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Arias-Moliz MT, Pérez-Carrasco V, Uroz-Torres D, Santana Ramos JD, García-Salcedo JA, Soriano M. Identification of keystone taxa in root canals and periapical lesions of post-treatment endodontic infections: Next generation microbiome research. Int Endod J 2024. [PMID: 38357799 DOI: 10.1111/iej.14046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
AIM The aim of this study was to analyse and compare the microbiome present in root canals and periapical lesions of teeth with post-treatment infections, and to identify the presence of keystone taxa in both habitats using next-generation sequencing analysis. METHODOLOGY Apices and periapical lesions of patients with post-treatment apical periodontitis were surgically extracted. Specimens were cryo-pulverized, bacterial DNA was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using the Illumina Miseq platform. Bioinformatic analysis was carried out with Mothur software, whilst diversity indices were obtained using operational taxonomic units (OTUs). The diversity indices were compared with the Kruskal-Wallis test, and community composition differences were explored with Permutational Multivariate Analysis of Variance (PERMANOVA). A bacterial functional study was performed with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Co-occurrence network analyses were performed using the Sparse Correlations for Compositional data (SparCC). Eigencentrality, clr-based abundance and ubiquitousness were applied to infer keystone taxa. P values <.05 were considered statistically significant. RESULTS Thirty-two apices and thirty-nine periapical lesions were sequenced and analysed. A similar alpha-diversity (p < .05) and community composition (p = .91) was observed for apices and lesion samples. The most abundant OTUs identified amongst all samples included Fusobacterium nucleatum, Prevotella loescheii, Streptococcus intermedius, Porphyromonas gingivalis, Parvimonas micra, Synergistetes bacterium, Tannerella forsythia and Peptostreptococcus stomatis. The metabolic pathways with >0.81% abundances included membrane transport, genetic information processing and metabolic pathways. F. nucleatum was identified as a keystone taxon as it showed ubiquitousness, an eigenvector centrality value of 0.83 and a clr-based abundance >4. CONCLUSIONS The microbiome in apices and periapical lesions of post-treatment endodontic infections showed a similar diversity and taxonomic composition. Co-occurrence network analyses at OTU level identified F. nucleatum as a keystone taxon candidate in these infections.
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Affiliation(s)
- Maria Teresa Arias-Moliz
- Department of Microbiology, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Virginia Pérez-Carrasco
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | | | - Jose Antonio García-Salcedo
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Soriano
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Center for Research in Mediterranean Intensive Agrosystems and Agri-Food Biotechnology (CIAIMBITAL), University of Almeria, Almería, Spain
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Kumari S, Sharma A, Singh A, Nagendra SB, Qurishi AA, Parmar NJ, Mehta DN. Use of Endodontic Procedures in Young Permanent Teeth. J Pharm Bioallied Sci 2024; 16:S797-S799. [PMID: 38595543 PMCID: PMC11000935 DOI: 10.4103/jpbs.jpbs_1018_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background Regenerative endodontic procedures (REPs) have emerged as a promising treatment option for young permanent teeth with pulp necrosis, offering the potential for tissue repair and preservation. Materials and Methods A retrospective analysis was conducted on a cohort of 30 patients aged 8 to 16 years with pulp necrosis in young permanent teeth. The patients underwent REPs, including disinfection, triple antibiotic paste application, and a coronal barrier. Clinical and radiographic data were collected at baseline and follow-up appointments at 6, 12, and 24 months. Radiographs were analyzed for root lengthening, apical closure, and resolution of periapical lesions. Results The mean increase in root length after 24 months was 3.42 mm (SD ± 1.12 mm), and 90% of cases demonstrated complete apical closure. The overall success rate, defined as the absence of clinical symptoms and radiographic evidence of pathology, was 80. Conclusion REPs show promising outcomes in young permanent teeth with pulp necrosis, promoting root development, and apical closure.
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Affiliation(s)
- Sujata Kumari
- Department of Pedodontics and Preventive Dentistry, Central Speciality Hospital, Patna, Bihar, India
| | - Ankita Sharma
- Department of Pedodontics and Preventive Dentistry, PGIDS, Rohtak, Haryana, India
| | - Abhishek Singh
- Department of Conservative Dentistry and Endodontics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Sangala Bhavani Nagendra
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth Bharati Vidyapeeth Deemed University, Maharashtra, India
| | - Ahtesham A. Qurishi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jizan University, Saudi Arabia
| | - Nirav J. Parmar
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Science, Dharsinh Desai University, Nadiad, Gujarat, India
| | - Dhaval Niranjan Mehta
- Professor and Head, Department of Oral Medicine and Radiology, Narsinbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujrat, India
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Muttanahally KS, Sheppard S, Yadav S, Tadinada A. The Utility of Cone Beam Computed Tomography Scans in Diagnosing and Treating Anterior Lesions of the Maxilla and Mandible. Cureus 2024; 16:e52804. [PMID: 38389599 PMCID: PMC10883409 DOI: 10.7759/cureus.52804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The standard screening protocol for radiographic examination in dentistry as per the American Dental Association recommendations is a panoramic radiograph (PAN) and four horizontal bitewings. PAN inherently suffers from several shortcomings like the superimposition of anatomic structures, especially of the cervical spine that obscures a significant portion of the anterior maxilla and mandible. This region has a significant amount of pathology that is not adequately imaged. Three-dimensional (3D) imaging provides circumferential information on the area of interest and adds value to the diagnosis and treatment planning of pathology, especially in the anterior maxilla and mandible. However, there is not an adequate number of well-designed studies that articulate the true value addition of 3D imaging for the evaluation of this region. OBJECTIVES The objective of this study is to evaluate the value addition of 3D imaging in diagnosing pathologies in the anterior maxilla and mandible when compared to two-dimensional PAN. MATERIALS AND METHODS A total of 25 cases that had a diagnosis of anterior pathology and had both a PAN and a cone beam computed tomography (CBCT) scan were collected for this study. An institutional review board approval to retrospectively evaluate these data was obtained. The PAN and CBCT scans were randomly evaluated by a second-year dental student, an oral and maxillofacial radiology resident in training, and a board-certified oral radiologist. The scans were evaluated using a three-point modified Likert scale, where 1 represents "not visible or clear," 2 represents "visible but not clear," and 3 represents "visible and clear." The lesions were evaluated for characteristics like lesion location, size & shape, internal contents, borders of the lesion, cortical integrity, locularity, and effect on adjacent structures like root resorption. After the evaluation was completed, a comparison of the lesion diagnosis was done with histopathology to confirm the diagnosis. The evaluators were also asked to comment on the specific feature that 3D imaging provided that added value to the case. Kappa analysis was done to evaluate inter-operator reliability. RESULTS PAN demonstrated significantly lower efficacy in identifying and diagnosing lesions. Only 56% of cases were analyzed using PAN, with 44% deemed undetectable or poorly visualized. These challenging cases necessitated CBCT scans for accurate diagnosis, which successfully diagnosed all 25 cases. The p-value of 0.0002 for PAN implies a highly significant difference from histopathology, suggesting the distinctions are not due to chance. Conversely, the p-value of 0.3273 for CBCT implies that observed differences may be random, lacking sufficient evidence to reject the null hypothesis. CBCT scans consistently outperformed PAN in visualizing various lesion characteristics, underscoring their superior diagnostic capabilities. CONCLUSIONS In this study, with a small sample size, 3D imaging provided a significant value addition to the diagnosis and treatment planning by providing additional information regarding the location, extent, internal content, and effect on adjacent structures. The practical implications for clinical settings, along with comparisons to current literature, underscore the study's distinctiveness.
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Affiliation(s)
- Kavya Shankar Muttanahally
- Oral and Maxillofacial Radiology, Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Samantha Sheppard
- Department of General Dentistry, University of Connecticut, Farmington, USA
| | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
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Hadzic A, Urschler M, Press JNA, Riedl R, Rugani P, Štern D, Kirnbauer B. Evaluating a Periapical Lesion Detection CNN on a Clinically Representative CBCT Dataset-A Validation Study. J Clin Med 2023; 13:197. [PMID: 38202204 PMCID: PMC10779652 DOI: 10.3390/jcm13010197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this validation study was to comprehensively evaluate the performance and generalization capability of a deep learning-based periapical lesion detection algorithm on a clinically representative cone-beam computed tomography (CBCT) dataset and test for non-inferiority. The evaluation involved 195 CBCT images of adult upper and lower jaws, where sensitivity and specificity metrics were calculated for all teeth, stratified by jaw, and stratified by tooth type. Furthermore, each lesion was assigned a periapical index score based on its size to enable a score-based evaluation. Non-inferiority tests were conducted with proportions of 90% for sensitivity and 82% for specificity. The algorithm achieved an overall sensitivity of 86.7% and a specificity of 84.3%. The non-inferiority test indicated the rejection of the null hypothesis for specificity but not for sensitivity. However, when excluding lesions with a periapical index score of one (i.e., very small lesions), the sensitivity improved to 90.4%. Despite the challenges posed by the dataset, the algorithm demonstrated promising results. Nevertheless, further improvements are needed to enhance the algorithm's robustness, particularly in detecting very small lesions and the handling of artifacts and outliers commonly encountered in real-world clinical scenarios.
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Affiliation(s)
- Arnela Hadzic
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; (A.H.); (R.R.)
| | - Martin Urschler
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; (A.H.); (R.R.)
| | - Jan-Niclas Aaron Press
- Division of Oral Surgery and Orthodontics, Medical University of Graz, 8010 Graz, Austria (P.R.); (B.K.)
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; (A.H.); (R.R.)
| | - Petra Rugani
- Division of Oral Surgery and Orthodontics, Medical University of Graz, 8010 Graz, Austria (P.R.); (B.K.)
| | - Darko Štern
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria
| | - Barbara Kirnbauer
- Division of Oral Surgery and Orthodontics, Medical University of Graz, 8010 Graz, Austria (P.R.); (B.K.)
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Liu X, He G, Qiu Z, Chen F, Wang J, Huang Z, Zhang P, Zhang J, Zhong L, Ding C, Chen X. Diabetes Mellitus Increases the Risk of Apical Periodontitis in Endodontically-Treated Teeth: A Meta-Analysis from 15 Studies. J Endod 2023; 49:1605-1616. [PMID: 37506763 DOI: 10.1016/j.joen.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION At present, the incidence of diabetes mellitus (DM) is gradually increasing globally. In clinical practice, many patients with diabetes with apical periodontitis (AP) have poor and slow healing of periapical lesions. However, the potential relationship between the 2 is still unclear and controversial. The consensus is that DM can be deemed a risk factor for AP in endodontically-treated teeth. Therefore, we pooled existing studies and carried out a meta-analysis to explore the potential association between the 2. METHODS Studies that met the inclusion criteria were selected from the database, and relevant data were extracted. Stata SE 17.0 software was used to analyze the relevant data, and the Newcastle-Ottawa Scale was used to assess the literature's quality. The pooled odds ratio (OR) with a 95% confidence interval (CI) was used to determine the strength of the association between DM and the prevalence of AP after root canal treatment (RCT). RESULTS After searching, 262 relevant studies were retrieved, fifteen of which met the inclusion criteria. A total of 1087 patients with 2226 teeth were included in this meta-analysis. According to the findings, diabetics showed a higher prevalence of AP after RCT than controls at the tooth level (OR = 1.51, 95% CI = 1.22-1.87, P < .01). At the patient level, DM increased the probability of developing AP in RCT teeth more than 3 times (OR = 3.38, 95% CI = 1.65-6.93, P < .01). Additionally, subgroup analysis was performed by blood glucose status, preoperative AP, and study design. Except for the status of blood glucose, the results were significant in the other 2 groups (P < .05). CONCLUSIONS Available scientific evidence suggests that DM may increase the risk of AP in endodontically-treated teeth. In teeth with preoperative AP, DM might promote the development of AP.
