Method 300: a complementary teaching methodology in Dentistry.

This study evaluated Method 300, a complementary teaching methodology in Dentistry. Thirty participants were divided into 6 groups according to the scores obtained in a placement test ranging from 0 to 10. Students with scores lower than 6 were classified as having poor academic performance; students with scores equal to or greater than 6 were considered as having good academic performance. Each group included at least one student with good performance. Our methodology consisted of two application cycles, each including one different test; however, only students with low performance could undergo the second testing. Students held meetings twice a week for one hour and thirty minutes. Of the 54 students initially enrolled in the subject, 24 dropped out, leaving 30 students who completed all the proposed activities. In cycle 1, 24 (80%) students showed poor academic performance and 6 (20%) good. Students with poor performance in P1 significantly improved after P1 300 test application (P < 0.001). After cycle 1 activities, all 30 participants showed significant improvement. In cycle 2, the number of students with good performance tripled when compared to cycle 1, resulting in a decrease in the number of students with poor performance (P = 0.205). Results show that the Method 300 is an important teaching-learning resource in Dentistry, to be used as a complementary methodology to lectures.

Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions.

Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.

Omega-3 Fatty Acids Alter Systemic Inflammatory Mediators Caused by Apical Periodontitis.

INTRODUCTION: This study investigated the effects of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) on serum inflammatory mediators of rats with pulp exposure-induced apical periodontitis. METHODS: Forty male Wistar rats were divided into the following groups: control, untreated rats (C); control rats treated with ω-3 PUFAs (C-O); rats with pulp exposure-induced apical periodontitis (AP); and rats with pulp exposure-induced apical periodontitis treated with ω-3 PUFAs (AP-O). ω-3 PUFAs were administered orally once a day for 15 days before pulp exposure and continued for 30 days after pulp exposure. The rats were sacrificed, and then blood and jaw samples were collected. Blood analysis was conducted to determine the total number of leukocytes including neutrophils, monocytes, and lymphocytes. Proinflammatory cytokines tumor necrosis factor alpha, interleukin (IL) 6, and IL-17 were quantified by enzyme-linked immunosorbent assay. Histologic analysis was performed to confirm the development of apical periodontitis. The data were statistically evaluated using analysis of variance and the Tukey posttest. The significance level was set at 5%. RESULTS: The development of apical periodontitis was confirmed in all infected groups. Bone destruction was larger in the AP group compared with the AP-O group (P < .05). Blood analysis showed that the AP and AP-O groups showed higher numbers of lymphocytes, leukocytes, monocytes, eosinophils, and expressions of tumor necrosis factor alpha and IL-6 compared with the C and C-O groups (P < .05). In contrast, the presence of leukocytes, lymphocytes, and the expression of IL-6 decreased in the AP-O group compared with the AP group (P < .05). CONCLUSIONS: ω-3 PUFA supplementation influences the systemic effects caused by apical periodontitis, decreasing the number of leukocytes, lymphocytes, and IL-6 in rat blood.

Th1/Th2/Th17/Treg Balance in Apical Periodontitis of Normoglycemic and Diabetic Rats.

INTRODUCTION: The aim of this study was to evaluate the inflammatory profile of T helper (Th) cells in normoglycemic (N) and diabetic rats with apical periodontitis (AP). METHODS: Twenty male Wistar rats were divided in 2 groups: N rats and rats with diabetes mellitus (DM). DM was induced using streptozotocin, and AP was induced by dental pulp exposure of the first mandibular molar to the oral environment. After 30 days, the mandibles were removed and processed for histologic analysis, bacterial analysis, and immunochemical assays for interleukin (IL)-6, tumor necrosis factor alpha, IL-17, IL-23, interferon gamma, and IL-10. The Mann-Whitney U test and Student t test were used for statistical analysis (P < .05). RESULTS: The DM group showed more intense inflammatory infiltrate with larger sizes of bone reabsorption and a greater presence of bacteria than the N group (P < .05). Proinflammatory cytokine levels in the DM group were also greater than those in the N group (P < .05). However, interferon gamma was more intense in the N group than in the DM group (P < .05). CONCLUSIONS: The inflammatory profile of AP in DM is different from that in the N group, suggesting that Th1 is a secondary strain and the Th17 strain is predominant in DM.

