the healing phase following root canal treatment in teeth with apical periodontitis. MATERIALS AND METHODS Apical periodontitis was induced in dogs teeth, and root canal treatment was performed in a single visit or using calcium hydroxide as intracanal medication. One hundred and eighty days following treatment the presence of inflammation was examined, and the tissues were stained to detect osteoclasts by means of a tartrate resistant alkaline phosphatase (TRAP) assay. Synthesis of MMP-9 was detected using Western blotting and immunohistochemistry. RESULTS Teeth with apical periodontitis that had root canal therapy performed in a single visit presented a higher synthesis of MMP-9 compared with root canal treatment using calcium hydroxide. Treatment with calcium hydroxide resulted in a reduced amount of inflammatory cells and MMP-9 positive cells. Osteoclast formation, the number of MMP-9 positive osteoclasts and cementocytes, was reduced following root canal treatment, regardless of the root canal treatment protocol used. CONCLUSION Root canal treatment reduced the amount of inflammatory cells and osteoclasts in periapical area. The use of calcium hydroxide as intracanal medication resulted in a lower synthesis of MMP-9, though the number of osteoclasts and MMP-9 positive osteoclasts were similar between the groups. CLINICAL RELEVANCE Periapical bone repair following root canal treatment is impacted by therapy performed either in single visit or using calcium hydroxide dressing measured by inflammatory cell recruitment, osteoclast formation, and MMP-9 synthesis.
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Affiliation(s)
| | - Maya Fernanda Manfrin Arnez
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Renato Petille
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fernanda Regina Ribeiro-Santos
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- Universidade de Pernambuco, Arco Verde, PE, Brazil
| | - Marina Fernandes de Sena
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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13
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Georgiou AC, Crielaard W, Ouwerling P, McLean W, Lappin DF, van der Waal SV. The influence of apical periodontitis on the concentration of inflammatory mediators in peripheral blood plasma and the metagenomic profiling of endodontic infections: Study design and protocol. Contemp Clin Trials Commun 2020; 21:100686. [PMID: 33490705 PMCID: PMC7810621 DOI: 10.1016/j.conctc.2020.100686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
Increased systemic inflammation has been identified in presence of oral disease, specifically endodontic disease. It is important to investigate whether treatment of the oral disease ameliorates systemic inflammation. Furthermore, there is no information about the extent to which different microorganisms may trigger inflammatory response. Objectives Primarily (i) to compare the plasma concentrations of inflammatory mediators of apical periodontitis (AP) subjects to controls, (ii) to evaluate whether elimination of the endodontic infection reduces systemic inflammation (iii) to investigate the microbiome of root canal infections. Secondarily i) to correlate the inflammatory mediator data with the microbiome data to investigate whether the type of infection influences the type and severity of the inflammatory condition ii) to examine patterns in the inflammatory mediator data before and after tooth extraction in order to establish a biomarker signature of AP/oral disease. This is a multi-centre prospective case-control intervention study. The cohort will consist of 30 healthy human volunteers with one or two teeth with a root-tip inflammation and 30 matched healthy controls. Peripheral blood will be drawn at 6 time points, 3 before and 3 after the extraction of the tooth with apical periodontitis. The teeth will be pulverized, DNA extraction and sequencing will be performed. This study aims to compare the concentration of inflammatory blood plasma proteins in between AP-subjects and controls at different time points before and after the tooth extraction in a systematic and complete way. Additionally the composition of the root canal microbiome in association with the inflammatory response of the host will be assessed.