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Affiliation(s)
- Xinyue Liu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Guiying He
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhengjie Qiu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Feng Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jiapeng Wang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zheng Huang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Pengtao Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jian Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; College of Materials, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Liangjun Zhong
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Cheng Ding
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
| | - Xing Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
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Herbst SR, Pitchika V, Krois J, Krasowski A, Schwendicke F. Machine Learning to Predict Apical Lesions: A Cross-Sectional and Model Development Study. J Clin Med 2023; 12:5464. [PMID: 37685531 PMCID: PMC10488275 DOI: 10.3390/jcm12175464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: We aimed to identify factors associated with the presence of apical lesions (AL) in panoramic radiographs and to evaluate the predictive value of the identified factors. (2) Methodology: Panoramic radiographs from 1071 patients (age: 11-93 a, mean: 50.6 a ± 19.7 a) with 27,532 teeth were included. Each radiograph was independently assessed by five experienced dentists for AL. A range of shallow machine learning algorithms (logistic regression, k-nearest neighbor, decision tree, random forest, support vector machine, adaptive and gradient boosting) were employed to identify factors at both the patient and tooth level associated with AL and to predict AL. (3) Results: AL were detected in 522 patients (48.7%) and 1133 teeth (4.1%), whereas males showed a significantly higher prevalence than females (52.5%/44.8%; p < 0.05). Logistic regression found that an existing root canal treatment was the most important risk factor (adjusted Odds Ratio 16.89; 95% CI: 13.98-20.41), followed by the tooth type 'molar' (2.54; 2.1-3.08) and the restoration with a crown (2.1; 1.67-2.63). Associations between factors and AL were stronger and accuracy higher when using fewer complex models like decision tree (F1 score: 0.9 (0.89-0.9)). (4) Conclusions: The presence of AL was higher in root-canal treated teeth, those with crowns and molars. More complex machine learning models did not outperform less-complex ones.
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Affiliation(s)
| | | | | | | | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité–Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (S.R.H.); (V.P.); (J.K.); (A.K.)
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Krongbaramee T, Wongpattaraworakul W, Lanzel EA, Hellstein JW, Teixeira FB. Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study. J Endod 2023:S0099-2399(23)00467-3. [PMID: 37543187 DOI: 10.1016/j.joen.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION Radiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be low, they often mimic periapical pathoses, and consequently, histopathologic examinations after surgical revisions are nurtured. METHODS Biopsies submitted to the College of Dentistry between 2003 and 2021 were reviewed. Clinicopathologic characteristics were collected, including age, sex, medical history, location, sensibility tests, and clinic impressions from each specimen. Histopathologic diagnosis and gross description were also part of our database. RESULTS A total of 72,055 pathology reports were reviewed, of which 10,031 lesions (13.9%) met the criterion of being intraosseous lesions at the periradicular area. Among those 10,031 lesions, 7.94% (n = 796) were of non-endodontic origin, 7153 were documented as non-vital, and 2.36% (n = 169) of these non-vital teeth were diagnosed with a non-endodontic origin. A total of 5707 lesions were obtained from surgeries within the periapical tissues, primarily performed by endodontists (94.02%). Non-endodontic lesions were reported in 1.09% of the cases. Odontogenic keratocyst was the most common non-endodontic diagnosis, followed by nasopalatine duct cyst and benign fibro-osseous lesion, respectively. CONCLUSIONS Pathologic findings of the periradicular tissues are not always from endodontic origin. The probability of encountering non-endodontic lesions is almost 8%. Even in clinically reported teeth with pulp necrosis, 1%-3% of biopsies were confirmed as non-endodontic lesions.
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Affiliation(s)
- Tadkamol Krongbaramee
- Division of Endodontics, Department of Restorative Dentistry & Periodontology, Chiang Mai University, Chiang Mai, Thailand; Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Wattawan Wongpattaraworakul
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Emily A Lanzel
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - John W Hellstein
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Fabricio B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa.
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Liu Q, Li S, Tang T, Wu Y. The roles of stress-induced premature senescence and Akt/FoxO1 signaling in periapical lesions. Oral Dis 2023. [PMID: 37530471 DOI: 10.1111/odi.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/28/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES There is little knowledge about oxidative stress-induced senescence involvement in apical periodontitis. Here, we explored its molecular mechanism in periapical lesions. METHODS Ten cases of radicular cysts and five cases of periapical granulomas were randomly selected. Immunohistochemical analysis was performed to detect the expression and correlation between Senescence-associated factor polymerase I and transcript release factor (PTRF) and Akt/FoxO1 signaling. Human periodontal ligament cells (hPDLCs) pretreated with LY294002 were exposed to H2 O2 -induced oxidative stress conditions and then cell proliferation, senescence, apoptosis, and associated signaling were evaluated by EdU labeling, β-galactosidase assay, RT-qPCR, and western blot analysis, respectively. RESULTS Polymerase I and transcript release factor and Akt/FoxO1 signaling were more frequently expressed in the radicular cyst than in periapical granulomas. Notably, cells in radicular cysts showed Akt activation, FoxO1 phosphorylation, and cytoplasmic translocation. In vitro, prominent H2 O2 -induced senescence was observed in hPDLCs. LY294002, a PI3K inhibitor, attenuated the expression levels of senescence (Klotho, P16INK4), apoptosis (Bad, Fas), phosphorylated Akt, and phosphorylated FoxO1; however, did not affect cell proliferation. CONCLUSIONS Our data indicated that senescence is present in clinical periapical lesions, and Akt/FoxO1 signaling is involved in the H2 O2 -induced cellular senescence, which could serve as a potential therapeutic target.
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Affiliation(s)
- Qian Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Shue Li
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Ting Tang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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Marques-Ferreira M, Abrantes AM, Paula A, Laranjo M, Pires AS, Caramelo F, Segura-Egea JJ, Brito A, Carvalho L, Botelho MF, Carrilho E, Marto CM, Paulo S. The Role of Apical Periodontitis Disease in the Development of Bisphosphonate-Related Osteonecrosis of the Jaw: An Animal Study. Dent J (Basel) 2023; 11:168. [PMID: 37504234 PMCID: PMC10377877 DOI: 10.3390/dj11070168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Microorganisms and their by-products are responsible for establishing pulpal and periapical diseases. Healing is compromised in patients under bisphosphonate therapy, and the presence of periapical infections can potentially lead to the development of medication-related osteonecrosis of the jaw (MRONJ). This work aimed to evaluate if bisphosphonate therapy is a risk factor for MRONJ development in the presence of periapical lesions. METHODS Two groups of 10 female Wistar rats were used. The experimental group received zoledronate (0.1 mg/kg) intraperitoneally, and the control received a saline solution, three times a week for three weeks. One week after the last injection, apical periodontitis was induced through pulpal exposure in the mandibular first molars. Twenty-one days later, the animals were intravenously injected with 99mTc-HMDP, and the radioactivity uptake by mandibular specimens was counted. In addition, sample radiographs and a histological examination were performed. RESULTS The bone loss was higher in the control group when compared to the experimental group (p = 0.027). 99mTc-HMDP uptake in the control was reduced compared with the experimental group, although without statistical significance. CONCLUSIONS In the presence of zoledronate therapy, apical periodontitis does not increase the risk of MRONJ development, and periapical lesions have lower bone resorption when compared to the control group.
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Affiliation(s)
- Manuel Marques-Ferreira
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Institute of Endodontics, Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Ana Margarida Abrantes
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Biophysics, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Anabela Paula
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Mafalda Laranjo
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Biophysics, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Ana Salomé Pires
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Biophysics, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Francisco Caramelo
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Juan José Segura-Egea
- Department of Stomatology (Endodontics Section), University of Sevilla, 41009 Sevilla, Spain
| | - Ana Brito
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Lina Carvalho
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. of Coimbra, IAP, Faculty of Medicine, 3004-504 Coimbra, Portugal
| | - Maria Filomena Botelho
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Biophysics, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Eunice Carrilho
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Univ. Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Carlos Miguel Marto
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Univ. Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. of Coimbra, Institute of Experimental Pathology, Faculty of Medicine, 3000-548 Coimbra, Portugal
| | - Siri Paulo
- Univ. Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, 3000-548 Coimbra, Portugal
- Univ. Coimbra, Institute of Endodontics, Faculty of Medicine, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
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10
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Ishii K, Tamura T, Hatori K, Himi K, Nakamura T, Toyama Y, Miyata T, Takeichi O. Elevated Foxo3a and Fas-ligand expression in human periapical granulomas as a potential treatment target. Oral Dis 2023; 29:1128-1136. [PMID: 34674361 DOI: 10.1111/odi.14052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/12/2021] [Accepted: 10/12/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Periapical granuloma is a common periodontitis type involving chronic inflammation; however, the efficacy of current therapies is limited. Its molecular pathogenesis also remains obscure. Forkhead box transcription factor class o3a (Foxo3a) and Fas-ligand (FasL) are associated with chronic inflammation. Therefore, in this study, we aimed to clarify the roles of Foxo3a and FasL in periapical granuloma pathophysiology. SUBJECTS AND METHODS Periapical lesions were obtained from patients during endodontic surgery and tooth extraction; those diagnosed with periapical granulomas using haematoxylin and eosin staining were further analysed. Immunohistochemical analysis was performed for Foxo3a and FasL, and real-time polymerase chain reaction was performed for FOXO3A, FASL and interleukin (IL)-1β. Healthy gingival tissues were also examined as controls. RESULTS Neutrophils, lymphocytes and plasma cells in the periapical granulomas, but not healthy tissues, expressed Foxo3a. Dual-colour immunofluorescence imaging revealed Foxo3a and FasL co-expression in leukocytes. FOXO3A, FASL and IL-1β mRNA levels in healthy gingival tissues were significantly lower than those in the periapical granulomas. Additionally, FOXO3A and IL-1β expressions were negatively correlated. CONCLUSIONS Phosphorylated Foxo3a may reduce IL-1β release by inhibiting apoptosis through FasL in periapical periodontitis and prevent exacerbation. Thus, Foxo3a is a potential therapeutic agent for periapical periodontitis.
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Affiliation(s)
- Kae Ishii
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Takahito Tamura
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Nihon University Graduate School of Dentistry, Dental Research Center, Tokyo, Japan
| | - Keisuke Hatori
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Division of Advanced Dental Treatment, Dental Research Center, Tokyo, Japan
| | - Kazuma Himi
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Takeshi Nakamura
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Nihon University Graduate School of Dentistry, Dental Research Center, Tokyo, Japan
| | - Yurika Toyama
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Nihon University Graduate School of Dentistry, Dental Research Center, Tokyo, Japan
| | - Taiki Miyata
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Nihon University Graduate School of Dentistry, Dental Research Center, Tokyo, Japan
| | - Osamu Takeichi
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan
- Division of Advanced Dental Treatment, Dental Research Center, Tokyo, Japan
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11
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Pérez-Carrasco V, Uroz-Torres D, Soriano M, Solana C, Ruiz-Linares M, Garcia-Salcedo JA, Arias-Moliz MT. Microbiome in paired root apices and periapical lesions and its association with clinical signs in persistent apical periodontitis using next-generation sequencing. Int Endod J 2023; 56:622-636. [PMID: 36689323 DOI: 10.1111/iej.13893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
AIM To assess and compare the microbiome of paired root apices and periapical lesions from cases with failed endodontic treatment and to associate the microbiome and bacterial metabolic pathways in both sites with asymptomatic apical periodontitis (AAP) and symptomatic apical periodontitis (SAP), using next-generation sequencing (NGS). METHODOLOGY Matched root apices and periapical lesions of patients with failed root canal treatments were surgically extracted. Specimens were cryopulverized, bacterial DNA was extracted and the V3-V4 hypervariable regions of the 16 S rRNA gene were amplified and sequenced using the Illumina Miseq platform. Diversity and community composition were studied in the paired samples, as well as in AAP and SAP cases. Diversity indices were compared in each case by means of the Wilcoxon matched-pairs signed rank and Mann-Whitney U tests. Differences in the community composition were explored with multivariate statistical analysis and Linear discriminant analysis Effect Size (LEfSe). Bacterial functional study was performed through the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. RESULTS Twenty-one paired apices and lesions were successfully sequenced and analysed, identifying a total of 21 phyla and 600 genera. A higher alpha-diversity was observed in the periapical lesions, although no global differences in the community composition between the two sites were found (p = .87), the most prevalent genera being Fusobacterium, Porphyromonas and Streptococcus. Prevotella, Clostridiales_vadinBB60_group, Bosea, Phreatobacter, Afipia and Xanthobacteriaceae_unclassified were enriched in SAP samples, while Pseudopropionibacterium, Campylobacter and Peptoniphilus were significantly more abundant in AAP cases (p < .05). Metabolic pathways involved in the amino acid metabolism or degradation and flagellum assembly were more abundant in SAP samples, whereas glucose metabolism-related pathways were associated with AAP. CONCLUSIONS The bacterial community composition was similar in the apices and periapical lesions. The microbiome was different in AAP and SAP samples, gram-negative bacteria showing higher relative abundances in SAP cases. An association was observed between amino acid degradation and flagellum assembly pathways, and the development of tenderness to percussion or palpation.
