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Strazzi-Sahyon HB, Banci HA, Maltarollo TFH, Martinez CMT, Rocha EA, Figueiredo RB, Garcia DCS, Constantino CJL, Spin-Neto R, Duarte MAH, Cintra LTA, Dos Santos PH, Sivieri-Araujo G. The impact of methylene blue photosensitizer, aPDT and a calcium hydroxide-based paste on the physicochemical and mechanical characteristics of root canal dentin and the bonding interface of fiberglass posts. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 253:112878. [PMID: 38447252 DOI: 10.1016/j.jphotobiol.2024.112878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/06/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE To investigate the influence of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) and calcium hydroxide (CH) medication on the mechanical characteristics, degree of conversion (DC), quantification, and volume of gaps at the adhesive interface of glass fiber posts (GFPs) luted to distinct thirds of root canal dentin. Additionally, the microhardness (MH), elastic modulus (Eit), morphology, and chemical structure of the intraradicular dentin were assessed. MATERIALS AND METHODS 6 experimental groups were formed by sorting 102 bovine incisors. Canals receiving deionized water irrigation as a negative control; canals receiving deionized water irrigation and filled with CH as a positive control; groups treated with CH + MB at 50 and 100 mg/L without irradiation; and groups treated with CH + MB at 50 and 100 mg/L irradiated by red laser for 60 s (660 nm; 100 mW; 6.5 J; 72 J/cm2). MH, Eit, and DC properties were evaluated for both the resin cement layer and root dentin substrate (n = 8). Volume and quantification of gaps at the bonding interface (n = 6), and dentin morphology and chemical content were investigated (n = 3). Data were analyzed using a repeated-measures 2-way ANOVA followed by Tukey post hoc analysis (α = 0.05). RESULTS The distinct intraradicular thirds and treatment with MB-mediated aPDT, whether activated or not, in combination with CH, had a significant impact on the mechanical characteristics of the root dentin. This effect was also observed in the MH, Eit, DC, quantification, and volume of gaps at the luting interface (P < .05). In general, a higher concentration of MB, whether activated by a red laser or not, led to lower values in the mechanical properties of the root dentin, as well as in MH, Eit, and DC at the adhesive interface (P < .05). Additionally, these groups exhibited higher values for quantification and volume of gaps at the luting substrate (P < .05). Scanning electron micrographs and energy dispersive X-ray spectra showed qualitative similarity among all groups, except for the negative experimental control group. CONCLUSIONS MB-mediated aPDT at 50 mg/L, in combination with CH, demonstrated favorable physico-chemical and mechanical characteristics in intraradicular dentin, along with satisfactory mechanical features and the adhesive interface integrity for GFPs at all intraradicular depths. CLINICAL SIGNIFICANCE MB-mediated aPDT at a concentration of 50 mg/L combined to CH medication represents a suitable choice for photosensitization in the context of intracanal disinfection following the biomechanical procedure and prior to luting of intraradicular restorations.
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Affiliation(s)
- Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil; Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo - USP, Bauru, SP, Brazil.
| | - Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Thalya Fernanda Horsth Maltarollo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Carolina Martins Teixeira Martinez
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Eloísa Alexo Rocha
- Etec Araçatuba - Public School, Centro Paula Souza Araçatuba, SP, Brazil
| | - Roberto Braga Figueiredo
- Department of Metallurgical and Materials Engineering, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Dayana Cristina Silva Garcia
- Department of Materials Engineering and Civil Construction, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Carlos José Leopoldo Constantino
- Department of Physics, School of Technology and Applied Sciences, São Paulo State University - UNESP, Presidente Prudente, SP, Brazil.