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Affiliation(s)
- A C Georgiou
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - W Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - P Ouwerling
- Tandheelkundig Centrum Molenvliet, Alphen aan den Rijn, the Netherlands
| | - W McLean
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - D F Lappin
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - S V van der Waal
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.,Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
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14
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The Apical Root Canal System of Teeth with Posttreatment Apical Periodontitis: Correlating Microbiologic, Tomographic, and Histopathologic Findings. J Endod 2020; 46:1195-1203. [DOI: 10.1016/j.joen.2020.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 01/20/2023]
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15
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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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16
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Carvalho CAT, Hasna AA, Carvalho AS, Vilela PDGF, Ramos LDP, Valera MC, Oliveira LDD. Clinical Study of Sodium Hypochlorite, Polymyxin B And Limewater Effect on MMP-3,-8,-9 In Apical Periodontitis. Braz Dent J 2020; 31:116-121. [PMID: 32556009 DOI: 10.1590/0103-6440202003081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/25/2019] [Indexed: 12/19/2022] Open
Abstract
This study aimed to evaluate sodium hypochlorite (NaOCl), limewater (LW), and Polymyxin B (PMB) as irrigants over MMP-3, MMP-8 and MMP-9. Thirty-three patients with apical periodontitis of single-rooted teeth were treated according to three-experimental groups (n=11): group-1: 2.5% NaOCl was used as irrigant; group-2: 2.5% NaOCl for the first two files and LW: [0.14% Ca(OH)2] for the last two files; group-3: 2.5% NaOCl for the first two files and PMB for the last two files. The association of Ca(OH)2 and CHX was used as an intracanal medication in all groups. Four root canal samplings (S) were collected: S1) immediately after access cavity; S2) after biomechanical preparation; S3) after EDTA application; and S4) after removal of the intracanal medication. After quantification of MMP-3, MMP-8, and MMP-9, the data were analyzed by Friedman and Kruskal-Wallis tests and completed by Dunn test (5%). Regardless the used irrigant, there was no difference in reducing MMP-3 or MMP-8 (P=0,5273, P=0,7048 respectively). However, in reducing MMP-9 (P=0,0246) the NaOCl group was the most effective followed by NaOCl+LW group and NaOCl+PMB group respectively. The intracanal medication [Ca(OH)2 + CHX] with the NaOCl and NaOCl+LW was effective in reducing MMP-8 (P<0,0001, P=0,0025) and MMP-9 (P=0,0007, P=0,0047) respectively, but not for the group of NaOCl+PMB which was not effective in reducing MMP-8 or MMP-9 (P=0,1718, P=0,1953) respectively. NaOCl and NaOCl+LW were effective in reducing MMP-9 levels, and this effectivity could be improved by the use of the intracanal medication [Ca(OH)2 + CHX] in reducing MMP-8 and MMP-9 levels.
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Affiliation(s)
- Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontic Division, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontic Division, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Alessandra Sverberi Carvalho
- Department of Restorative Dentistry, Endodontic Division, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Polyana das Graças Figueiredo Vilela
- Department of Biosciences and Oral Diagnosis, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Lucas de Paula Ramos
- Department of Biosciences and Oral Diagnosis, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Endodontic Division, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, UNESP - São Paulo State University, Institute of Science and Technology, São José dos Campos, SP, Brazil
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17
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Sarmento EB, Gomes CC, Pires FR, Pinto LC, Antunes LAA, Armada L. Immunoexpression of bone resorption biomarkers in apical periodontitis in diabetics and normoglycaemics. Int Endod J 2020; 53:1025-1032. [DOI: 10.1111/iej.13305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Affiliation(s)
- E. B. Sarmento
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - C. C. Gomes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - F. R. Pires
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
| | - L. C. Pinto
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. A. A. Antunes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. Armada
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
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18
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de Souza LC, Cavalla F, Maili L, Garlet GP, Vieira AR, Silva RM, Letra A. WNT gene polymorphisms and predisposition to apical periodontitis. Sci Rep 2019; 9:18980. [PMID: 31831777 PMCID: PMC6908593 DOI: 10.1038/s41598-019-55293-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
Single nucleotide polymorphisms (SNPs) in WNT genes may impact gene/protein function and contribute to individual predisposition to apical periodontitis (AP). Here, we investigated the association of SNPs in/nearby WNT3, WNT3A, WNT5A, WNT8A, WNT9B and WNT11 genes with AP using a case-control dataset. Cases were defined as individuals with deep caries and AP (n = 188); controls had deep caries and no AP (n = 230). Genotyping was performed using Taqman chemistry in real time PCR. Data analyses was performed using Fisher Exact tests assuming a Bonferroni correction threshold value of 0.005. Single-SNP association analysis revealed a trend for association with WNT3 rs9890413 genotypes (P = 0.009) under a dominant model and allelic association for WNT3A rs1745420 (P = 0.009). Haplotypes involving WNT3-WNT9B-WNT3A alleles were also significantly associated with AP (P ≤ 0.003). Luciferase reporter assays showed higher transcriptional activity (1.4-fold) with the alternate G allele in rs1745420. Expression of WNT3, WNT3A and WNT5A in AP tissues was significantly higher than in control tissues, and inversely correlated with the expression of SERPINB1, COL1A1 and TIMP1 (P < 0.05). Our results suggest that WNT genes have a role in modulating AP and polymorphisms in these genes may increase susceptibility to AP.