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Affiliation(s)
- Virginia Pérez-Carrasco
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Microbiology Unit, University Hospital Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - David Uroz-Torres
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Private Practice, Granada, Spain
| | - Miguel Soriano
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Center for Research in Mediterranean Intensive Agrosystems and Agri-Food Biotechnology (CIAIMBITAL), University of Almeria, Almería, Spain
| | - Carmen Solana
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Private Practice, Granada, Spain
| | - Matilde Ruiz-Linares
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Stomatology, University of Granada, Granada, Spain
| | - Jose Antonio Garcia-Salcedo
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Microbiology Unit, University Hospital Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Maria Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Microbiology, University of Granada, Granada, Spain
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12
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Hajihassani N, Ramezani M, Tofangchiha M, Bayereh F, Ranjbaran M, Zanza A, Reda R, Testarelli L. Pattern of Endodontic Lesions of Maxillary and Mandibular Posterior Teeth: A Cone-Beam Computed Tomography Study. J Imaging 2022; 8. [PMID: 36286384 DOI: 10.3390/jimaging8100290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
The pattern of expansion of endodontic lesions in the jaws has been less commonly addressed in the literature. For this reason, the aim of this study is to assess the pattern of endodontic lesions of maxillary and mandibular posterior teeth using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 317 endodontic lesions of posterior teeth on CBCT scans retrieved from a radiology center in Qazvin, Iran, from 2020 to 2022. Endodontic lesions were assessed on sagittal, coronal, and axial sections by an endodontist and dental student using the Romexis software. The largest lesion diameter was measured occluso-apically, mesiodistally, and buccolingually. Lesion size was analyzed based on age, gender, jaw, tooth type, and presence/absence of root filling by independent samples t-tests and a one-way Analysis Of Variannce (ANOVA). The largest diameter of lesions in the maxilla and mandible was recorded in the occluso-apical dimension followed by buccolingual and mesiodistal dimensions (p > 0.05). The pattern of lesions was the same in teeth with and without endodontic treatment, but it was significantly different in maxillary and mandibular endodontically treated teeth in the occluso-apical and buccolingual dimensions (p < 0.05). No significant correlation was noted with tooth type or jaw except for maxillary and mandibular first molar lesions, which were significantly different in the occluso-apical dimension (p < 0.05). Lesion size in all three dimensions was significantly greater in males than females (p < 0.05), and was the highest in the occluso-apical dimension in both genders. In the maxilla, the mean lesion size significantly decreased in the mesiodistal dimension with age (p < 0.05). In conclusion, the largest lesion diameter in the maxilla and mandible was found in the occluso-apical dimension, indicating the role of bone density in the pattern of lesions.
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13
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Yu B, Wang R, Luo H, Yang D, Wang S, Yu Y, Okamura H, Qiu L. Histone Demethylase Jmjd3 Regulates the Osteogenic Differentiation and Cytokine Expressions of Periodontal Ligament Cells. Acta Med Okayama 2022; 76:281-290. [PMID: 35790358 DOI: 10.18926/amo/63722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Periodontal ligament (PDL) cells are critical for the bone remodeling process in periapical lesions since they can differentiate into osteoblasts and secrete osteoclastogenesis-promoting cytokines. Post-translational histone modifications including alterations of the methylation status of H3K27 are involved in cell differentiation and inflammatory reaction. The histone demethylase Jumonji domain-containing 3 (Jmjd3) specifically removes methylation of H3K27. We investigated whether Jmjd3 is involved in the osteogenic differentiation and secretion of PDL cells' inflammatory factors. Jmjd3 expression in periapical lesions was examined by immunostaining. Using siRNA specific for Jmjd3 or the specific Jmjd3 inhibitor GSK-J4, we determined Jmjd3's roles in osteogenic differentiation and cytokine production by real-time RT-PCR. The locations of Jmjd3 and NF-κB were analyzed by immunocytochemistry. Compared to healthy PDLs, the periapical lesion samples showed higher Jmjd3 expression. Treatment with GSK-J4 or Jmjd3 siRNA suppressed PDL cells' osteogenic differentiation by suppressing the expressions of bone-related genes (Runx2, Osterix, and osteocalcin) and mineralization. Jmjd3 knockdown decreased the expressions of cytokines (TNF-α, IL-1β, and IL-6) induced by lipopolysaccharide extracted from Porphyromonas endodontalis (Pe-LPS). Pe-LPS induced the nuclear translocations of Jmjd3 and NF-κB; the latter was inhibited by GSK-J4 treatment. Jmjd3 appears to regulate PDL cells' osteogenic differentiation and proinflammatory cytokine expressions.
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Affiliation(s)
- Bo Yu
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Rui Wang
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Huikun Luo
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Di Yang
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Simo Wang
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Yaqiong Yu
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Hirohiko Okamura
- Department of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Lihong Qiu
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Peña-Oyarzún D, San Martin C, Hernández-Cáceres MP, Lavandero S, Morselli E, Budini M, Burgos PV, Criollo A. Autophagy in aging-related oral diseases. Front Endocrinol (Lausanne) 2022; 13:903836. [PMID: 35992149 PMCID: PMC9390882 DOI: 10.3389/fendo.2022.903836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Autophagy is an intracellular degradation mechanism that allows recycling of organelles and macromolecules. Autophagic function increases metabolite availability modulating metabolic pathways, differentiation and cell survival. The oral environment is composed of several structures, including mineralized and soft tissues, which are formed by complex interactions between epithelial and mesenchymal cells. With aging, increased prevalence of oral diseases such as periodontitis, oral cancer and periapical lesions are observed in humans. These aging-related oral diseases are chronic conditions that alter the epithelial-mesenchymal homeostasis, disrupting the oral tissue architecture affecting the quality of life of the patients. Given that autophagy levels are reduced with age, the purpose of this review is to discuss the link between autophagy and age-related oral diseases.
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Affiliation(s)
- Daniel Peña-Oyarzún
- Physiology Department, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
- Interdisciplinary Center for Research in Territorial Health of the Aconcagua Valley (CIISTe Aconcagua), School of Medicine, Faculty of Medicine, San Felipe Campus, Universidad de Valparaíso, San Felipe, Chile
- Instituto de Investigación en Ciencias Odontológicas (ICOD), Facultad de Odontología, Universidad de Chile, Santiago, Chile
| | - Carla San Martin
- Interdisciplinary Center for Research in Territorial Health of the Aconcagua Valley (CIISTe Aconcagua), School of Medicine, Faculty of Medicine, San Felipe Campus, Universidad de Valparaíso, San Felipe, Chile
| | - María Paz Hernández-Cáceres
- Instituto de Investigación en Ciencias Odontológicas (ICOD), Facultad de Odontología, Universidad de Chile, Santiago, Chile
| | - Sergio Lavandero
- Advanced Center for Chronic Diseases (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas & Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
- Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Eugenia Morselli
- Department of Basic Sciences, Faculty of Medicine and Sciences, Universidad San Sebastián, Santiago de Chile, Chile
- Autophagy Research Center, Universidad de Chile, Santiago de Chile, Chile
| | - Mauricio Budini
- Instituto de Investigación en Ciencias Odontológicas (ICOD), Facultad de Odontología, Universidad de Chile, Santiago, Chile
- Autophagy Research Center, Universidad de Chile, Santiago de Chile, Chile
| | - Patricia V. Burgos
- Autophagy Research Center, Universidad de Chile, Santiago de Chile, Chile
- Centro de Biología Celular y Biomedicina (CEBICEM), Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE-UC), Facultad de Ciencias Biológicas, Pontificia Universidad Católica, Santiago, Chile
- Centro Ciencia & Vida, Fundación Ciencia & Vida, Santiago, Chile
| | - Alfredo Criollo
- Instituto de Investigación en Ciencias Odontológicas (ICOD), Facultad de Odontología, Universidad de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas & Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Autophagy Research Center, Universidad de Chile, Santiago de Chile, Chile
- *Correspondence: Alfredo Criollo,
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16
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Pociask E, Nurzynska K, Obuchowicz R, Bałon P, Uryga D, Strzelecki M, Izworski A, Piórkowski A. Differential Diagnosis of Cysts and Granulomas Supported by Texture Analysis of Intraoral Radiographs. Sensors (Basel) 2021; 21:s21227481. [PMID: 34833558 PMCID: PMC8618739 DOI: 10.3390/s21227481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 01/11/2023]
Abstract
The aim of this study was to evaluate whether textural analysis could differentiate between the two common types of lytic lesions imaged with use of radiography. Sixty-two patients were enrolled in the study with intraoral radiograph images and a histological reference study. Full textural analysis was performed using MaZda software. For over 10,000 features, logistic regression models were applied. Fragments containing lesion edges were characterized by significant correlation of structural information. Although the input images were stored using lossy compression and their scale was not preserved, the obtained results confirmed the possibility of distinguishing between cysts and granulomas with use of textural analysis of intraoral radiographs. It was shown that the important information distinguishing the aforementioned types of lesions is located at the edges and not within the lesion.
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Affiliation(s)
- Elżbieta Pociask
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland; (P.B.); (A.I.)
- Correspondence: (E.P.); (A.P.)
| | - Karolina Nurzynska
- Department of Algorithmics and Software, Silesian University of Technology, 44-100 Gliwice, Poland;
| | - Rafał Obuchowicz
- Department of Diagnostic Imaging, Medical College, Jagiellonian University, 31-501 Krakow, Poland;
| | - Paulina Bałon
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland; (P.B.); (A.I.)
| | - Daniel Uryga
- Department of Oral Surgery, Medical College, Jagiellonian University, 31-155 Krakow, Poland;
| | - Michał Strzelecki
- Institute of Electronics, Lodz University of Technology, 93-590 Lodz, Poland;
| | - Andrzej Izworski
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland; (P.B.); (A.I.)
| | - Adam Piórkowski
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland; (P.B.); (A.I.)
- Correspondence: (E.P.); (A.P.)
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17
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Aloutaibi YA, Alkarim AS, Qumri EM, Almansour LA, Alghamdi FT. Chronic Endodontic Infections and Cardiovascular Diseases: Does the Evidence Support an Independent Association? Cureus 2021; 13:e19864. [PMID: 34976491 PMCID: PMC8712192 DOI: 10.7759/cureus.19864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 01/08/2023] Open
Abstract
Previous studies have shown that endodontic infections might increase the risk of cardiovascular diseases. However, there is no conclusive evidence that endodontic infections are associated with cardiovascular diseases among individuals with cardiac conditions. This systematic review aimed to collect and evaluate the current evidence on the relationship between chronic endodontic infections and cardiovascular diseases. The PubMed, Scopus, and Web of Science databases were searched, and Google Scholar was used to retrieve relevant clinical studies within the past 10 years (2011-2021). Observational studies (prospective cohort, retrospective cohort, cross-sectional, and case-control studies), which investigated the impact of endodontic infections and apical periodontitis in individuals with cardiac conditions at risk of cardiovascular disease, in English were considered. Review papers, duplicates, animal studies, and other irrelevant studies were excluded. Four investigators independently carried out the study selection and data collection processes. Quality assessment was performed in this review. Fourteen studies with 960,652 human subjects were included in this review. No association between endodontic infections and cardiovascular diseases among individuals with cardiac conditions was noted. Most of the studies showed a moderate overall risk of bias by 57.14% (n=8). There is weak evidence regarding the association between cardiovascular diseases and chronic endodontic infections. Further longitudinal clinical studies are required to determine the association between cardiovascular diseases and endodontic infections.
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Affiliation(s)
- Yaser A Aloutaibi
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Abdulaziz S Alkarim
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Esraa M Qumri
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Lolo A Almansour
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Faisal T Alghamdi
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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18
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Wang L, Yang F, Qiu Y, Ye L, Song D, Huang D. The Potential Roles of T Cells in Periapical Lesions. J Endod 2021; 48:70-79. [PMID: 34627784 DOI: 10.1016/j.joen.2021.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Periapical lesions are inflammatory diseases mainly caused by microbial infection from the root canal system, affecting the integrity of alveolar bone, periapical cementum, and periodontal ligament. The invasion of pathogenic microorganisms activates local inflammation and host immune response, especially the recruitment and differentiation of T cells. Many studies have discussed the fundamental roles of T cell-related immunological regulation and the possible clinical significance of cytokine disorders in periapical lesions. However, oral pathogen-mediated T cell immune response is far more clarified. Therefore, the aim of this study was to discuss the research status of T cell-related immunology involved in the progression of periapical lesions and potential future directions. METHODS We conducted a literature review focusing on T cell-related immunology in periapical lesions by searching PubMed, Web of Science, Scopus and ScienceDirect online databases. RESULTS In total 108 articles were involved in this narrative review. During the development of periapical lesions, the infiltrated number of different types of T cells and the secretion of T cell-related cytokines in root apex region reflected the inflammatory status of periapical lesions. In addition, it was also highly correlated with the periapical bone destruction. Future study could attempt to provide a wider and deeper study on the expression profile and regulatory function of T cells in the development of periapical lesions. CONCLUSION This review would help us understand the essence of the T cell-related pathology of periapical lesions and raise the potential therapeutic targets for the treatment of apical periodontitis.