Evaluation of the relationship between obturation length and presence of apical periodontitis by CBCT: an observational cross-sectional study.

OBJECTIVE: The aim of this study was to evaluate the relationship between length of root canal obturation (RCO) and the presence of apical periodontitis (AP) in different dental groups using cone-beam computed tomography (CBCT) analysis. MATERIALS AND METHODS: A total of 392 roots with canal treatment performed for more than 4 years were evaluated using CBCT. Distances from the apex to the tip of filling material were measured and classified as more than 2 mm short of the apex, approximately 1-2 mm short of the apex, at the apex, and beyond the apex. Odds ratio, confidence interval, and the χ2 test were used for statistical analyses. RESULTS: The frequency of AP was significantly greater in molars than in the other tooth groups (p < 0.05). Moreover, RCO that ended 1-2 mm short of the apex was associated with a lower prevalence of AP in molars and premolars (p < 0.05) and in anterior teeth (p < 0.1) when compared with RCO at the apex, more than 2 mm short of the apex, or beyond the apex. When the RCO reached the apex, there was no difference in the presence of AP among dental groups (p > 0.05). CONCLUSION: The length of RCOs can influence the presence of AP, with molars showing a higher prevalence. RCOs ending 1-2 mm short of the apex are associated with an absence of AP. CLINICAL RELEVANCE: The length of obturation is related to the presence of apical peridontitis and consequently to the success of endodontic treatment.

Endodontic infections increase leukocyte and lymphocyte levels in the blood.

OBJECTIVES: The aim of this study was to determine whether the presence of single or multiple apical periodontitis (AP) alters blood cell counts and cytokine production. MATERIAL AND METHODS: Thirty rats were divided into three groups: a control group comprising rats without AP, a group called 1AP comprising rats with AP in one tooth, and a group called 4AP comprising rats with AP in four teeth. Endodontic infection was induced by pulp exposure of the first right maxillary molar in the 1AP group or by exposing the first and second right maxillary and mandibular molars in the 4AP group. A blood count and cytokine levels were obtained 30 days after infection by collecting blood by cardiac puncture. The maxillae were dissected and stained with hematoxylin and eosin to evaluate the inflammatory infiltrate. The data were tabulated and subjected to statistical analysis (P < 0.05). RESULTS: Histological analysis showed a predominance of mononuclear inflammatory cells. In blood, significant increase of leukocytes, lymphocytes, and tumor necrosis factor alpha (TNF-α) in 4AP compared with the control and 1AP groups (P < 0.05) was observed. In addition, significant decrease of interleukin-4 (IL-4) in 1AP and 4AP groups compared with the control was observed (P < 0.05). CONCLUSIONS: In the rat model, the presence of multiple AP can affect health by increasing lymphocyte and TNF-α levels in the blood. CLINICAL RELEVANCE: The presence of endodontic infections can interfere with the blood profile, altering systemic health.

Diabetes increases interleukin-17 levels in periapical, hepatic, and renal tissues in rats.

OBJECTIVES: This study aimed to evaluate the association between endodontic infection and diabetes on interleukin-17 levels in periapical, hepatic, and renal tissues of rats. DESIGN: Forty male rats were divided into groups: normoglycemic rats (N), normoglycemic rats with apical periodontitis (N-AP), rats with experimental diabetes (ED), and rats with experimental diabetes and apical periodontitis (ED-AP). Diabetes was induced by intravenous streptozotocin injection, and blood sugar levels were monitored to confirm disease development. Apical periodontitis (AP) was induced by pulp exposure to the oral environment during 30days. After 30days, hepatic and renal tissues were obtained, and IL-17 levels were quantified by ELISA. The right hemi-jaw was used to quantify IL-17 levels by immunohistochemistry. The values obtained in parametric tests were tabulated and analyzed statistically by analysis of variance (ANOVA) and Tukey tests, and the values obtained for scores were statistically analyzed by using the Kruskal-Wallis and Dun tests. The level of significance was set at 5%. RESULTS: ED and ED-AP groups expressed significantly higher IL-17 levels in both hepatic and renal tissues (p<0.05), compared to N and N-AP groups. Apical periodontitis (AP) in ED-AP group was significantly more severe than that in N-AP group (p<0.05). Furthermore, there was a significantly larger increase in the IL-17 levels in ED-AP group compared to N group (p<0.05). CONCLUSION: Our results indicate that diabetes increases IL-17 levels in hepatic and renal tissues and also enhances IL-17 production in apical periodontitis area of rats.