| | - Rubens Spin-Neto
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | | | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
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Virdee SS, Bashir NZ, Krstic M, Camilleri J, Grant MM, Cooper PR, Tomson PL. Periradicular tissue fluid-derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross-sectional study. Int Endod J 2023; 56:1222-1240. [PMID: 37464545 DOI: 10.1111/iej.13956] [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: 03/15/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Periradicular tissue fluid (PTF) offers a source of diagnostic, prognostic and predictive biomarkers for endodontic disease. AIMS (1) To optimize basic parameters for PTF paper point sampling in vitro for subsequent in vivo application. (2) To compare proteomes of PTF from teeth with normal apical tissues (NAT) and asymptomatic apical periodontitis (AAP) using high-throughput panels. METHODOLOGY (1) To assess volume absorbance, paper points (n = 20) of multiple brands, sizes and sampling durations were inserted into PBS/1%BSA at several depths. Wetted lengths (mm) were measured against standard curves to determine volume absorbance (μL). To assess analyte recovery, paper points (n = 6) loaded with 2 μL recombinant IL-1β (15.6 ng/mL) were eluted into 250 μL: (i) PBS; (ii) PBS/1% BSA; (iii) PBS/0.1% Tween20; (iv) PBS/0.25 M NaCl. These then underwent: (i) vortexing; (ii) vortexing/centrifugation; (iii) centrifugation; (iv) incubation/vortexing/centrifugation. Sandwich-ELISAs determined analyte recovery (%) against positive controls. (2) Using optimized protocols, PTF was retrieved from permanent teeth with NAT or AAP after accessing root canals. Samples, normalized to total fluid volume (TFV), were analysed to determine proteomic profiles (pg/TFV) of NAT and AAP via O-link Target-48 panel. Correlations between AAP and diagnostic accuracy were explored using principal-component analysis (PCA) and area under receive-operating-characteristic curves (AUC [95% CI]), respectively. Statistical comparisons were made using Mann-Whitney U, anova and post hoc Bonferonni tests (α < .01). RESULTS (1) UnoDent's 'Classic' points facilitated maximum volume absorbance (p < .05), with no significant differences after 60 s (1.6 μL [1.30-1.73]), 1 mm depth and up to 40/0.02 (2.2 μL [1.98-2.20]). For elution, vortexing (89.3%) and PBS/1% BSA (86.9%) yielded the largest IL-1β recovery (p < .05). (2) 41 (NAT: 13; AAP: 31) PTF samples proceeded to analysis. The panel detected 18 analytes (CCL-2, -3, -4; CSF-1; CXCL-8, -9; HGF; IL-1β, -6, -17A, -18; MMP-1, -12; OLR-1; OSM; TNFSF-10, -12; VEGF-A) in ≥75% of AAP samples at statistically higher concentrations (p < .01). CXCL-8, IL-1β, OLR-1, OSM and TNFSF-12 were strongly correlated to AAP. 'Excellent' diagnostic performance was observed for TNFSF-12 (AUC: 0.94 [95% CI: 0.86-1.00]) and the PCA-derived cluster (AUC: 0.96 [95% CI: 0.89-1.00]). CONCLUSIONS Optimized PTF sampling parameters were identified in this study. When applied clinically, high-throughput proteomic analyses revealed complex interconnected networks of potential biomarkers. TNFSF-12 discriminated periradicular disease from health the greatest; however, clustering analytes further improved diagnostic accuracy. Additional independent investigations are required to validate these findings.