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Affiliation(s)
- Liu Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Qiu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Altaie AM, Venkatachalam T, Samaranayake LP, Soliman SSM, Hamoudi R. Comparative Metabolomics Reveals the Microenvironment of Common T-Helper Cells and Differential Immune Cells Linked to Unique Periapical Lesions. Front Immunol 2021; 12:707267. [PMID: 34539639 PMCID: PMC8446658 DOI: 10.3389/fimmu.2021.707267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Periapical abscesses, radicular cysts, and periapical granulomas are the most frequently identified pathological lesions in the alveolar bone. While little is known about the initiation and progression of these conditions, the metabolic environment and the related immunological behaviors were examined for the first time to model the development of each pathological condition. Metabolites were extracted from each lesion and profiled using gas chromatography-mass spectrometry in comparison with healthy pulp tissue. The metabolites were clustered and linked to their related immune cell fractions. Clusters I and J in the periapical abscess upregulated the expression of MMP-9, IL-8, CYP4F3, and VEGF, while clusters L and M were related to lipophagy and apoptosis in radicular cyst, and cluster P in periapical granuloma, which contains L-(+)-lactic acid and ethylene glycol, was related to granuloma formation. Oleic acid, 17-octadecynoic acid, 1-nonadecene, and L-(+)-lactic acid were significantly the highest unique metabolites in healthy pulp tissue, periapical abscess, radicular cyst, and periapical granuloma, respectively. The correlated enriched metabolic pathways were identified, and the related active genes were predicted. Glutamatergic synapse (16–20),-hydroxyeicosatetraenoic acids, lipophagy, and retinoid X receptor coupled with vitamin D receptor were the most significantly enriched pathways in healthy control, abscess, cyst, and granuloma, respectively. Compared with the healthy control, significant upregulation in the gene expression of CYP4F3, VEGF, IL-8, TLR2 (P < 0.0001), and MMP-9 (P < 0.001) was found in the abscesses. While IL-12A was significantly upregulated in cysts (P < 0.01), IL-17A represents the highest significantly upregulated gene in granulomas (P < 0.0001). From the predicted active genes, CIBERSORT suggested the presence of natural killer cells, dendritic cells, pro-inflammatory M1 macrophages, and anti-inflammatory M2 macrophages in different proportions. In addition, the single nucleotide polymorphisms related to IL-10, IL-12A, and IL-17D genes were shown to be associated with periapical lesions and other oral lesions. Collectively, the unique metabolism and related immune response shape up an environment that initiates and maintains the existence and progression of these oral lesions, suggesting an important role in diagnosis and effective targeted therapy.
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Affiliation(s)
- Alaa Muayad Altaie
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Thenmozhi Venkatachalam
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Lakshman P Samaranayake
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Department of Oral Biosciences, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Sameh S M Soliman
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Rifat Hamoudi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Division of Surgery and Interventional Science, University College London, London, United Kingdom
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20
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Song Y, Wang L, Li J, Yang F, Gao Y, Song D, Sun J, Ye L, Zhang L, Huang D. The Expression of Semaphorin 7A in Human Periapical Lesions. J Endod 2021; 47:1631-1639. [PMID: 34126161 DOI: 10.1016/j.joen.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Semaphorin 7A (SEMA7A) is a membrane-bound or secretory protein exerting multiple functions in the regulation of inflammation, neural degradation, and cancer progression. Human periapical lesions are chronic and infectious diseases mainly caused by bacteria. However, the involvement of SEMA7A in human periapical lesions is still unclear. This study aimed to explore the expression of SEMA7A in human periapical lesions accompanied by the potential association of SEMA7A with matrix metalloproteinase (MMP)-1 and MMP-3 during the progression of apical periodontitis. METHODS Samples of periapical lesions and healthy controls were collected. Total RNA and protein were extracted respectively for quantitative real-time polymerase chain reaction and Western blot analysis. Additionally, 6 healthy samples and 27 periapical lesion samples were fixed, dehydrated, and embedded for further histologic and immunochemical analysis. The expression of SEMA7A was quantified by average integrated optical density. Immunofluorescence analysis was conducted to explore the colocalization of SEMA7A/MMP-1 and SEMA7A/MMP-3. RESULTS Compared with healthy controls, the messenger RNA and protein expression of SEMA7A was markedly up-regulated in periapical lesions. A stronger expression of MMP-1, MMP-3, and inflammatory cytokines was exhibited in periapical lesions than in healthy groups. An increasing expression of SEMA7A can be observed in both the periapical granuloma group and the radicular cyst group compared with the normal group (P < .01). Immunofluorescence results showed the colocalization of SEMA7A with both MMP-1 and MMP-3 in vascular vessels and extracellular matrix. CONCLUSIONS SEMA7A was up-regulated in periapical periodontitis and might be involved in the tissue destruction and infiltration of immune cells in periapical lesions.
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Affiliation(s)
- Yao Song
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiatong Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuxuan Gao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jianxun Sun
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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21
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Wang HW, Kok SH, Yang CN, Hong CY, Chi CW, Chen MH, Cheng SJ, Shun CT, Yang H, Lin SK. Blockade of fatty acid signalling inhibits lipopolysaccharide-induced macrophage recruitment and progression of apical periodontitis. Int Endod J 2021; 54:902-915. [PMID: 33369764 DOI: 10.1111/iej.13468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 01/11/2023]
Abstract
AIM To examine the role of palmitic acid in lipopolysaccharide (LPS)-stimulated chemotaxis of macrophages and the potential contribution of saturated fatty acid in signalling during the pathogenesis of apical periodontitis. METHODOLOGY J774, a mouse macrophage cell line, was used in the experiments. After treatment with LPS, proteolytic maturation of sterol regulatory element-binding protein-1c (SREBP-1c) and expression of fatty acid synthase (FASN) were examined by Western analysis. Levels of palmitic acid were measured by reverse phase-high performance liquid chromatography-mass spectrometry. Knockdown of SREBP-1c and FASN was accomplished by small interfering RNA technology. Secretion of CC-chemokine ligand 2 (CCL2) and cellular chemotaxis were assessed by enzyme-linked immunosorbent assay and transwell migration assay, respectively. Sulfo-N-succinimidyl oleate (SSO) treatment was used to inhibit fatty acid signalling in vitro and also in a rat model of apical periodontitis. All data were first subjected to Levene's test. In vitro data were then analysed using ANOVA followed by Tukey's multiple comparison test. Data from animal experiments were analysed by independent t-tests. The significant level was set at 0.05. RESULTS LPS stimulated proteolytic maturation of SREBP-1c and FASN expression in macrophages and significantly enhanced palmitic acid synthesis (P < 0.05). Knockdown of SREBP-1c attenuated LPS-enhanced FASN expression. Knockdown of FASN significantly suppressed LPS-enhanced palmitic acid synthesis (P < 0.05). LPS and exogenous palmitic acid significantly enhanced CCL2 secretion and macrophage chemotaxis (all P < 0.05). Inhibition of FASN expression significantly alleviated LPS-augmented CCL2 secretion (P < 0.05). SSO significantly suppressed CCL2 secretion and macrophage chemotaxis augmented by LPS and palmitic acid (all P < 0.05). In a rat model of induced apical periodontitis, SSO treatment significantly attenuated progression of apical periodontitis and macrophage recruitment (all P < 0.05). CONCLUSIONS LPS/SREBP-1c/FASN/palmitic acid signalling contributed to tissue destruction caused by bacterial infection. Modulation of lipid metabolism and signalling may be helpful for the management of apical periodontitis.
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Affiliation(s)
- H-W Wang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - S-H Kok
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - C-N Yang
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - C-Y Hong
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan
| | - C-W Chi
- Department of Dentistry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - M-H Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - S-J Cheng
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - C-T Shun
- Department of Forensic Medicine and Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - H Yang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - S-K Lin
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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22
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Bronzato JD, Davidian MES, de Castro M, de-Jesus-Soares A, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BPFA. Bacteria and virulence factors in periapical lesions associated with teeth following primary and secondary root canal treatment. Int Endod J 2020; 54:660-671. [PMID: 33270246 DOI: 10.1111/iej.13457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022]
Abstract
AIM This cross-sectional study aimed to investigate the microbial profile and to quantify the levels of endotoxins (LPS) and lipoteichoic acid (LTA) present in periapical lesions associated with root filled teeth and those that had received root canal retreatment. It also aimed to investigate the association between microorganisms and their virulence factors with clinical and radiographic features. METHODOLOGY Patients with periapical lesions in teeth with post-treatment endodontic disease following primary root canal treatment (n = 19) and unsuccessful root canal retreatment (n = 13) were treatment planned for endodontic microsurgery, where the periapical lesions were collected. Clinical and radiographic data were also collected. For microbiological analysis, nested polymerase chain reaction was used to detect 17 bacterial species. Levels of LPS and LTA were determined using limulus amebocyte lysate and enzyme-linked immunosorbent assays, respectively. The Student t-test or Wilcoxon-Mann-Whitney tests were applied to compare the data on LPS and LTA with clinical and radiographic features. The associations between the clinical and radiographic features and the bacterial species were analysed using the Fisher's exact test. A significance level of 5% was adopted. RESULTS Bacterial DNA, LPS and LTA were detected in all samples. Parvimonas micra was the most commonly detected species in all groups, followed by Enterococcus faecalis, Fusobacterium nucleatum and Porphyromonas endodontalis. The type of endodontic treatment, whether a primary root canal treatment or retreatment, was not associated with the presence of any bacterial species in periapical lesions. The levels of LPS and LTA in periapical lesions of root filled teeth were not significantly different from those that had been retreated. Associations between the levels of LPS and LTA with clinical signs and symptoms were found. No association was found between specific bacteria and clinical features. CONCLUSION Periapical lesions associated with teeth after primary root canal treatment and retreatment had similar polymicrobial composition. The levels of LPS and LTA in periapical lesions associated with teeth after primary root canal treatment and retreatment were similar, and both were associated with the same symptomatology.
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Affiliation(s)
- J D Bronzato
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M E S Davidian
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M de Castro
- Department of Applied Mathematics and Statistics, Institute of Mathematics and Computing Sciences, University of São Paulo, São Carlos, Brazil
| | - A de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - C C R Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - J F A Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M A Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - B P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
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23
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Zhang MM, Fang GF, Chen XT, Liang YH. Four-year Outcome of Nonsurgical Root Canal Retreatment Using Cone-beam Computed Tomography: A Prospective Cohort Study. J Endod 2020; 47:382-390. [PMID: 33130061 DOI: 10.1016/j.joen.2020.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The purpose of this prospective study was to investigate the 4-year outcome and prognostic factors of nonsurgical root canal retreatment determined by measuring the volumetric change of periapical radiolucencies on cone-beam computed tomographic (CBCT) scans. METHODS Ninety-seven endodontically treated teeth from 80 patients diagnosed as apical periodontitis and indicated for root canal retreatment were included. Retreatment was performed by 7 endodontic specialists using a standardized treatment protocol. The teeth were reexamined clinically and radiographically 48-67 months after retreatment. The volume of preoperative and postoperative periapical radiolucencies on CBCT images was independently measured by 2 examiners. Radiographic outcome is presented in 4 categories: absence, reduction, enlargement, or unchanged. Reduction or enlargement was determined when the volumetric change of radiolucency was 20% or more. Multivariate logistic regression was performed for predictor analysis. RESULTS Sixty-two teeth (63.9%) from 50 patients returned for follow-up. Fifty-eight teeth were included in the prognostic analysis, all of which were symptom free. The 4 remaining teeth that had been extracted because of fracture were excluded. The total volume of periapical radiolucencies at 4 years postoperatively decreased by 94.6% compared with that preoperatively (P < .001), with an average reduction of 83.4% (95% confidence interval, 69.2%-97.5%). The periapical radiolucencies were determined as absence in 44 teeth (75.9%), reduction in 10 teeth (17.2%), unchanged in 1 tooth (1.7%), and enlargement in 3 teeth (5.2%). Tooth type was identified as an outcome predictor (P < .05). CONCLUSIONS The 4-year outcome of endodontic retreatment is predictable, with a significant volumetric reduction in periapical radiolucencies.