Oral health, diabetes, and body weight.

OBJECTIVES: The effects of apical periodontitis (AP) and periodontal disease (PD) on organ weights in rats with diabetes mellitus (DM) were evaluated. DESIGN: Eighty male rats (Rattus norvegicus albinus, Wistar) were divided into eight groups of ten: normoglycemic (N), AP, PD, AP+PD, DM, DM+AP, DM+PD, and DM+AP+PD. DM was induced by streptozotocin; AP, by dental exposure to the oral environment; and PD, by periodontal ligature. Blood glucose concentration was measured at 0, 6, 15, and 35days; body weight, measured daily; and animals were sacrificed after 30days after induction of oral infections. Liver, kidney, pancreas, brain, heart, lungs, and gonads were each weighed. Glycemia, feed intake, organ weight, and body weight were subjected to statistical analyses (p<0.05). RESULTS: Glycemic levels were higher in all diabetic groups after day 6, but were consistently similar in normoglycemic groups. Blood glucose was higher in DM+PD and DM+AP+PD groups than in the DM group at days 15 and 35. The feed intake was similar among all groups. Brain, heart, and gonad weights were significantly increased in DM+AP+PD. Kidney and lung weights were increased in DM, regardless of the presence of oral infections. Liver weight was reduced in AP and/or PD. Pancreas weight was reduced in DM, independent of AP or PD. Among the normoglycemic groups, there were no significant differences among organ weights. CONCLUSION: Apical periodontitis and periodontal disease may potentiate the adverse effects of diabetes.

Multiple Apical Periodontitis Influences Serum Levels of Cytokines and Nitric Oxide.

INTRODUCTION: This study evaluated whether apical periodontitis (AP) in a single tooth or in multiple teeth affected serum levels of inflammatory mediators and influenced blood homeostasis. METHODS: Thirty male Wistar rats were divided into 3 groups of 10 rats each: control group, healthy rats; 1AP group, rats with AP in 1 tooth; and 4AP group, rats with AP in 4 teeth. After 30 days, the rats were anesthetized, and their blood was collected through cardiac puncture to quantify tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interleukin (IL)-6, IL-17, IL-23, and nitric oxide (NO) levels. The rats were then sacrificed by administering an anesthetic overdose. Their maxillary and mandibular molars were collected and processed for histologic analysis with hematoxylin-eosin and for immunohistochemical staining of the cytokines and NO-producing enzyme nitric oxide synthase. Results of these analyses were statistically analyzed; P < .05 was considered statistically significant. RESULTS: Rats in the 1AP and 4AP groups showed increased IL-6, IL-17, IL-23, TNF-α, IFN-γ, and NO synthase expression; inflammatory cell infiltration; and moderate bone resorption in affected teeth. Serum TNF-α, IL-6, IL-17, and IL-23 levels were higher in rats in the 4AP group than in those in the control group (P < .05). Serum NO levels were significantly lower in rats in the 1AP and 4AP groups than in those in the control group (P < .05). Serum IFN-γ levels were not different among rats in the 3 groups (P > .05). CONCLUSIONS: These results suggested that AP affected blood homeostasis by altering the serum levels of inflammatory cytokines and NO.

Perfil inflamatório local e sistêmico de ratos wistar com múltiplas infecções endodônticas / Local and systemic inflammatory profile of Wistar rats with multiple endodontics infections