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Affiliation(s)
- Satnam S Virdee
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | | | - Milan Krstic
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Josette Camilleri
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Melissa M Grant
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Paul R Cooper
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Phillip L Tomson
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
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Khoshbin E, Salehi R, Behroozi R, Sadr S, Zamani A, Farhadian M, Karkehabadi H. The effect of low-dose aspirin on aspirin triggered lipoxin, interleukin 1 beta, and prostaglandin E2 levels in periapical fluid: a double-blind randomized clinical trial. BMC Oral Health 2023; 23:530. [PMID: 37525211 PMCID: PMC10388445 DOI: 10.1186/s12903-023-03243-0] [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: 04/14/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The role of pro-resolving mediators in inflammation is a new concern in research. The effect of low-dose aspirin on production of a special kind of these mediators named aspirin triggered lipoxin (ATL) has been studied on different tissues. This randomized clinical trial evaluated the effect of low-dose aspirin on ATL and pro-inflammatory mediators' level in periapical fluid of necrotic teeth with large lesions. METHODS Twenty-four patients with necrotic pulp and periapical lesion were randomly assigned to low-dose aspirin and placebo groups. In the first appointment, canals were shaped up to F3 size and #40 K-file and cleaned with 10 milliliters 2.5% sodium hypochlorite and 17% Ethylenediaminetetraacetic acid. Periapical fluid was sampled by a paper cone. The tooth was temporized without any intracanal medication. Tablets were administered for 7 days, then the teeth were re-opened and the sampling were repeated. Interleukin-1 beta (IL-1β), prostaglandin E2 (PGE2) and ATL were analyzed by enzyme-linked immunosorbent assay. Data were analyzed with paired t-test using SPSS statistical software, version 21 (α = 0.05). RESULTS A significant reduction in PGE2 and IL-1β was noted in the aspirin-treated group while an increase in ATL was observed (P < 0.001). There was no significant difference in the mediator scores before and after in the placebo-treated group (P > 0.05). CONCLUSION Low-dose aspirin can influence the inflammatory process by reducing pro-inflammatory mediators such as PGE2 and IL-1β, as well as increasing the pro-resolving mediators such as ATL. TRIAL REGISTRATION IRCT20191211045702N1.
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Affiliation(s)
- Elham Khoshbin
- Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Razieh Salehi
- Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Endodontics, School of dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rooholah Behroozi
- Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soroush Sadr
- Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Zamani
- Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Karkehabadi
- Department of Endodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Endodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Arias Z, Nizami MZI, Chen X, Chai X, Xu B, Kuang C, Omori K, Takashiba S. Recent Advances in Apical Periodontitis Treatment: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10040488. [PMID: 37106675 PMCID: PMC10136087 DOI: 10.3390/bioengineering10040488] [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: 03/01/2023] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Apical periodontitis is an inflammatory response caused by pulp infection. It induces bone resorption in the apical and periapical regions of the tooth. The most conservative approach to treat this condition is nonsurgical endodontic treatment. However, clinical failure has been reported with this approach; thus, alternative procedures are required. This review highlights recent literature regarding advanced approaches for the treatment of apical periodontitis. Various therapies, including biological medications, antioxidants, specialized pro-resolving lipid mediators, and stem cell therapy, have been tested to increase the success rate of treatment for apical periodontitis. Some of these approaches remain in the in vivo phase of research, while others have just entered the translational research phase to validate clinical application. However, a detailed understanding of the molecular mechanisms that occur during development of the immunoinflammatory reaction in apical periodontitis remains unclear. The aim of this review was to summarize advanced approaches for the treatment of apical periodontitis. Further research can confirm the potential of these alternative nonsurgical endodontic treatment approaches.
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Affiliation(s)
- Zulema Arias
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Mohammed Zahedul Islam Nizami
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR 999077, China
| | - Xiaoting Chen
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Xinyi Chai
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Bin Xu
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Canyan Kuang
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kazuhiro Omori
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