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Affiliation(s)
- Ming-Ming Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Gao-Feng Fang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiao-Tong Chen
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China; Department of Stomatology, Peking University International Hospital, Beijing, China.
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24
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Sghaireen MG. Thickening of Schneiderian membrane secondary to periapical lesions: A retrospective radiographic analysis. J Int Soc Prev Community Dent 2020; 10:316-322. [PMID: 32802778 PMCID: PMC7402264 DOI: 10.4103/jispcd.jispcd_101_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 12/18/2022] Open
Abstract
Aim: The aim of this study was to investigate the possible correlation between adjacent periapical lesions of maxillary teeth and Schneiderian membrane thickness (SMT). Materials and Methods: An analytical study of case-control study design was conducted. From the archives, cone beam computed tomography (CBCT) images of 83 patients with periapical lesion in any of the maxillary posterior teeth were randomly selected as the case group. The normal, contralateral teeth in the same patient were considered in the control group. Eighty-eight teeth were considered in each group, comprising a total sample of 176. For each sample in case group, the distance from the border of the periapical lesion to the cortical bone of the bony floor of the maxillary sinus and SMT were measured. SMT on the contralateral side adjacent to the healthy (control) teeth was also measured. Data were presented in mean ± standard deviation and inferential statistics was performed using independent t test and analysis of variance (ANOVA). Later Pearson correlation and multiple linear logistic regression were carried out using Statistical Package for the Social Sciences software program, version 21.0 at 95% confidence interval. Results: Teeth with periapical lesion were found to have significantly (P < 0.001) increased SMT when compared with that of adjacent to healthy teeth. On the contrary, nonsignificant differences were found in SMT when genders and age groups were compared (P = 0.295 and 0.060, respectively). A strong negative correlation was observed between distance of the lesion to the sinus and SMT (P = 0.003). Conclusion: Neighboring periapical lesions of maxillary teeth are associated with SMT that is worsened when the lesion is close to the sinus.
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Affiliation(s)
- Mohammed G Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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25
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Myciński P, Dobroś K, Kaczmarzyk T, Zarzecka J. Assessment of conformity between clinical (radiological) and histopathological diagnoses of chronic inflammatory periapical lesions treated with apicoectomy. Clinical and histopathological diagnoses of periapical lesions. Research article. Folia Med Cracov 2020; 60:103-111. [PMID: 33821855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Periapical inflammation is one of the most common pathologies within the jaws, leading to the destruction of periodontal ligaments, bone resorption and the formation of periapical granulomas or radicular cysts. The final diagnosis can be made only on the basis of histopathological examination. The aim of the study was to assess the conformity between clinical and histopathological diagnosis of inflammatory periapical lesions treated with apicoectomy. MATERIALS AND METHODS The case histories of 52 patients subjected to surgical treatment at the Clinic of Conservative Dentistry with Endodontics between 2008 and 2018 were analyzed. Demographic data (age, gender), clinical (radiological) diagnosis, and data on the presence of sinus tracts and causal tooth were obtained from patients' records. RESULTS In the light of clinical and radiological examination, 32 (61.5%) periapical granulomas, 18 (34.6%) radicular cysts and 2 (3.9%) periapical scars were diagnosed, whereas the result of histopathological examination revealed granuloma in 34 (65.4%) cases and in 18 (34.6%) - radicular cyst. For clinical diagnosis of granuloma, the result coincided with the result of the histopathological examination in 28 cases, and in the case of cysts in 14. The analysis showed a significant relationship between the clinical and histopathological diagnoses (p <0.05). CONCLUSIONS The study emphasizes the importance of histopathological assessment for the proper diagnosis of periapical lesions. CLINICAL RELEVANCE The article emphasizes the high importance of histopathological examination for the correct diagnosis of chronic inflammatory periapical lesions.
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Affiliation(s)
- Paweł Myciński
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
| | - Katarzyna Dobroś
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Kaczmarzyk
- Department of Oral Surgery, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jolanta Zarzecka
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Gaêta-Araujo H, Nascimento EHL, Brasil DM, Gomes AF, Freitas DQ, De Oliveira-Santos C. Detection of Simulated Periapical Lesion in Intraoral Digital Radiography with Different Brightness and Contrast. Eur Endod J 2019; 4:133-8. [PMID: 32161900 DOI: 10.14744/eej.2019.46036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/17/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: To assess the detection of simulated periapical lesions in digital intraoral radiography with different levels of brightness and contrast combinations, and to investigate the observers’ preference of image quality for this diagnostic task. Methods: Digital radiographs were acquired prior to periapical lesion simulation and after each one of four defects enlargement. Original images were adjusted in 4 brightness and contrast combinations. Five observers evaluated the images according to the presence of periapical lesion on a 5-point scale. In a second moment, the observers ordinated the images subjectively, according to quality, from the best to the worst to detect the bone defect. The area under the receiver operating characteristic curve was calculated for the diagnostic values and compared by two-way ANOVA. The significance level was set at 5% (P<0.05). Results: No differences were found between the diagnostic values of the five combinations of brightness and contrast (P>0.05). The overall results showed low values of area under the Receiver Operating Characteristic (ROC) curve and sensitivity of the periapical radiography in the detection of periapical lesions of sizes from 1 to 3, which rose substantially in size 4. For image quality, combinations with the lowest brightness and highest contrast were preferred by the observers in 58% of the cases. Conclusion: Brightness and contrast adjustments do not influence the detection of simulated periapical lesions in digital intraoral radiography. Lower brightness and higher contrast images were preferred for this diagnostic task.
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Aksoy U, Savtekin G, Şehirli AÖ, Kermeoğlu F, Kalender A, Özkayalar H, Sayıner S, Orhan K. Effects of alpha-lipoic acid therapy on experimentally induced apical periodontitis: a biochemical, histopathological and micro-CT analysis. Int Endod J 2019; 52:1317-1326. [PMID: 30900747 DOI: 10.1111/iej.13121] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/18/2019] [Indexed: 12/23/2022]
Abstract
AIM To investigate the possible therapeutic effects of alpha-lipoic acid (ALA) in a model of chronic apical periodontitis in rats by analysing biochemical, histopathological and micro-CT parameters. METHODOLOGY The study was approved by the Animal Ethics Committee of the Near East University. Thirty-two Wistar rats were divided into four groups of eight rats each: Control Group; ALA Group; AP Group; AP + ALA Group. In the AP and AP + ALA groups, the pulp chambers of the mandibular first molars were surgically exposed and were left open to the oral environment for 4-weeks to allow the establishment of periapical lesions. The rats in the Control and AP groups were treated intraperitoneally with saline solution (with a daily dose of 100 mg kg-1 , for 28 days after periapical lesion induction). The rats in the ALA and AP + ALA groups were treated intraperitoneally with ALA (with a daily dose of 100 mg kg-1 , for 28 days after periapical lesion induction). After decapitation, the trunk blood was collected for the assessment of biochemical parameters. The mandibles were surgically removed and dissected for histopathologic analysis and further scanned with micro-CT. Groups of data were compared with a two-way analysis of variance (two-way anova) followed by Sidak's multiple comparison tests. Values of P < 0.05 were regarded as significant. RESULTS TNF-α, IL-1β, MMP-1, MMP-2 levels were significantly lower in AP + ALA group compared with AP group (P < 0.05). There was a significant difference between the AP and AP + ALA groups according to assessment of the inflammatory scores (P < 0.05). The periapical inflammatory infiltrates were significantly more severe (P < 0.05) in the AP group. The AP + ALA group exhibited lower values both in terms of surface area and volume of resorption cavities than the AP group and this difference was significant (P < 0.05). CONCLUSION alpha-lipoic acid treatment provided therapeutic effects on the inhibition of periapical bone loss.
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Affiliation(s)
- U Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - G Savtekin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - A Ö Şehirli
- Departments of Pharmacology, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - F Kermeoğlu
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - A Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - H Özkayalar
- Department of Pathology, Faculty of Medicine, Near East University, Mersin 10, Turkey
| | - S Sayıner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Mersin 10, Turkey
| | - K Orhan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Colavite PM, Cavalla F, Garlet TP, Azevedo MDCS, Melchiades JL, Campanelli AP, Letra A, Trombone APF, Silva RM, Garlet GP. TBX21-1993T/C polymorphism association with Th1 and Th17 response at periapex and with periapical lesions development risk. J Leukoc Biol 2018; 105:609-619. [PMID: 30548981 DOI: 10.1002/jlb.6a0918-339r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/13/2018] [Accepted: 12/01/2018] [Indexed: 12/23/2022] Open
Abstract
TBX21-1993T/C (rs4794067) polymorphism increases the transcriptional activity of the Tbx21, essential for interferon gamma (IFNg) transcription, but its functional impact on development Th1- response in vivo remains unclear, as well its potential influence over inflammatory osteolytic conditions, such as periapical lesions. Therefore, this study comprises a case-control and functional investigation of Tbx21 genetic variations impact on Th1 response in vivo and in vitro, and its impact on periapical lesions risk and outcome, performed with a population of healthy controls (H; N = 283) and patients presenting periapical lesions (L; N = 188) or deep caries (DC; N = 152). TBX21-1993T/C genotyping demonstrated that the polymorphic allele C, as well TC/TC+CC genotypes, was significantly less frequent in the L patients compared to H and DC groups. Additionally, gene expression analysis demonstrates that T-cell-specific T-box transcription factor (Tbet) and IFNg transcripts levels were downregulated whereas IL-17 levels were upregulated in the TBX21-1993 C carriers (TC/TC+CC) in comparison with the TT group. Also, while TT and TC+CC genotypes are equally prevalent in the lesions presenting low IFN/IL17 ratio, a significant decrease in polymorphic TC+CC genotypes was observed in lesions presenting intermediate and high IFN/IL17 ratio. In vitro experiments confirmed the predisposition to Th1 polarization associated with TBX21-1993, since PBMC CD4 T cells from T allele carriers produce higher IFNg levels upon CD3/CD28 stimulation than the C group, in both standard/neutral and Th1-polarizing culture conditions. In conclusion, the TBX21-1993 T allele and TC/CC genotypes predispose to Th1-type immune response development in vitro, influence immune response polarization in vivo, and consequently account for the risk for apical periodontitis development.
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Affiliation(s)
- Priscila Maria Colavite
- Department of Biological Sciences, School of Dentistry of Bauru, University of Sao Paulo, Bauru, Brazil
| | - Franco Cavalla
- Department of Biological Sciences, School of Dentistry of Bauru, University of Sao Paulo, Bauru, Brazil.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Thiago Pompermaier Garlet
- Department of Structural and Molecular Biology and Genetics, State University of Ponta Grossa, Ponta Grossa, Brazil
| | | | - Jessica Lima Melchiades
- Department of Biological Sciences, School of Dentistry of Bauru, University of Sao Paulo, Bauru, Brazil
| | - Ana Paula Campanelli
- Department of Biological Sciences, School of Dentistry of Bauru, University of Sao Paulo, Bauru, Brazil
| | - Ariadne Letra
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Department of Diagnostic and Biomedical Sciences, and Center for Craniofacial Research, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | - Renato Menezes Silva
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Lai EHH, Yang CN, Lin SK, Wang HW, Kok SH, Hong CY, Su IH, Yang H, Chang JZC. Metformin Ameliorates Periapical Lesions through Suppression of Hypoxia-induced Apoptosis of Osteoblasts. J Endod 2018; 44:1817-1825. [PMID: 30293696 DOI: 10.1016/j.joen.2018.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/04/2018] [Accepted: 08/12/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Intramuscular injection of metformin has been shown to inhibit the progression of periapical lesions in rats by decreasing the number of receptor activator of nuclear factor-κβ ligand- and tartrate-resistant acid phosphatase-positive cells. In this study, we investigated the effect of metformin on hypoxia-induced apoptosis of osteoblasts and the therapeutic activity of intracanal metformin in induced periapical lesions in rats. METHODS The influence of metformin on hypoxia-induced mitochondrial superoxide production in human osteoblasts was examined by using MitoSOX (Invitrogen, Carlsbad, CA) fluorescence dye signaling. The release of cytochrome c from mitochondria and the cleavage of procaspase-9 and poly(adenosine diphosphate-ribose) polymerase were evaluated by Western blot analysis. Apoptotic cell fraction was assessed by DNA content flow cytometry. In a rat model of induced periapical lesions, the effect of intracanal metformin on disease progression was appraised by 2-dimensional radiography and micro-computed tomographic imaging. Oxidative lesions and apoptotic activity of osteoblasts in vivo were estimated, respectively, by 8-hydroxy-2'-deoxyguanosine staining and terminal deoxynucleotidyl transferase dUTP nick end labeling. RESULTS Metformin inhibited hypoxia-enhanced mitochondrial superoxide production in osteoblasts. Metformin suppressed hypoxia-induced cytochrome c release from mitochondria and the cleavage of procaspase-9 and poly(adenosine diphosphate-ribose) polymerase. Metformin repressed hypoxia-augmented apoptotic cell fraction. In a rat model, intracanal metformin diminished the size of periapical lesions and the oxidative damage and apoptotic activity in osteoblasts. CONCLUSIONS Hypoxia increased oxidative stress in osteoblasts and enhanced cell death through activation of the mitochondrial pathway of apoptosis. Metformin attenuated the oxidative and cytotoxic action of hypoxia. The therapeutic effect of metformin on periapical lesions is partially caused by its antioxidative activity.