O objetivo deste trabalho foi colaborar com o entendimento dos mecanismos que envolvem a relação entre as infeções de origem endodôntica e o estado de homeostasia corpórea. Para isso investigamos o perfil inflamatório local da periodontite apical induzida e relacionamos com alterações no perfil sistêmico em ratos portadores de uma ou múltiplas infecções de origem endodôntica. Foram utilizados 30 ratos da linhagem Wistar distribuídos em 3 grupos de 10 animais: ratos saudáveis; 1AP – ratos com infecção endodôntica em um elemento dentário; 4AP ratos com infecções endodônticas em 4 elementos dentários. Após 30 dias, foi coletado sangue por punção cardíaca para a realização do hemograma (hemácias, volume globular, hemoglobina, VCM, CHCM, leucócitos, neutrófilos, linfócito, monócito, eosinófilo, basófilo e plaquetas); da quantificação sérica das citocinas pró-inflamatórias (TNF-α, IFN- γ, IL-6, IL-17, IL-23) por ELISA e da quantificação de óxido nítrico (NO). Após coleta sanguínea, os animais foram sacrificados, as maxilas e mandíbulas foram processadas para análise em microscopia de luz em coloração de H.E. e para marcação imunoistoquímica dos mediadores inflamatórios supracitados. Os resultados das diferentes análises e a relação entre os achados locais e sistêmicos foram analisados por testes estatísticos específicos para cada caso (p<0.05). Nas análises histológicas, foi confirmada a presença de periodontites apicais no 1AP e 4AP, com infiltrado inflamatório moderado. Além disso, foi observado aumento de todos os mediadores supracitados nas lesões quando comparado aos tecidos saudáveis (p<0.05). Nas análises séricas, foi observado aumento linfócitos, leucócitos, TNF-α, IL-6, IL-17 e IL-23 no 4AP quando comparado aos ratos saudáveis (p<0.05). Além disso, houve diminuição do NO no 1AP e 4AP quando comparados aos ratos saudáveis (p<0.05). O nível de IFN- γ não foi diferente entre os grupos (p>0.05). Conclui-se que a presença de periodontite apical em múltiplos...

The aim of this work will contribute to understanding of the mechanisms that involve the relationship between infections of endodontic origin and state of bodily homeostasis. Thus, we propose to investigate the profile of local inflammatory induced apical periodontitis and correlate with changes in the profile systemic model with a onlyl or multiple endodontic infections. It were used 30 Wistar rats divided into three groups of 10 animals each: healthy rats; 1AP - rats with only endodontic infection; 4AP rats with multiple endodontic infections. After 30 days, blood was collected by cardiac puncture for complete blood count (RBCs, packed cell volume, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration, leukocytes, neutrophil, lymphocyte, monocyte, eosinophil, basophil and platelets), serum quantification of proinflammatory cytokines (IL-17, IL-23, IL-6, TNF-α, IFN-γ) by ELISA and nitric oxide. After blood collection, the animals were killed, the jaws were processed for light microscopy in HE staining and immunohistochemical staining of inflammatory mediators above. The results of the different analyzes and the correlation between the local and systemic findings were analyzed by statistical tests specific to each case (p<0,05). Histological analysis confirmed the presence of apical periodontitis in 1AP and 4AP, with moderate inflammatory infiltrate. Furthermore, it was observed increase of all above mediators in lesions when compared to healthy tissue (p<0,05). In serum analysis, 4AP showed lymphocytes, leukocytes, TNF-α, IL-6, IL-17 and IL-23 increase when compared to healthy rats (p <0.05). Furthermore, there was a decrease of NO in 4AP and 1AP when compared to healthy rats (p<0,05). IFN-γ level was not different between the groups (p>0.05). It is concluded that the presence of apical periodontitis in multiple teeth can lead to significant alterations from increased serum lymphocytes, leukocytes and pro-inflammatory cytokines...

Apical periodontitis and periodontal disease increase serum IL-17 levels in normoglycemic and diabetic rats.

OBJECTIVES: This study aimed to evaluate the influence of apical periodontitis (AP) and/or periodontal disease (PD) on serum interleukin-17 (IL-17) levels in a rat model of diabetes mellitus (DM). METHODS: Eighty male Wistar rats were divided into eight groups of ten animals each: normoglycemic, AP, PD, AP+PD, DM, DM+AP, DM+PD, and DM+AP+PD. DM was induced using streptozotocin, AP by dental pulp exposure to the oral environment, and PD by periodontal ligature. The animals were sacrificed after 30 days, and venous blood samples were collected via cardiac puncture to determine the serum IL-17 and neutrophil levels. The maxillae were dissected and processed for radiographic analysis. The periapical lesion areas were quantified in pixels. The total assessed values were tabulated according to each experimental group and were statistically analyzed using Spearman's correlation and Kruskal-Wallis test (p < 0.05). RESULTS: A significant difference in the serum IL-17 levels was observed between the groups without oral infections and the groups with AP+PD-associated lesions, regardless of the presence of DM (p < 0.05). Diabetes increased the neutrophil levels, regardless of the presence of oral infection. However, a combination of two oral infections increased the neutrophil levels in DM rats (p < 0.05). The level of bone resorption lesions was greater in DM rats than in normoglycemic rats (p < 0.05). CONCLUSION: The combination of AP and PD increased the serum IL-17 levels in DM and normoglycemic rats and increased the neutrophil levels in DM rats. Diabetes increased the neutrophil levels and bone resorption in rats. CLINICAL SIGNIFICANCE: AP is capable of potentiating systemic inflammatory changes when associated with PD, and increases in blood glucose can accelerate the pathogenesis of oral infections.