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Affiliation(s)
- Letícia Chaves de Souza
- Department of Endodontics, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA
| | - Franco Cavalla
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA
- Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago, 7520355, Chile
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, 17012, Brazil
| | - Lorena Maili
- Department of Pediatrics, University of Texas Health Science Center at Houston McGovern Medical School, Houston, 77030, USA
- Pediatric Research Center, University of Texas Health Science Center at Houston McGovern Medical School, Houston, 77030, USA
| | - Gustavo P Garlet
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, 17012, Brazil
| | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, 15229, USA
| | - Renato M Silva
- Department of Endodontics, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA
| | - Ariadne Letra
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA.
- Pediatric Research Center, University of Texas Health Science Center at Houston McGovern Medical School, Houston, 77030, USA.
- Department of Diagnostic and Biomedical Sciences, University of Texas Health Science Center School of Dentistry, Houston, 77054, USA.
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19
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20
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Fouad AF. Microbiological aspects of traumatic injuries. Dent Traumatol 2019; 35:324-332. [PMID: 31125490 DOI: 10.1111/edt.12494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022]
Abstract
After traumatic injuries to teeth, microorganisms may invade the compromised pulp tissue and initiate pulp infection and periapical inflammation. In addition to bone resorption that typically accompanies pulp necrosis, root resorption frequently occurs. Root resorption has several variants that may occur shortly after the trauma or at a later stage. The pathological changes seen after traumatic injuries to teeth are invariably linked to the presence of microbial irritants. The presence of bacterial biofilms in the dental pulp space can be treated with regenerative or therapeutic endodontic procedures. However, necrosis of periodontal ligament is usually terminal for the tooth involved. In this review, the sources of bacteria after traumatic injuries are discussed. The types and role of microorganisms involved in the pathogenesis of endodontic pathosis after traumatic injuries are presented, and contemporary approaches for the management of these conditions are reviewed. Contemporary antimicrobial strategies are discussed. The rationale for the use of systemic and topical antimicrobials is presented. Finally, novel approaches to the use of antimicrobial therapies, particularly in regenerative procedures, are reviewed.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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21
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Li X, Hu L, Ma L, Chang S, Wang W, Feng Y, Xu Y, Hu J, Zhang C, Wang S. Severe periodontitis may influence cementum and dental pulp through inflammation, oxidative stress, and apoptosis. J Periodontol 2019; 90:1297-1306. [DOI: 10.1002/jper.18-0604] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Xiangchun Li
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
- Department of Stomatologythe First Hospital of Qinhuangdao Hebei P. R. China
| | - Liang Hu
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Linsha Ma
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Shimin Chang
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Weili Wang
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Yuanyong Feng
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Yipu Xu
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Jinchao Hu
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Chunmei Zhang
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
| | - Songlin Wang
- Beijing Key Laboratory of Tooth Regeneration and Function ReconstructionCapital Medical University School of Stomatology Beijing P. R. China
- Department of Biochemistry and Molecular BiologyCapital Medical University School of Basic Medical Sciences Beijing P. R. China
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22
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Braz-Silva PH, Bergamini ML, Mardegan AP, De Rosa CS, Hasseus B, Jonasson P. Inflammatory profile of chronic apical periodontitis: a literature review. Acta Odontol Scand 2019; 77:173-180. [PMID: 30585523 DOI: 10.1080/00016357.2018.1521005] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Apical periodontitis caused by root canal infection is the most frequent pathological lesion in the jaws, mainly manifested as periapical granulomas and cysts. Understanding of the formation and progression of apical periodontitis as well as the identification of inflammatory biomarkers can help increase the knowledge of pathogenic mechanisms, improve the diagnosis and provide support for different therapeutic strategies. The objective of the present article is to review inflammatory biomarkers such as cytokines, chemokines, inflammatory cells, neuropeptides, RANK/RANKL/OPG system and other inflammatory markers and to relate these systems to the development and progression of pathological conditions related to apical periodontitis.