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Strazzi-Sahyon HB, Banci HA, Melo FSD, Soares LS, Spin-Neto R, Duarte MAH, Cintra LTA, Dos Santos PH, Sivieri-Araujo G. In vitro study on how photodynamic therapy and calcium hydroxide medication influence adhesive interface properties of glass-fiber posts to intraradicular dentin. J Mech Behav Biomed Mater 2023; 141:105757. [PMID: 36924612 DOI: 10.1016/j.jmbbm.2023.105757] [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: 01/05/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE This in vitro study evaluated the influence of antimicrobial photodynamic therapy (aPDT), using methylene blue (MB) as photosensitizer (PS) and calcium hydroxide (CH) as intracanal medication on adhesive bond strength, sealing, and integrity of the luting interface of glass-fiber posts to different thirds of endodontically treated root canal dentin. MATERIAL AND METHODS 102 incisors were sorted into 6 groups: a negative control irrigated with deionized water; a positive control irrigated with deionized water and filled with CH; CH + MB 50 mg/L without laser radiation; CH + MB 100 mg/L without laser radiation; CH + MB 50 mg/L radiated by red laser; and CH + MB 100 mg/L radiated by red laser. Push-out bond strength (n = 8), adhesive interface sealing (n = 3), and volume and quantification of voids (n = 6) were assessed using a universal testing machine, confocal laser scanning microscope, and computerized microtomography, respectively. Scanning electron micrographs were obtained from representative samples to qualify the fracture patterns. Push-out bond strength and adhesive interface integrity data were subjected to 2-way ANOVA for repeated measures followed by Tukey's test (α = 0.05). Adhesive interface sealing was evaluated by the inter-examiner Kappa test and submitted to Kruskal-Wallis and Dunns tests (α = 0.05). RESULTS Assessing the apical region, the positive control and MB100WA + Ca(OH)2 groups showed lower adhesive bond strength compared to the MB100A + Ca(OH)2 group (P < 0.05). The cervical third showed higher bond strength than the apical third for the positive control, MB50WA + Ca(OH)2, MB100WA + Ca(OH)2, and MB50A + Ca(OH)2 groups (P < 0.05). A prevalence of mixed failure was observed in all experimental groups. There were no statistically significant differences in adhesive interface sealing for any of the parameters assessed (P > 0.05). MB100WA + Ca(OH)2 and MB100A + Ca(OH)2 groups promoted a higher volume and quantification of voids compared to the negative control group evaluating the cervical third (P < 0.05). In general, there were no differences in the quantification of voids comparing the intraradicular thirds (P > 0.05), differently to the volume of voids in which, in general, the cervical third promoted higher values compared to the middle and apical thirds (P < 0.05). CONCLUSION aPDT with methylene blue PS at 50 mg/L associated with calcium hydroxide as intracanal medication demonstrated satisfactory bond strength, sealing, and integrity of the adhesive interface at any intraradicular depth.
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Affiliation(s)
- Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil; Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, USP, Bauru, SP, Brazil.
| | - Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil.
| | - Fernanda Santos de Melo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil.
| | - Lucas Silva Soares
- Etec Araçatuba -Public School, Centro Paula Souza Araçatuba, SP, Brazil.
| | - Rubens Spin-Neto
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, São Paulo University, USP, Bauru, SP, Brazil.
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil.
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil; Dental Research Institute, University of Toronto, Faculty of Dentistry, Toronto, ON, Canada.
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil.
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Bolat N, Erzurumlu Y, Aşcı H, Özmen Ö, Üreyen Kaya B. Selenium ameliorates inflammation by decreasing autophagic flux and mitogen-activated protein kinase signalling on experimentally induced rat periapical lesions. Int Endod J 2023; 56:227-244. [PMID: 36314140 DOI: 10.1111/iej.13861] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
AIM To reveal the molecular mechanisms that targets mitogen-activated protein kinase (MAPK) signalling and the autophagic flux and to investigate the possible effects of the systemic administration of selenium (Se) on experimentally induced rat periapical lesions. METHODOLOGY Thirty adult Sprague-Dawley rats were divided equally into negative control, positive control and Se groups. In the positive control and Se groups, the pulp chambers of their mandibular first molars were exposed to the oral environment to induce periapical lesions The Se group received daily intraperitoneal injections of Se at a dose of 0.1 mg kg-1 . After 28 days, the amount of bone destruction; severity of inflammation; penetration of microorganisms along the root canal; collagen degradation in periodontal ligament; interleukin (IL)-6, hypoxia-inducible factor-1 (HIF-1), cyclooxygenase-2 (COX-2) and caspase-3 expression; autophagic flux; and p38 MAPK signalling were evaluated using radiographic, histopathological, Gram staining, picrosirius red stain, immunohistochemical, quantitative real-time polymerase chain (qRT-PCR) and Western blot methods, respectively. These data were analysed through the Kruskal-Wallis and Dunnett's tests (p < .05). RESULTS The area of radiographic periapical bone loss, histopathological scores, the area of periapical bone loss and the scores for the bacteria localisation, the intensity of immunohistochemical staining for IL-6, HIF-1, COX-2 and caspase-3 in the Se group was significantly less than those of the positive control group (p < .01). The mRNA expression levels of Beclin-1, Atg3, Atg5, Atg7 and Atg16L1 were lower in the Se group than in the positive control group (p < .01). The protein expressions of Beclin-1, Atg5 and LC3-II, the phosphorylation ratio of the p38 MAPK and the ratios of LC3II/LC3I were significantly higher (p < .05) in the positive control and Se groups. On the contrary, the expression of the p62/SQSTM1 protein was significantly lower (p < .05) in the positive control and Se groups than in the negative control group. CONCLUSION The induction of periapical lesions in rats increased autophagic flux and activated p38 MAPK signal transduction processes. Se suppressed the inflammatory process, reduced bone destruction and both the autophagic flux and p38 MAPK activation.