The use of NaOCl in combination with CHX produces cytotoxic product.

OBJECTIVES: The combination of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) yields a "precipitate potentially toxic" (PPT). The aim of this study was to evaluate the tissue response to implanted polyethylene tubes filled with PPT-soaked fibrin sponge. METHODS: Forty rats received four polyethylene tubes each; each tube was filled with fibrin sponge soaked by 2.5 % NaOCl, 2.0 % CHX, PPT (2.5 % NaOCl plus 2.0 % CHX), or not soaked (control). The observation time points were 7, 15, 30, 60, and 90 days. At each time point, eight animals were killed, and the tubes and surrounding tissues were removed, fixed, and prepared for light microscopic analysis by performing glycol methacrylate embedding, serial cutting into 3-µm sections, and hematoxylin-eosin staining. Qualitative and quantitative evaluations of the reactions were performed. Results were statistically analyzed by Kruskal-Wallis test (p < 0.05). RESULTS: All chemical solutions caused moderate reactions at 7 days. On day 30, PPT group was more cytotoxic than the control group and the CHX group (p < 0.05). On days 15 and 60, PPT group was more cytotoxic than the control group (p < 0.05). On day 90, there was no statistically significant difference between the different groups. CONCLUSION: PPT is more cytotoxic than NaOCl and CHX alone, particularly in the short term. CLINICAL SIGNIFICANCE: Protocols which suggest the use of CHX and NaOCl must be revised because this mixture produces cytotoxic product.

Combined therapy with mineral trioxideaggregate, and guided tissue regeneration for a large radicular cyst: a 13-year follow-up

Biomaterials such as membrane barriers and/or bone grafts are often used to enhance periapical new bone formation. A combination of apical surgery and these biomaterials is one of the latest treatment options for avoiding tooth extraction. In case of periapical lesions, guided tissue regeneration (GTR) is attempted to improve the self-regenerative healing process by excluding undesired proliferation of the gingival connective tissue or migration of the oral epithelial cells into osseous defects. In many cases, GTR is necessary for achieving periodontal tissue healing. This report describes the healing process after surgery in a challenging case with a long-term followup. In this case report, endodontic surgery was followed by retrograde sealing with mineral trioxide aggregate (MTA) in the maxillary right central incisor and left lateral incisor. Apicectomy was performed in the maxillary left central incisor and a 1-mm filling was removed. The bone defect was filled with an anorganic bone graft and covered with a decalcified cortical osseous membrane. No intraoperative or postoperative complications were observed. After 13 years of follow-up, the patient showed no clinical signs or symptoms associated with the lesion and radiographic examination showed progressive resolution of radiolucency. In conclusion, the combination of apical surgery and regenerative techniques can successfully help the treatment of periapical lesions of endodontic origin and is suitable for the management of challenging cases.

Biocompatibility and biomineralization assessment of a new root canal sealer and root-end filling material.

OBJECTIVE: This study investigated the short-term subcutaneous tissue reaction and biomineralization ability of two epoxy-based root canal sealers containing calcium hydroxide (MBP and MBPc) and ProRoot MTA. MATERIALS AND METHODS: Polyethylene tubes containing the materials were implanted into the dorsal connective tissue of Wistar rats (n = 52) for 7 or 30 days; empty implanted tubes served as controls. Specimens were stained with hematoxylin-eosin and von Kossa stain or left unstained for observation under polarized light. Qualitative and quantitative evaluations of all tissue reactions were performed. One-way anova and the Kruskal-Wallis test were used for statistical analysis (P < 0.05). RESULTS: No significant differences were observed among the groups. All three materials induced mild-to-moderate tissue reactions at 7 days, which decreased over time. Dystrophic mineralization and birefringent structures were observed only in the ProRoot MTA (®) group. CONCLUSION: Both MBP and MBPc appear to be biocompatible but do not stimulate biomineralization.