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Affiliation(s)
- Eddie Hsiang-Hua Lai
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Cheng-Ning Yang
- Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Sze-Kwan Lin
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Han-Wei Wang
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Sang-Heng Kok
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Chi-Yuan Hong
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan; College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan
| | - I-Hsuan Su
- Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
| | - Hsiang Yang
- Department of Dentistry, School of Dentistry, College of Medicine, Taipei, Taiwan
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Karunakaran JV, Abraham CS, Karthik AK, Jayaprakash N. Successful Nonsurgical Management of Periapical Lesions of Endodontic Origin: A Conservative Orthograde Approach. J Pharm Bioallied Sci 2017; 9:S246-S251. [PMID: 29284973 PMCID: PMC5731023 DOI: 10.4103/jpbs.jpbs_100_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periapical lesions of endodontic origin are common pathological conditions affecting periradicular tissues. Microbial infection of pulpal tissues is primarily responsible for initiation and progression of apical periodontitis. The primary objective of endodontic therapy should be to restore involved teeth to a state of normalcy nonsurgically. Different nonsurgical management techniques, namely, conservative root canal therapy, decompression technique, method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and tissue repair therapy, active nonsurgical decompression technique, and the apexum procedure have been advocated. New techniques which use drug-loaded injectable scaffolds, simvastatin, and epigallocatechin-3-gallate have been tried. Surgical option should be considered when intra- or extra-radicular infections are persistent. Incidence of nonendodontic periapical lesions has also been reported. An accurate diagnosis of the periapical lesion whether it is of endodontic or nonendodontic origin has to be made. Surgical methods have many disadvantages, and hence should be considered as an option only in the case of failure of nonsurgical techniques. Assessment of healing of periapical lesions has to be done periodically which necessitates a long-term follow-up. Even large periapical lesions and retreatment cases where the lesion is of endodontic origin have been successfully managed nonsurgically with orthograde endodontic therapy.
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Affiliation(s)
- J V Karunakaran
- Department of Conservative Dentistry, JKK Nataraja Dental College, Komarapalayam, Namakkal, Tamil Nadu, India
| | - Chris Susan Abraham
- Department of Conservative Dentistry, JKK Nataraja Dental College, Komarapalayam, Namakkal, Tamil Nadu, India
| | - A Kaneesh Karthik
- Department of Oral and Maxillofacial Surgery, JKK Nataraja Dental College, Komarapalayam, Namakkal, Tamil Nadu, India
| | - N Jayaprakash
- Department of Conservative Dentistry, JKK Nataraja Dental College, Komarapalayam, Namakkal, Tamil Nadu, India
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Cassanta LTDC, Rodrigues V, Violatti-Filho JR, Teixeira Neto BA, Tavares VM, Bernal ECBA, Souza DM, Araujo MS, de Lima Pereira SA, Rodrigues DBR. Modulation of Matrix Metalloproteinase 14, Tissue Inhibitor of Metalloproteinase 3, Tissue Inhibitor of Metalloproteinase 4, and Inducible Nitric Oxide Synthase in the Development of Periapical Lesions. J Endod 2017; 43:1122-1129. [PMID: 28527839 DOI: 10.1016/j.joen.2017.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 02/07/2017] [Accepted: 02/24/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Periapical cysts and granulomas are chronic lesions caused by an inflammatory immune response against microbial challenge in the root canal. Different cell types, cytokines, and molecules have been associated with periapical lesion formation and expansion. Therefore, because of the chronic inflammatory state of these lesions, the aim of this study was to evaluate the in situ expression of matrix metalloproteinase (MMP)-14 and -19, tissue inhibitor of metalloproteinase (TIMP)-3 and -4, CD68, and inducible nitric oxide synthase (iNOS) in periapical cysts and granulomas. METHODS Sixteen cases of periapical cysts and 15 cases of periapical granulomas were analyzed. Ten normal dental pulps were used as the negative control. Immunohistochemistry was performed with anti-MMP-19, anti-MMP-14, anti-TIMP-3, anti-TIMP-4, anti-iNOS, and anti-CD68 antibodies. RESULTS The expression of TIMP-3, TIMP-4, iNOS, and CD68 was significantly higher in both the cyst and granuloma groups than in the control group. TIMP-4 was also significantly higher in cases of chronic apical abscess. There was also a significant difference in the expression of MMP-14 between the cyst and control groups. However, there were no differences in the expression of MMP-19 between the 3 groups. CONCLUSIONS Our data suggest that the expression of MMP-14, TIMP-3, and TIMP-4 is associated with the development of periapical lesions.
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Affiliation(s)
- Lorena Teodoro de Castro Cassanta
- Laboratory of Immunology, Department of Biological Sciences and Cefores, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil
| | - Virmondes Rodrigues
- Laboratory of Immunology, Department of Biological Sciences and Cefores, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil
| | | | | | | | | | - Danila Malheiros Souza
- Laboratory of Immunology, Department of Biological Sciences and Cefores, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil
| | | | | | - Denise Bertulucci Rocha Rodrigues
- Laboratory of Immunology, Department of Biological Sciences and Cefores, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil; Uberaba University, Uberaba, Minas Gerais, Brazil.
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Liu L, Deng J, Ji Q, Peng B. High-mobility Group Box 1 Is Associated with the Inflammatory Infiltration and Alveolar Bone Destruction in Rats Experimental Periapical Lesions. J Endod 2017; 43:964-969. [PMID: 28389071 DOI: 10.1016/j.joen.2016.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study was conducted to observe the immunohistochemical localization of high-mobility group box 1 (HMGB1) and its receptor, Toll-like receptor 4 (TRL4), in the development of periapical lesions induced in rats. The possible role of these molecules in the pathogenesis of periapical lesions was also explored. METHODS Periapical lesions developed within 35 days after mandibular first molar pulp exposure in Wistar rats. The animals were randomly killed at 0, 7, 14, 21, 28, and 35 days after pulp exposure. The jaws that contained the first molar were obtained and prepared for histologic analysis, enzyme histochemistry, immunohistochemistry, and double immunofluorescence staining. RESULTS From day 0 to 35, the areas of periapical bone loss increased and appeared to be stabilized on day 35. A few HMGB1-positive, TLR4-positive cells and osteoclasts could be observed on day 7. From day 7 to 28, the HMGB1 and TLR4 protein expression increased and subsequently remained stable. The number of osteoclasts multiplied from day 0 to 14 and then gradually decreased from day 14 to 35. Double immunofluorescence staining results showed HMGB1-positive, TLR4-positive cells around periapical lesions surrounding the apical foramen. CONCLUSIONS Thus, HMGB1 and TLR4 may be associated with the pathogenesis of the periapical lesions.
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Affiliation(s)
- Lingshuang Liu
- Department of Endodontics, The Affiliated Hospital of Qingdao University, Qingdao Shi, Shandong Sheng, China
| | - Jing Deng
- Department of Endodontics, The Affiliated Hospital of Qingdao University, Qingdao Shi, Shandong Sheng, China
| | - Qiuxia Ji
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao Shi, Shandong Sheng, China
| | - Bin Peng
- Department of Operative Dentistry and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Kunhappan S, Kunhappan N, Saraf KK, Kridutt V. Nonsurgical endodontic treatment of teeth associated with large periapical lesion using triple antibiotic paste and mineral trioxide aggregate apical plug: A case series. J Conserv Dent 2017; 20:141-145. [PMID: 28855765 PMCID: PMC5564243 DOI: 10.4103/0972-0707.212232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Periapical diseases are induced as a result of the direct or indirect involvement of oral bacteria. The etiologic factor being the degenerating pulp tissue. A periapical lesion is formed within an area of apical periodontitis which cannot form by itself and is inflammatory in origin. If the microbial etiology of periapical lesions and in the root canal is removed by nonsurgical root canal therapy the lesions regress. Mere surgical removal of the periapical lesions without proper root canal disinfection and obturation will not result in the healing of periapical tissues. Nonsurgical treatment with triple antibiotic paste offers a high success rate in the healing of large periapical lesions. The present clinical cases show the nonsurgical endodontic management of large periapical pathosis using triple antibiotic paste and mineral trioxide aggregate.
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Affiliation(s)
- Sanjeev Kunhappan
- Department of Conservative Dentistry and Endodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Neerja Kunhappan
- Department of Conservative Dentistry and Endodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - K K Saraf
- Department of Conservative Dentistry and Endodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Vaibhav Kridutt
- Department of Conservative Dentistry and Endodontics, Government Dental College, Raipur, Chhattisgarh, India
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El Khateeb SM, Abu-Hammad O, Fadel H, Dar-Odeh N. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors. J Int Soc Prev Community Dent 2017; 7:22-27. [PMID: 28316945 PMCID: PMC5343679 DOI: 10.4103/2231-0762.200707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/23/2016] [Indexed: 12/20/2022] Open
Abstract
AIMS AND OBJECTIVES To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. MATERIALS AND METHODS The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. RESULTS A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). CONCLUSIONS A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend.
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Affiliation(s)
- Sara M. El Khateeb
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Ain Shams University, Cairo, Egypt
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Osama Abu-Hammad
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan
- Department of Substitutive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Hani Fadel
- Department of Preventive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Najla Dar-Odeh
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
- Department of Oral Surgery, Oral Medicine and Periodontics, Faculty of Dentistry, Amman, Jordan
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Abstract
Macroautophagy/autophagy is a conserved lysosomal degradation process essential for cell physiology and human health. By regulating apoptosis, inflammation, pathogen clearance, immune response and other cellular processes, autophagy acts as a modulator of pathogenesis and is a potential therapeutic target in diverse diseases. With regard to oral disease, autophagy can be problematic either when it is activated or impaired, because this process is involved in diverse functions, depending on the specific disease and its level of progression. In particular, activated autophagy functions as a cytoprotective mechanism under environmental stress conditions, which regulates tumor growth and mediates resistance to anticancer treatment in established tumors. During infections and inflammation, activated autophagy selectively delivers microbial antigens to the immune systems, and is therefore connected to the elimination of intracellular pathogens. Impaired autophagy contributes to oxidative stress, genomic instability, chronic tissue damage, inflammation and tumorigenesis, and is involved in aberrant bacterial clearance and immune priming. Hence, substantial progress in the study of autophagy provides new insights into the pathogenesis of oral diseases. This review outlines the mechanisms of autophagy, and highlights the emerging roles of this process in oral cancer, periapical lesions, periodontal diseases, and oral candidiasis.
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Affiliation(s)
- Ya-Qin Tan
- a The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education , School and Hospital of Stomatology, Wuhan University , Wuhan , Hubei , China
| | - Jing Zhang
- a The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education , School and Hospital of Stomatology, Wuhan University , Wuhan , Hubei , China.,b Department of Oral Medicine , School and Hospital of Stomatology, Wuhan University , Wuhan , Hubei , China
| | - Gang Zhou
- a The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education , School and Hospital of Stomatology, Wuhan University , Wuhan , Hubei , China.,b Department of Oral Medicine , School and Hospital of Stomatology, Wuhan University , Wuhan , Hubei , China
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Tikku AP, Bharti R, Sharma N, Chandra A, Kumar A, Kumar S. Role of ultrasound and color doppler in diagnosis of periapical lesions of endodontic origin at varying bone thickness. J Conserv Dent 2016; 19:147-51. [PMID: 27099421 PMCID: PMC4815543 DOI: 10.4103/0972-0707.178694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS To access the role of ultrasound and color doppler in diagnosing periapical lesions of maxilla and mandible. SETTINGS AND DESIGN This study was conducted in the Department of Conservative Dentistry and Endodontics (Faculty of Dental Sciences), Department of Radiotherapy, and Department of Pathology. MATERIALS AND METHODS The study group comprised 30 patients with periapical lesions of endodontic origin in maxilla and mandible requiring endodontic surgery. After thorough clinical and radiographic examination patients were subjected to ultrasound and color doppler examination, where the lesions were assessed for their contents as to cystic or solid. Following which periapical surgery was done and the pathological tissue obtained was subjected to histopathological examination. The results of the ultrasound examination were correlated with histopathological features. The diagnostic validity of ultrasound was assessed by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. STATISTICAL ANALYSIS USED The statistical analysis was done using statistical package for social sciences (SPSS) version 15.0 statistical analysis software. The values were represented in number (%). RESULTS Within the limitations of the current study it can be stated that although ultrasound may not establish the definitive diagnosis, it can facilitate the differential diagnosis between cystic and solid granulomatous lesions. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone. CONCLUSION Ultrasound can routinely be recommended as a complimentary method for the diagnosis of periapical lesions of endodontic origin. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone.