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Affiliation(s)
- Nergiz Bolat
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Yalçin Erzurumlu
- Department of Biochemistry, Faculty of Pharmacy, Suleyman Demirel University, Isparta, Turkey
| | - Halil Aşcı
- Department of Pharmacology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Özlem Özmen
- Department of Pathology, Faculty of Veterinary, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Abdulrab S, Mostafa N, Al-Maweri SA, Abada H, Halboub E, Alhadainy HA. Antibacterial and anti-inflammatory efficacy of N-acetyl cysteine in endodontic treatment: a scoping review. BMC Oral Health 2022; 22:398. [PMID: 36096839 PMCID: PMC9469528 DOI: 10.1186/s12903-022-02433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022] Open
Abstract
Background This scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory. Methods PubMed, Scopus, Web of Science, and Google scholar search engines/databases were searched up to February 2022 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and identifying relevant studies. Results Out of 193 studies, 15 fulfilled the inclusion criteria and were processed for data extraction. Thirteen in vitro studies assessed antibacterial/antibiofilm efficacy of NAC, and reported good and promising efficacy: NAC was found as efficacious as the comparators (chlorhexidine, sodium hypochlorite, calcium hydroxide), or even showed higher efficacy. Regarding the anti-inflammatory efficacy of NAC, one in vitro study found it equivalent to, while one clinical trial revealed it more efficacious than calcium hydroxide. Conclusions There is accumulating evidence on the anti-microbial and anti-inflammatory efficacy of NAC in context of endodontics. However, further clinical trials with robust methodology and objective and reliable clinical, biological and microbial outcomes are warranted to translate its use for clinical practice on humans.
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Affiliation(s)
- Saleem Abdulrab
- Um Salal Health Centre, Primary Health Care Corporation, Doha, Qatar.
| | - Nawras Mostafa
- Um Salal Health Centre, Primary Health Care Corporation, Doha, Qatar
| | - Sadeq Ali Al-Maweri
- Department of Restorative Dentistry, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa
| | - Hisham Abada
- Department of Endodontics, Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.,Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sanaa, Yemen
| | - Hatem A Alhadainy
- Department of Endodontics, College of Dentistry, University of Tanta, Tanta, Egypt
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Local immunomodulatory effects of intracanal medications in apical periodontitis. J Endod 2022; 48:430-456. [PMID: 35032538 DOI: 10.1016/j.joen.2022.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 12/11/2022]
Abstract
The immune system is an extremely complex biological network that plays a crucial role in the hemostasis of periapical tissue, pathogenesis of apical periodontitis (AP) as well as periapical tissue healing. The successful elimination of microbial infections remains a significant challenge, mostly due to the ever-growing development of antimicrobial-resistant pathogens. The bacterial endurance in the root canal system contributes to features ranging from altered post-treatment healing to exacerbation of chronic periradicular immune response, that compromise the outcome of endodontic treatment. A highly effective strategy for combating infectious diseases and the associated inflammation-mediated tissue damage is to modulate the host immune response in conjunction with antimicrobial therapy. There are several medications currently used in endodontic treatment, however, they suffer various levels of microbial resistance and do not deliver all the required characteristics to simultaneously address both intracanal bacteria and periapical inflammation. Interaction of antimicrobial agents with the immune system can impact its function, leading to immune-suppressive or immune-stimulatory effects. The group of non-conventional antimicrobial medications, such as antimicrobial peptides, propolis, and nanomaterials, are agents that provide strong antimicrobial effectiveness and concomitant immunomodulatory and/or reparative effect, without any host tissue damages. Herein, we provide an overview of local immune modulation in AP and a comprehensive review of the immunomodulatory effect of antimicrobials intracanal medications applied in endodontics with specific emphasis on the antimicrobial nanomaterial-based approaches that provide immunomodulatory potential for successful clinical deployment in endodontics.