Influência da infecção endodôntica e/ou periodontal associadas à diabetes na quantificação sérica da citocina pró-inflamatória IL-17 e na glicemia de ratos Wistar / Influence of endodontic infection and/or periodontal associated with diabetes in serum levels proinflammatory cytokine IL-17 and on glycemia in Wistar rats

O objetivo deste trabalho foi avaliar a influência da periodontite apical e/ou doença periodontal associadas à diabetes na quantificação sérica da citocina pró-inflamatória IL-17 e na glicemia. Foram utilizados 80 ratos da linhagem Wistar divididos em 8 grupos de 10 ratos: G1 - ratos normoglicêmicos ; G2 - ratos com infecção endodôntica; G3 - ratos com infecção periodontal; G4 - ratos com infecção endodôntica e periodontal; G5 - ratos diabéticos; G6 - ratos diabéticos com infecção endodôntica; G7 - ratos diabéticos com infecção periodontal; G8 - ratos diabéticos com infecção endodôntica e periodontal. A diabetes foi induzida pela aplicação de estreptozotocina via veia peniana, cujo desenvolvimento da doença foi confirmado no sexto e último dia do experimento pela avaliação glicêmica no sangue por meio de uma punção na extremidade da cauda do animal, seguida de pequena compressão para a obtenção de uma gota de sangue. A infecção endodôntica foi induzida pela exposição pulpar do primeiro molar superior direito. A infecção periodontal foi induzida por meio da confecção de uma amarria junto ao colo dentário do segundo molar superior esquerdo. Com 30 dias pós-operatórios foi realizada a glicemia novamente e a coleta de sangue pela punção cardíaca para a quantificação da citocina IL-17 empregando a técnica de ELISA de captura. Os resultados foram analisados do pelo teste de análise de variância e teste de Tukey (p<0,05). O nível glicêmico foi maior em ratos diabéticos quando comparados com ratos controle aos 6 e 30 dias (p<0,05). Entretanto, aos 30 dias nos grupos de ratos diabéticos, observou-se que a presença da infecção periodontal isolada (G7) ou associada à endodôntica (G8) aumentou de forma significante a glicemia quando comparado com os ratos diabéticos sem infeções orais (G5) (p<0,05). A presença da doença sistêmica diabetes e da periodontite apical ou doença periodontal isoladas não foram capazes de elevar o nível sérico de IL-17 (p<0,05)...

The aim of the study was to evaluate the influence of periapical lesions and/or periodontal disease on the IL-17 serum and dosage glycemic a rat model of diabetes mellitus. Eighty male Wistar rats were divided into eight groups of ten animals each: normal rats (G1), rats with pulpal infection (G2), rats with periodontal disease (G3), rats with pulpal infection and periodontal disease (G4), diabetic rats (G5), diabetic rats with pulpal infection (G6), diabetic rats with periodontal disease (G7), diabetic rats with pulpal infection and periodontal disease (G8). Diabetes was induced using streptozotocin, pulpal infection were induced by dental pulp exposure to the oral environment and the periodontal disease by periodontal ligature. Blood glucose was measured by means of a perforation in the tail of the animal after 0, 6 and 30 days post-operative. The animals were sacrificed after 30 days and the IL-17 levels were measured by ELISA. The total assessed values was tabulated according to each experimental group and statistically analyzed by analysis of variance (ANOVA) followed by Tukey test (p<0.05). Glucose levels were higher in diabetic rats compared to control rats at 6, and 30 days (p <0.05). However, at 30 days, and among the groups of diabetic rats, it was observed that the presence of periodontal infection alone (G7) or associated with endodontic (G8) increased significantly the blood glucose compared to diabetic rats without oral infections (G5 ) (p <0.05). The presence of systemic disease diabetes was not able to increase the level of serum IL-17 (p <0.05). However, the presence of the associated oral infections (G4, G8) significantly elevated the serum level of IL-17, regardless of the presence of diabetes (p <0.05). It can be concluded that the endodontic infection when associated with periodontal disease may increase blood glucose levels in diabetic rats and the serum level of IL-17 in normoglycemic or diabetic rats...