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Affiliation(s)
- Aseem P Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neha Sharma
- Department of Conservative Dentistry and Endodontics, Government Dental College, Shimla, Himachal Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashutosh Kumar
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunil Kumar
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
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Aoki EM, Abdala-Júnior R, de Oliveira JX, Arita ES, Cortes ARG. Reliability and Reproducibility of Manual and Automated Volumetric Measurements of Periapical Lesions. J Endod 2015; 41:1555-9. [PMID: 26234544 DOI: 10.1016/j.joen.2015.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/17/2015] [Accepted: 06/20/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The present study aimed to test the reliability and reproducibility of 2 methods: manual and automated segmentation (using a threshold-based region growing algorithm) for measuring the volume of periapical lesions. METHODS A total of 43 cone-beam computed tomographic scans (14 men and 29 women, mean age of 54.6 ± 8.5 years) were analyzed by 3 observers. Intraobserver reproducibility and interobserver reliability were assessed using the intraclass correlation coefficient. Parametric correlation between manual and automated volumetric measurements was performed. In addition, the Student t test was also used to compare the mean time required for manual and automated volumetric measurements. RESULTS Automated segmentation showed slightly higher intraclass correlation coefficient values for all observers. A strong significant correlation was found between manual and automated volumetric measurements performed by the 3 observers. A significant difference in the mean procedure time was also found between both methods (P = .001). CONCLUSIONS Within the limitations of this study, the present results suggest that automated segmentation with a region growing algorithm is faster and slightly more reliable to calculate the volume of periapical lesions.
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Affiliation(s)
- Eduardo Massaharu Aoki
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinaldo Abdala-Júnior
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Arthur Rodriguez Gonzalez Cortes
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Talebzadeh B, Rahimi S, Abdollahi AA, Nouroloyuni A, Asghari V. Varicella Zoster Virus and Internal Root Resorption: A Case Report. J Endod 2015; 41:1375-81. [PMID: 25814244 DOI: 10.1016/j.joen.2015.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 01/25/2015] [Accepted: 02/08/2015] [Indexed: 11/25/2022]
Abstract
Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus. One of the less well-recognized maxillofacial complications is tooth root resorption. To our knowledge, this is the first case report about internal resorption associated with varicella zoster virus involving different dental quadrants. A 38-year-old woman presented with internal resorption of maxillary canine and first premolar tooth roots on the right quadrant and generalized internal resorption of second molars of both mandibular quadrants. The patient's medical history showed mild oral lichen planus and infection with varicella zoster virus (chickenpox) with severe clinical manifestations 5 years previously. The patient developed diabetes mellitus type I and hypothyroidism a short time after varicella zoster virus infection, and by the time of infection with this virus, oral lichen planus had progressed from the reticular pattern to the generalized severe erosive form. Viral etiology could also be considered in these diseases. The root canals of the affected teeth were debrided, irrigated, and dried, and calcium hydroxide paste was placed in the root canals for a week during the first treatment session. The root canals were obturated during the second session. Six-month follow-up showed improvement of oral lichen planus and resolution of widening of periodontal ligament of the affected teeth, with follow-up radiographs revealing no periapical problems. It appears some cases of internal root resorption classified as idiopathic might have viral etiology. Therefore, it is recommended that patients be questioned about a history of chickenpox and herpes zoster.
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Affiliation(s)
- Bita Talebzadeh
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Amir Ardalan Abdollahi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Nouroloyuni
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahide Asghari
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Velickovic M, Pejnovic N, Mitrovic S, Radosavljevic G, Jovanovic I, Kanjevac T, Jovicic N, Lukic A. ST2 deletion increases inflammatory bone destruction in experimentally induced periapical lesions in mice. J Endod 2015; 41:369-75. [PMID: 25595464 DOI: 10.1016/j.joen.2014.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/04/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION ST2 is a member of the interleukin (IL)-1 receptor family, and IL-33 is its natural ligand. ST2 signaling promotes Th2 immune response in allergy, autoimmunity, and chronic inflammatory disorders, but its role in the pathogenesis of periapical lesions is unknown. The purpose of this study was to investigate whether ST2 gene deletion affects the development of experimentally induced periapical lesions in mice. METHODS Pulps of mandibular molars from wild-type (WT) and ST2 knockout (ST2(-)/(-)) BALB/c mice were exposed and left open to the oral environment. After death, hemi-mandibles were isolated and prepared for histologic, immunohistochemical, and flow cytometric analysis. RESULTS The expression of IL-33 and its receptor ST2 was higher in periapical lesions in WT mice compared with normal root apices (both P < .05). The increased periapical bone loss observed in ST2(-)/(-) mice was associated with enhanced influx of neutrophils, CD3+ CXCR3+ Th1 cells, and CD3+ CCR6+ Th17 cells and increased number of tartrate-resistant acid phosphatase+ osteoclasts (all P < .05). Furthermore, periapical lesions in ST2(-)/(-) mice contained increased percentages of T cells expressing interferon-γ, IL-17, tumor necrosis factor-α, and IL-6 (all P < .05). In comparison with WT mice, CD3+ receptor activator of nuclear factor kappa B ligand+ T cells were increased, whereas CD3+ osteoprotegerin+ T cells were decreased in the lesions of ST2(-)/(-) mice (both P < .05). CONCLUSIONS ST2 deletion increases inflammatory bone loss in experimental periapical lesions in mice, which is associated with enhanced Th1/Th17 cell mediated periapical immune responses and increased osteoclastogenesis.
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Affiliation(s)
| | | | | | | | | | - Tatjana Kanjevac
- Department of Preventive and Pediatric Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Aleksandra Lukic
- Department of Endodontics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
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Xiao L, Zhu L, Yang S, Lei D, Xiao Y, Peng B. Different correlation of sphingosine-1-phosphate receptor 1 with receptor activator of nuclear factor kappa B ligand and regulatory T cells in rat periapical lesions. J Endod 2014; 41:479-86. [PMID: 25492490 DOI: 10.1016/j.joen.2014.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 08/13/2014] [Accepted: 10/16/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sphingosine-1-phosphate receptor 1 (S1P1) is crucial for regulation of immunity and bone metabolism. This study aimed to investigate the expression of S1P1 in rat periapical lesions and its relationship with receptor activator of nuclear factor kappa B ligand (RANKL) and regulatory T (Treg) cells. METHODS Periapical lesions were induced by pulp exposure in the first lower molars of 55 Wistar rats. Thirty rats were killed on days 0, 7, 14, 21, 28, and 35, and their mandibles were harvested for x-ray imaging, micro-computed tomography scanning, histologic observation, immunohistochemistry, enzyme histochemistry, and double immunofluorescence analysis. The remaining 25 rats were killed on days 0, 14, 21, 28, and 35, and mandibles were harvested for flow cytometry. RESULTS The volume and area of the periapical lesions increased from day 0 to day 21 and then remained comparably stable after day 28. S1P1-positive cells were observed in the inflammatory periapical regions; the number of S1P1-positive cells peaked at day 14 and then decreased from day 21 to day 35. The distribution of S1P1-positive cells was positively correlated with the dynamics of RANKL-positive cells but was negatively correlated with that of Treg cells. CONCLUSIONS S1P1 expression was differentially correlated with RANKL and Treg cell infiltration in the periapical lesions and is therefore a contributing factor to the pathogenesis of such lesions.
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Affiliation(s)
- Lan Xiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lingxin Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shasha Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dongqi Lei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove Campus, Brisbane, Australia
| | - Bin Peng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Raghu KN, Daniel JG, Razvi S, Vinaychandra R, Kini A, Nandakishore KJ. In vivo evaluation of the accuracy of working length determination using an electronic apex locater IPEX (NSK) on vital uninfected teeth and teeth with radiographic evidence of periapical lesions. J Int Soc Prev Community Dent 2014; 4:S204-8. [PMID: 25625080 PMCID: PMC4304060 DOI: 10.4103/2231-0762.149042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM To evaluate the accuracy of working length determination of an electronic apex locator, IPEX, on vital uninfected teeth and teeth with radiographic evidence of periapical lesions. MATERIALS AND METHODS Twenty vital and uninfected teeth and 16 teeth with a single canal and matured apices and having radiographic evidence of periapical lesions of 5-10 mm were taken for this study. Access cavities were prepared and pulp was considered to be vital if bleeding was present upon entering the chambers. No. 15 k-type file was used to determine the working length. X-rays were taken to determine the working length using Ingle's method, followed by determination using the electronic apex locator, IPEX. Teeth were then observed under 45 × magnification using stereomicroscope. No 15 k-type file was maneuvered till the emergence of the tip was seen and the real length of the tooth was thus measured in the instrument up to 0.5 mm accuracy using stereomicroscope. RESULTS The data were duly collected and entered, and the statistical analysis was done using Student's t test. In uninfected teeth, IPEX was found to be more reliable than Ingle's radiographic technique, but this was not statistically significant. In case of teeth with radiographic evidence of periapical lesions, the radiographic method appeared to be relatively more dependable; however, this difference was not statistically significant. CONCLUSION For rendering effective root canal procedure, both radiographs and electronic apex locators have important roles to play.
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Affiliation(s)
| | - Jacob G. Daniel
- Department of Conservative Dentistry and Endodontics, Raja Rajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - Shuaib Razvi
- Department of Conservative Dentistry and Endodontics, Raja Rajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - Ramachandra Vinaychandra
- Department of Conservative Dentistry and Endodontics, Raja Rajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - Annapurna Kini
- Department of Conservative Dentistry and Endodontics, Raja Rajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - Kunigal Jayram Nandakishore
- Department of Conservative Dentistry and Endodontics, Raja Rajeswari Dental College and Hospital, Bangalore, Karnataka, India
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Davies A, Mannocci F, Mitchell P, Andiappan M, Patel S. The detection of periapical pathoses in root filled teeth using single and parallax periapical radiographs versus cone beam computed tomography - a clinical study. Int Endod J 2014; 48:582-92. [PMID: 25074727 DOI: 10.1111/iej.12352] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/28/2014] [Indexed: 01/30/2023]
Abstract
AIM To clinically assess the diagnostic yield from single parallel periapical, two parallax radiographs and cone beam computed tomography (CBCT) by comparing the prevalence of periapical lesions associated with individual roots, and the total number of root canals in root-treated teeth in patients referred for root canal retreatment. METHODOLOGY Single and parallax periapical radiographs, and CBCT scans, were taken of 100 teeth in 78 patients who had been referred for root canal retreatment. The presence of a periapical lesion associated with each specific root and the number of identifiable root canals were assessed using each imaging modality by a consensus panel of two examiners. The number of root canals was confirmed using the dental-operating microscope during treatment. In addition, the panel was asked to decide whether they felt they had adequate information to manage each case. RESULTS A total of 209 paired roots were assessed for periapical lesions. Lesions were identified in 41%, 38% and 68% of paired roots when using single radiographs, two parallax radiographs and CBCT respectively. The number of root canals identified were 186, 218, 242 and 239 when using parallel, parallax, CBCT and the dental-operating microscope, respectively. CONCLUSIONS CBCT detected significantly more periapical lesions and root canals than both single and parallax periapical radiographs. There was no significant difference between CBCT and the clinical microscope in the identification of root canals. Whilst two parallax radiographs detect significantly more root canals than a single radiograph, they did not increase detection of periapical lesions when compared to a single periapical radiograph.