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Strazzi-Sahyon HB, Oliveira AKL, Carvalho AP, Figueiredo RB, Cintra LTA, Gomes-Filho JE, Dos Santos PH, Sivieri-Araujo G. Influence of photodynamic therapy and intracanal medication on Martens hardness, elastic modulus and bond strength of glass-fiber posts to endodontically treated root dentin. Photodiagnosis Photodyn Ther 2021; 36:102571. [PMID: 34626826 DOI: 10.1016/j.pdpdt.2021.102571] [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: 06/02/2021] [Revised: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The purpose of this in vitro study was to evaluate the influence of photodynamic therapy (PDT) with methylene blue photosensitizer (PS) and calcium hydroxide intracanal medication on Martens hardness (MH), elastic modulus (Eit) and adhesive bond strength of glass-fiber posts in different thirds of intraradicular dentin. METHODS Ninety-six bovine teeth were distributed into the following 6 experimental groups: a negative control irrigated with deionized water; a positive control irrigated with deionized water and filled with calcium hydroxide intracanal medication (Ca[OH]2); Ca[OH]2 + methylene blue 50 mg/L without activation; Ca[OH]2 + methylene blue 100 mg/L without activation; Ca[OH]2 + methylene blue 50 mg/L activated by red laser; and Ca[OH]2 + methylene blue 100 mg/L activated by red laser (n = 16). MH and Eit were measured using an ultramicrodurometer under load action of 3 mN (n = 8). Adhesive bond strength was measured using the push-out test in a universal testing machine (n = 8), and representative samples underwent scanning electron microscopy. Data on MH, Eit, and bond strength were subjected to normality tests and analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS Methylene blue PS, activated or not by red laser, associated with calcium hydroxide medication did not promote significant difference as compared to the control groups irrigated with deionized water, associated or not with the use of intracanal medication, regarding mechanical properties and bond strength (p > 0.05). Experimental groups showed no difference between the thirds regarding root canal depth (p > 0.05), except for the positive control group, in which the apical third showed higher Eit values than the middle third (p = 0.0324). There was a predominance of mixed failure in all experimental groups, excepted the red laser-activated group treated with the highest concentration of methylene blue, which showed predominance of adhesive failure. CONCLUSIONS PDT with methylene blue PS at 50 mg/L, associated with intracanal calcium hydroxide medication is a satisfactory alternative for endodontic treatment as there is no interference in the mechanical properties and bond strength among glass-fiber posts to intraradicular dentin at any depth of the root canal.
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Affiliation(s)
- Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Arianny Késsia Lara Oliveira
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba School of Dentistry, Rua José Bonifácio, 1193, 16015-050, Araçatuba, SP, Brazil
| | - Amanda Pereira Carvalho
- Department of Metallurgical and Materials Engineering, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Roberto Braga Figueiredo
- Department of Metallurgical and Materials Engineering, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba School of Dentistry, Rua José Bonifácio, 1193, 16015-050, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba School of Dentistry, Rua José Bonifácio, 1193, 16015-050, Araçatuba, SP, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba School of Dentistry, Rua José Bonifácio, 1193, 16015-050, Araçatuba, SP, Brazil.
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