Genetic Polymorphism and Expression of Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases in Periapical Lesions: Systematic Review.

INTRODUCTION: Recent studies involving genetic polymorphism and expression have provided information about their role in periapical lesions. This study aimed to evaluate if there is an association between the genetic polymorphism and gene and protein expressions of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in the periapical inflammatory response. METHODS: A systematic review was conducted through a rigorous search in electronic databases as well as a hand search. Two reviewers (κ = 0.90) evaluated the studies considering predetermined eligibility criteria, extracted data for interpretation, and finally used the Strengthening the Reporting of the Genetic Association statement to determine the quality of the scientific evidence. RESULTS: The initial search identified 251 studies. After excluding the duplicates and applying the eligibility criteria, 15 studies were eligible to be assessed in full. Two studies had grade A and 13 grade B quality according to the Strengthening the Reporting of the Genetic Association and were included. The selected studies showed that the periapical lesion tissue samples had a high concentration of MMPs; moreover, there was an expressive decrease in the concentration of MMPs and TIMPs in patients with periapical lesions after mechanical chemical preparation. In relation to genetic polymorphisms, MMP1, MMP2, MMP3, and MMP8 were associated with a higher risk of periapical lesions. Moreover, MMPs 1, 2, 3, 7, 8, 9, 13, 14, 16, and 25 and TIMP 1, 2, 3, and 4 can play an important role in the progression of periapical lesions. CONCLUSIONS: Based on articles with medium to high quality, MMPs and TIMPs are associated with the formation of periapical lesions (PROSPERO number: CDR42018100406).

Apical debris extrusion during instrumentation with continuous and reciprocating systems

Objective: to evaluate the amount of apical debris extrusion during root canal preparation using continuous and reciprocating systems. Material and Methods: Forty lower incisors were selected and randomly divided into four groups (n=10) for root canal preparation. Two multifile systems with continuous rotation (iRace® and Mtwo®) and two reciprocating single-file systems (Reciproc® and WaveOne®) were used. In the iRace® group, the R1 (15/.06), R2 (25/.04) and R3 (30/.04) instruments were used. In the Mtwo® group, the 10/.04, 15/.05, 20/.06, and 25/.06 instruments were used. In the Reciproc® and WaveOne® groups, the R25 and 25/.04 instruments were used, respectively. Apical debris extrusion was determined by calculating the difference between the pre- and post-instrumentation weight of the Eppendorf tubes. Statistical analysis was performed using the analysis of variance (ANOVA) test with the Bonferroni correction (p<0.05). Results: The iRace® group demonstrated significantly more apical extrusion than the Reciproc® group (p<0.05). There was no statistically significant difference between the Mtwo®, Reciproc®, and WaveOne® groups (p>0.05). Conclusion: All of the evaluated systems produced apical debris extrusion. The iRace® system produced more apical debris extrusion than the Reciproc® system, and there was no difference observed in this regard between the Mtwo®, Reciproc®, and WaveOne® systems.

Objetivo: avaliar a quantidade de debris extruidos apicalmente durante o preparo do canal radicular usando sistemas de rotação contínua e reciprocante. Materiais e Métodos: Quarenta incisivos inferiores foram selecionados e randomicamente divididos em quatro grupos (n=10) para o preparo do canal radicular. Dois sistemas de limas múltiplas de rotação contínua (iRace® e Mtwo®) e dois sistemas de limas únicas reciprocantes (Reciproc® e WaveOne®) foram usados. No grupo iRace®, foram utilizados os instrumentos R1 (15/.06), R2 (25/.04) e R3 (30/.04). No grupo Mtwo®, foram utilizados os instrumentos 10/.04, 15/.05, 20/.06, 25/.06. Nos grupos Reciproc® e WaveOne®, foram utilizados os instrumentos R25 e 25.04, respectivamente. A extrusão apical de debris foi calculada pela diferença entre os pesos dos tubos Eppendorf antes e após a instrumentação. A análise estatística foi feita usando o teste de análise de variância (ANOVA) seguida do teste de Bonferroni (p<0,05). Resultados: O grupo iRace® demonstrou significativamente mais extrusão quando comparado ao Reciproc (p<0,05). Não houve diferença estatisticamente significativa entre os grupos Mtwo®, Reciproc®, e WaveOne® (p>0,05). Conclusão: Todos os sistemas avaliados produziram extrusão apical de debris. O Sistema iRace® produziu mais extrusão apical de debris do que o Sistema Reciproc® e não foi observada diferença entre os sistemas Mtwo®, Reciproc® e WaveOne®.

Extrusão apical de debris após o uso de um instrumento reciprocante e uso suplementar de instrumento com liga MaxWire / Apically Extruded Debris Using Reciprocating Single File and Additional Use of MaxWire Allow File

Objetivo: O objetivo deste estudo foi avaliar a quantidade de debris extruídos apicalmente após o preparo do canal com o WaveOne Gold e o uso suplementar do instrumento XP-Endo Finisher. Material e Métodos: Quarenta pré-molares humanos com canal único foram selecionados e divididos em dois grupos (n = 20): preparo com instrumento WaveOne Gold e preparo com instrumento WaveOne Gold + XP-Endo Finisher. Os canais radiculares foram instrumentados seguindo as instruções do fabricante e a água destilada foi usada como irrigante. Debris extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pesados previamente em balança analítico. O peso dos detritos extruídos foi estabelecido subtraindo-se o peso pré-instrumentação e pós-instrumentação dos tubos Eppendorf para cada grupo. Resultados: Os dados foram analisados pelos testes de Shapiro-Wilk e Mann-Whitney, com nível de significância de 5%. Não houve diferença significativa entre os grupos (p = 0,66) em relação à quantidade debris extruídos apicalmente. Conclusão: A presença de debris extruídos apicalmente ocorreu nos dois grupos; no entanto, o uso adicional do instrumento XP-Endo Finisher não contribuiu para o aumento significativo da extrusão apical de detritos quando comparado ao uso isolado do instrumento WaveOne Gold.

Objective: the aim of this study was to evaluate the amount of apically extruded debris after the preparation with WaveOne Gold and additional use of XP-Endo Finisher file. Material and Methods: Forty human one-rooted premolars were selected and divided into two groups (n=20): WaveOne Gold and WaveOne Gold and XP-Endo finisher. Subsequently, the root canals were instrumented following the manufacturer's instructions and distilled water was used as irrigant. Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and postinstrumentation weight of the Eppendorf tubes for each group. Results: The data were analyzed using Shapiro-Wilk and Mann-Whitney tests, with significant level of 5%. There was no significant difference between groups (p=0.66) in relation to apically extruded debris. Conclusion: apically extruded debris occurred in both groups; however, the additional use of the XP-Endo Finisher instrument did not contribute to the significant increase of apical extrusion of debris when compared to the isolated use of WaveOne Gold