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Affiliation(s)
- A Davies
- Department of Endodontology, Kings College Dental Institute, Guys Hospital, London Bridge, London, UK
| | - F Mannocci
- Department of Endodontology, Kings College Dental Institute, Guys Hospital, London Bridge, London, UK
| | - P Mitchell
- Department of Endodontology, Kings College Dental Institute, Guys Hospital, London Bridge, London, UK
| | - M Andiappan
- Biomedical Statistics, Kings College Dental Institute, Denmark Hill, London, UK
| | - S Patel
- Department of Endodontology, Kings College Dental Institute, Guys Hospital, London Bridge, London, UK
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Abstract
Collagenase-3 (matrix metalloproteinase-13) is a metalloproteinase (MMP) that is associated with bone lesions and exhibits variable expression patterns in odontogenic cysts; it may play a role in regulating focal proliferation and maturation of jaw cyst epithelium. We studied the localization, staining intensity and distribution of collagenase-3 in 13 periapical granulomas with epithelium, 16 periapical granulomas without epithelium and 10 radicular cysts using archived formalin fixed, paraffin embedded tissues. A monoclonal antibody against human collagenase-3 was used to evaluate its expression. Immunohistochemical staining intensities of collagenase-3 in all periapical lesions were (-), 4 (10%); (+), 1 (3%); (++), 22 (56%) and (+++), 12 (31%); differences were not statistically significant. Immunohistochemical distribution of collagenase-3 in epithelial cells was (-), 17 (44%); (+), 17 (44%); (++), 5 (13%); in fibroblasts it was (-), 8 (20%); (+), 23 (59%); (++), 8 (21%); in plasma cells it was (-), 7 (18%); (+), 22 (56%); (++), 10 (26%); in macrophages it was (-), 7 (18%); (+), and 15 (38%); and (++), 17 (44%). Statistically significant differences were found in epithelial cells (p = 0.00) and fibroblasts (p = 0.02), whereas differences were not statistically significant for plasma cells and macrophages. Collagenase-3 may play a role in the conversion of a periapical granuloma with epithelium to radicular cyst. MMP's influence not only epithelial rest cell migration, but also invasion of various stromal cells into granulomatous tissue.
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Affiliation(s)
- G Bhalla
- Himachal Institute of Dental Sciences , Paontasahib, HP , India
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Sun Z, Wang L, Peng B. Kinetics of glycogen synthase kinase (GSK)3β and phosphorylated GSK3β (Ser 9) expression in experimentally induced periapical lesions. Int Endod J 2014; 47:1107-16. [PMID: 24494585 DOI: 10.1111/iej.12258] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/29/2014] [Indexed: 02/05/2023]
Abstract
AIM To investigate the kinetics of GSK3β and p-GSK3β (Ser 9) expression in experimentally induced rat periapical lesions and to explore their possible functions in the pathogenesis of periapical lesions. METHODOLOGY Periapical lesions were established in Wistar rats by occlusal pulp exposure in mandibular first molar teeth. The animals were killed on days 0, 7, 14, 21 and 28. Micro-computed tomographic, histological and enzyme histochemical analyses were performed to detect the progression of periapical lesions. Immunohistochemistry, double-dye immunofluorescence and Western blot were performed to determine the expression of GSK3β and p-GSK3β (Ser 9) in periapical tissues. RESULTS From day 0 to day 28, the lesion volume and area gradually expanded, and the GSK3β-positive cells gradually ascended. A few p-GSK3β (Ser 9)-positive cells and osteoclasts appeared on day 7 and then climaxed on day 14. The numbers then simultaneously decreased from day 21 to day 28. Western blot analysis revealed that p-GSK3β (Ser 9) and GSK3β proteins were expressed at all time-points. The positive cells and protein expression ratio of p-GSK3β (Ser 9) against GSK3β increased from day 0 to day 14 and then decreased from day 14 to day 28. Finally, double-dye immunofluorescence assay revealed that p-GSK3β (Ser 9)-positive and RANKL-positive cells were co-localized around periapical lesions on days 14 and 28. CONCLUSIONS GSK3β and p-GSK3β (Ser 9) can be observed and may be involved in alveolar bone resorption and inflammatory response in periapical lesions, as well as associated with periapical lesion pathogenesis.
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Affiliation(s)
- Z Sun
- School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Liu S, Li Q, Liu Y. Immunohistochemical localization of NALP3 inflammasome in experimental periapical lesions. Int Endod J 2014; 47:949-57. [PMID: 24386947 DOI: 10.1111/iej.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 01/01/2014] [Indexed: 02/07/2023]
Abstract
AIM To explore the role of NALP3 inflammasome [NALP3, its effector molecule apoptosis associated speck-like protein (ASC), caspase-1, interleukin (IL)-1β and IL-18] in the development of periapical lesions in rats. METHODOLOGY Periapical lesions were developed within 21 days after mandibular first molar pulp exposure in Sprague-Dawley rats. The animals were randomly sacrificed at 0, 1, 3, 7, 10, 14 and 21 days after pulpal exposure. The bilateral mandibles were extracted for histological processing, then they were haematoxylin-eosin (HE) stained to examine inflammation infiltration in the apical region and immunohistochemically examined for the NALP3 inflammasome signalling pathway. Data were analysed by one-way analysis of variance and the Pearson(') s correlation and linear tendency test. RESULTS NALP3 was detected in the cytoplasm of fibroblasts, monocytes, neutrophils, macrophages and vascular endothelial cells in the periapical region. From day 1 to day 21, the number of NALP3-positive cells ascended and was significantly correlated with the intensity of inflammatory infiltration (r = 0.776, P < 0.01). ASC, caspase-1, IL-1β and IL-18 were all expressed in the inflammatory periapical tissues. The positive cell counts of IL-1β and IL-18 were significantly correlated with that of NALP3, and r = 0.718, P < 0.01; r = 0.688, P < 0.01, respectively. CONCLUSIONS NALP3 inflammasome is expressed in the inflammatory periapical tissues. This cytokine-signalling pathway may therefore be crucial in the regulatory control of inflammatory responses in periapical tissues and the development of periapical lesions.
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Affiliation(s)
- S Liu
- Department of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Azuma MM, Samuel RO, Gomes-Filho JE, Dezan-Junior E, Cintra LTA. The role of IL-6 on apical periodontitis: a systematic review. Int Endod J 2013; 47:615-21. [PMID: 24224782 DOI: 10.1111/iej.12196] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/16/2013] [Indexed: 01/08/2023]
Abstract
The aim of this review was to examine current knowledge of the role of interleukin-6 (IL-6) in apical periodontitis (AP) pathogenesis as an inflammatory or pro-inflammatory cytokine. It also looked at whether IL-6 could serve as a measure for differential diagnosis or as a biomarker that can further predict the progression of bone resorption. A systematic review relating to AP and IL-6 was made via PubMed, BIOSIS, Cochrane, EMBASE and Web of Science databases using keywords and controlled vocabulary. Two independent reviewers first screened titles and abstracts and then the full texts. The reference lists of the identified publications were examined for additional titles. Eighteen papers were studied in total. In vitro studies (n = 6) revealed that IL-6 is present in AP, and its levels are proportional to the size of the periapical lesions. Neutrophils and macrophages resident in these lesions can produce IL-6 in vitro after a bacterial stimulus. Animal studies (n = 5) showed that IL-6 is present in AP and that osteoblasts can produce IL-6 in vivo. On the other hand, two studies using IL-6 knockout mice revealed larger periapical lesions when compared with control groups, demonstrating IL-6's role as an anti-inflammatory cytokine. In human studies (n = 7), IL-6 was identified in AP, and its levels were higher in symptomatic, epithelialized and large lesions than in asymptomatic and small lesions. These data lead to the conclusion that IL-6 may play a pro-inflammatory role, increasing its levels and reabsorbing bone in the presence of infections. When IL-6 is not present, other cytokines such as IL-1 and TNF-α induce bone resorption. Further studies about the relationship between AP development and the cytokine network must be performed to establish the exact role of each cytokine in the inflammatory process.
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Affiliation(s)
- M M Azuma
- Department of Endodontics, Araçatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Pope O, Sathorn C, Parashos P. A comparative investigation of cone-beam computed tomography and periapical radiography in the diagnosis of a healthy periapex. J Endod 2013; 40:360-5. [PMID: 24565653 DOI: 10.1016/j.joen.2013.10.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/27/2013] [Accepted: 10/01/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This research aimed to compare the appearance of healthy periapical tissues on cone-beam computed tomography (CBCT) with periapical radiography and to measure the periodontal ligament (PDL) space on CBCT for teeth with healthy and necrotic pulps. METHODS Patient records from specialist endodontic practices were examined for teeth that had a high-resolution (0.08-mm voxel) and small field-of-view CBCT scan, a periapical radiograph, and clinical pulp tests (CO2 and electric pulp testing). The periapical regions of the CBCT scans and radiographs were scored individually by 2 calibrated, blinded examiners by using a modified CBCT-periapical index (CBCT-PAI) for both and represented as CBCT-PAI and PAI, respectively. The Fisher exact and χ(2) statistics tested the relationships between CBCT-PAI, PAI, and pulp status. RESULTS Of 200 teeth included in the study, 166 showed clinical signs of pulpal health, and the CBCT-PAI score was greater than the PAI in 72% (119 of 166), with a vital pulp likely to have a radiographic PDL space widening of 0-1 mm (P < .001). Although 2 healthy teeth showed radiolucencies 2-4 mm on CBCT scan when the periapical radiograph showed none, a PDL space of greater than 1-2 mm was indicative of a necrotic pulp (P < .001). CONCLUSIONS Teeth with necrotic pulps were more likely to have PDL widening, but the PDL space of a healthy tooth demonstrated significant variation when examined by CBCT. The radiographic interpretation of health and disease on CBCT must be further investigated before usage in outcome or epidemiologic investigations. This research questions the traditional radiographic interpretation of the PDL space.
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Affiliation(s)
- Oliver Pope
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Chankhrit Sathorn
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Parashos
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
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Hu Y, Xiong H, Peng B. Expression of a cytokine, interleukin-23, in experimental periapical lesions. Int Endod J 2013; 46:896-903. [PMID: 23520984 DOI: 10.1111/iej.12077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 01/29/2013] [Indexed: 11/27/2022]
Abstract
AIM To investigate the expression of interleukin (IL)-23, a new member of the IL-12 family, in experimental periapical lesions. METHODOLOGY Periapical lesions were induced in Wistar rats by occlusal surface pulp exposure in mandibular first molars. The rats were randomly sacrificed 0, 7, 14, 21, 28, 35, 42 and 56 days after pulp exposure. The jaws that contained the first molars were obtained and routinely prepared for radiographic, histological, enzyme histochemical, immunohistochemical and double immunofluorescence analyses. Data were analysed by one-way analysis of variance and the Pearson correlation test. RESULTS The number of IL-23-positive cells increased from day 7 to day 35 and then gradually decreased. The number of osteoclasts increased and peaked on day 14 and then gradually decreased from day 21 to day 56. A significant positive correlation existed between the number of IL-23 positive cells and the size of bone resorption in periapical lesions from day 7 to day 56 (r = 0.875, P < 0.01). CONCLUSIONS Interleukin-23 can be observed and may be associated with inflammatory response and bone resorption in periapical lesions.
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Affiliation(s)
- Y Hu
- School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Prince CN, Annapurna CS, Sivaraj S, Ali IM. Ultrasound imaging in the diagnosis of periapical lesions. J Pharm Bioallied Sci 2012; 4:S369-72. [PMID: 23066292 PMCID: PMC3467915 DOI: 10.4103/0975-7406.100275] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/09/2022] Open
Abstract
Background and Objectives: To assess the diagnostic capability of real-time ultrasound imaging, together with the application of color power Doppler in the identification and differential diagnosis of the periapical lesions. Materials and Methods: Fifteen patients with periapical lesions of pulpal origin, diagnosed with clinical and conventional radiographic examination, were examined further using ultrasonography. The results from the biopsies of the lesions were compared and statistically analyzed. Results: The differential diagnosis between periapical granulomas and cystic lesions, which were based on the ultrasonographic findings, were confirmed by the results of the histopathologic examination in 13 (86.7%) of 15 cases, one being granuloma and 14 being cystic lesion. Interpretation and Conclusion: Ultrasound real-time imaging is a technique that may help make a differential diagnosis between cysts and granulomas by revealing the nature of the content of a bony lesion. This technique may have further applications in the study of other lesions of the jaws.
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Affiliation(s)
- Christo Naveen Prince
- Department of Oral Medicine and Radiology, JKK Nattaraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
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Goel S, Nagendrareddy SG, Raju MS, Krishnojirao DRJ, Rastogi R, Mohan RPS, Gupta S. Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions. Indian J Radiol Imaging 2012; 21:279-83. [PMID: 22223940 PMCID: PMC3249943 DOI: 10.4103/0971-3026.90688] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions. Materials and Methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed. Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case. Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions.
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Affiliation(s)
- Sumit Goel
- Department of Oral Medicine and Radiology, Subharti Dental College and Hospital, Meerut, India
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