Biomaterials in periapical regeneration after microsurgical endodontics: A narrative review.

BACKGROUND: The objective of this narrative review was to analyze the available scientific evidence regarding the application of biomaterials in endodontic microsurgery and its influence in post-surgical tissue repair. MATERIAL AND METHODS: The review question was Do biomaterials used in endodontic microsurgery influence post-surgical tissue repair and regeneration? Systematic MEDLINE/PubMed review was used to evaluate and present the results. RESULTS: The search yielded 131 references, 82 of which were selected for full text review after reading the abstracts. After a manual search in the references of the articles selected, 52 references were eliminated. Finally, 30 articles were selected. CONCLUSIONS: Bone grafts, membranes and bioceramics, especially MTA, are biomaterials with the ability to stimulate periapical tissue regeneration. This is one of many reason why bioceramics are the best choice as retrograde sealing materials. However, microsurgically treated periapical lesions can heal completely without the need to use bone grafts or membranes. Those techniques are indicated in endodontic microsurgery when additional stimulation of tissue regeneration is required, or when bone collapse needs to be prevented. Key words:Bioactive endodontic cements, endodontic surgery, periapical repair.

Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis.

AIM: This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). METHODS: The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. RESULTS: Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth-4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07-1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. CONCLUSIONS: Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.

Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis.

AIM: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. MATERIAL AND METHODS: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. RESULTS: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17-10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. CONCLUSIONS: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.

Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia.

Fibromyalgia is a chronic pain syndrome with unknown etiology. Recent studies have shown some evidence demonstrating that oxidative stress, mitochondrial dysfunction and inflammation may have a role in the pathophysiology of fibromyalgia. Despite several skin-related symptoms accompanied by small fiber neuropathy have been studied in FM, these mitochondrial changes have not been yet studied in this tissue. Skin biopsies from patients showed a significant mitochondrial dysfunction with reduced mitochondrial chain activities and bioenergetics levels and increased levels of oxidative stress. These data were related to increased levels of inflammation and correlated with pain, the principal symptom of FM. All these parameters have shown a role in peripheral nerve damage which has been observed in FM as a possible responsible to allodynia. Our findings may support the role of oxidative stress, mitochondrial dysfunction and inflammation as interdependent events in the pathophysiology of FM with a special role in the peripheral alterations.

Clinical symptoms in fibromyalgia are associated to overweight and lipid profile.

In order to analyze the association between body mass index (BMI), lipid profile and clinical symptoms in patients with fibromyalgia, we assessed BMI levels, lipid profile and its association with clinical symptoms in 183 patients with fibromyalgia. The patients were evaluated using tender points, FIQ and Visual Analogue Scales of pain (VAS). Serum lipid profile analysis (total cholesterol, triglyceride, HDL, LDL and VLDL), and biochemical parameters were measured in the biochemistry laboratory. The BMI distribution of the nonobese, overweight and obese patients' groups were relatively even with 37.7, 35.5 and 26.8%, respectively, with a mean BMI of 27.3 ± 4.9. The number of tender points showed significantly positive correlation with higher BMI (P < 0.05). A total of 57.9% of patients showed increased levels of total cholesterol, 63.4 % increased levels of LDL cholesterol and 19.9% high levels of triglycerides. BMI, total cholesterol and triglycerides showed high association with some clinical parameters. Overweight and lipid profile could be associated with fibromyalgia symptoms. A treatment program with weight loss strategies, and control in diet and increased physical activity is advised to patients.

Coenzyme Q10 in salivary cells correlate with blood cells in Fibromyalgia: improvement in clinical and biochemical parameter after oral treatment.

OBJECTIVE: We have determined Coenzyme Q(10) (CoQ(10)) levels in salivary cells (SCs) and mononuclear blood cells (BMCs) from Fibromyalgia (FM), and we study the influence of oral CoQ(10) supplementation on cells levels and clinical symptoms. METHODS: CoQ(10) was determined by high-performance liquid chromatography (HPLC). Ten patients were supplemented daily with 300 mg of CoQ(10) during 3 months. RESULTS: CoQ(10) were reduced in both cell models. Oral supplementation showed an improvement in clinical symptoms and restored levels. CONCLUSIONS: Patients with FM showed an important dysfunction in CoQ(10) levels and might benefit from oral supplementation.

Utility of Periodontal exploration in patients with Fibromyalgia.

OBJECTIVE: [corrected] Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology, which affects predominantly women. Mitochondrial alteration could have a role in the pathophysilogical mechanisms of inflammatory conditions as FM and periodontitis. The aim of the present study was assay the relationship between both diseases and mitochondrial dysfunction. PATIENT AND METHODS: We study the presence of periodontitis in twelve patients diagnosed of FM and mitochondrial dysfunction described. The diagnosis of FM was established according to ACR criteria and clinical symptoms were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI). RESULTS: Only one patients of twelve included and agreed to participate in the study were diagnosed with periodontitis. CONCLUSIONS: Pending studies with larger numbers of patients, we can conclude that mitochondrial dysfunction in FM is a itself event not related with periodontitis. Periodontitis could be considered a exclusion criterion in all studies about mitochondrial dysfunction in patients. Key words:Peridontitis, fibromyalgia, mitocondrial dysfunction, oxidative stress.