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Affiliation(s)
- Paulo Henrique Braz-Silva
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Virology, Institute of Tropical Medicine of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil
| | - Mariana Lobo Bergamini
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Andressa Pinto Mardegan
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Catharina Simioni De Rosa
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Bengt Hasseus
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Jonasson
- Department of Endodontology, Institute of Odontology The Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
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23
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Santos-Junior AO, De Castro Pinto L, Mateo-Castillo JF, Pinheiro CR. Success or failure of endodontic treatments: A retrospective study. J Conserv Dent 2019; 22:129-132. [PMID: 31142980 PMCID: PMC6519185 DOI: 10.4103/jcd.jcd_507_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/07/2019] [Accepted: 01/16/2019] [Indexed: 02/03/2023] Open
Abstract
CONTEXT Well-conducted endodontic therapy is necessary for the dental rehabilitation of the individuals with cleft lip and palate. AIM The aim of this study was to verify the success and failure index of endodontic treatments performed in the Endodontic Sector of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, (HRAC/USP), Bauru, Brazil. MATERIALS AND METHODS The preservation records (at least 2 years) of the endodontic treatments performed in the HRAC/USP were verified, indicating the success or failure of the treatment, and these treatments were divided into three groups (vital pulp, necrotic pulp, and endodontic retreatment). The Chi-square statistical test was applied with a significance level of 5%. RESULTS A total of 1216 endodontic treatments were quantified with a minimum of 2 years of prenatal care at HRAC/USP. The vital pulp group had a success rate of 99.4% (535 treatments) and 0.6% failure (3 treatments), 98.6% of success in the necrotic pulp group (577 treatments) and 1.4% failure (8 treatments), and 95.6% success rate (89 treatments) and 4.4% failure (4 treatments) in the endodontic reintervention group. CONCLUSION From the results found, we can conclude that there was a high success rate in the treatments and endodontic retreatments performed in the Endodontics Sector of the HRAC/USP, considering that well-conducted endodontic therapy is extremely important in the oral rehabilitation of individuals with cleft lip and palate.
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Affiliation(s)
- Airton Oliveira Santos-Junior
- Department of Endodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Lidiane De Castro Pinto
- Department of Endodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Jose Francisco Mateo-Castillo
- Department of Endodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Claudia Ramos Pinheiro
- Department of Endodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Endodontics, Endodontic Specialization, Dentistry Postgraduate Center- CPO Uningá, Bauru, São Paulo, Brazil
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Yu Y, Li X, Mi J, Qu L, Yang D, Guo J, Qiu L. Resveratrol Suppresses Matrix Metalloproteinase-2 Activation Induced by Lipopolysaccharide in Mouse Osteoblasts via Interactions with AMP-Activated Protein Kinase and Suppressor of Cytokine Signaling 1. Molecules 2018; 23:molecules23092327. [PMID: 30213073 PMCID: PMC6225262 DOI: 10.3390/molecules23092327] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 12/18/2022] Open
Abstract
Porphyromonas endodontalis (P. endodontalis) lipopolysaccharide (LPS) is associated with the progression of bone resorption in periodontal and periapical diseases. Matrix metalloproteinase-2 (MMP-2) expression and activity are elevated in apical periodontitis and have been suggested to participate in bone resorption. Therefore, inhibiting MMP-2 activation may be considered a therapeutic strategy for treating apical periodontitis. Resveratrol is a natural non-flavonoid polyphenol that has been reported to have antioxidant, anti-cancer, and anti-inflammatory properties. However, the capacity of resveratrol to protect osteoblast cells from P. endodontalis LPS insults and the mechanism of its inhibitory effects on MMP-2 activation is poorly understood. Here, we demonstrate that cell viability is unchanged when 10 mg L−1P. endodontalis LPS is used, and MMP-2 expression is drastically induced by P. endodontalis LPS in a concentration- and time-dependent manner. Twenty micromolar resveratrol did not reduce MC3T3-E1 cell viability. Resveratrol increased AMP-activated protein kinase (AMPK) phosphorylation, and Compound C, a specific AMPK inhibitor, partially abolished the resveratrol-mediated phosphorylation of AMPK. In addition, AMPK inhibition blocked the effects of resveratrol on MMP-2 expression and activity in LPS-induced MC3T3-E1 cells. Treatment with resveratrol also induced suppressor of cytokine signaling 1 (SOCS1) expression in MC3T3-E1 cells. SOCS1 siRNA negated the inhibitory effects of resveratrol on LPS-induced MMP-2 production. Additionally, resveratrol-induced SOCS1 upregulation was reduced by treatment with compound C. These results demonstrate that AMPK and SOCS1 activation are important signaling events during resveratrol-mediated inhibition of MMP-2 production in response to LPS in MC3T3-E1 cells, and there is crosstalk between AMPK and SOCS1 signaling.
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Affiliation(s)
- Yaqiong Yu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
- Liaoning Province Key Laboratory of Oral Diseases, Shenyang 110002, China.
| | - Xiaolin Li
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
| | - Jing Mi
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
| | - Liu Qu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
| | - Di Yang
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
| | - Jiajie Guo
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang 110002, China.
- Liaoning Province Key Laboratory of Oral Diseases, Shenyang 110002, China.
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