Biological investigation of resinous endodontic sealers containing calcium hydroxide.

The purpose of this study was to evaluate, in vivo, the biocompatibility, biomineralization, collagen maturation and the in vitro antibacterial and cytotoxicity of resinous endodontic sealers containing calcium hydroxide. Forty rats were implanted with polyethylene tubes containing Sealer 26, Sealer Plus, Dia-ProSeal and an empty tube, examined after 7, 15, 30 and 60 days. Antimicrobial activity was evaluated against Enterococcus faecalis by Agar Diffusion Test (ADT) through inhibition zones. For cytotoxicity, undifferentiated pulp cells (OD-21) were cultured and assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, exposed to dilution of serial extracts at 6, 24, 48h. Cytotoxicity was analyzed by two-way ANOVA and Bonferroni correction. Kruskal-Wallis test followed by Dunn test was performed for nonparametric data (p<0.05). MTT assay revealed cell proliferation affected by sealers extract in all periods (p<0.0001), except for Dia-Proseal and Sealer Plus ⅛ dilution. Subcutaneous analysis showed at day 7th moderate inflammatory infiltration. After 30 days, Sealer 26 still showed moderate inflammatory infiltrate compared to mild inflammation from control and Dia-ProSeal (p = 0.006). At day 60th, all groups showed similar mild inflammatory infiltrate (p>0.05). Sealer 26 induced more biomineralization than other sealers in all periods. At 7 and 15 days, all sealers had significant percentage of immature collagen fibers. After 60 days Sealer 26 showed more mature fibers compared to other sealers (p<0.001). All sealers had a smaller zone of inhibition than chlorhexidine, but with no significant difference among any group (p>0.05). All sealers showed satisfactory biological responses with in vitro/in vivo biocompatibility and antimicrobial activity against planktonic bacteria. Sealer 26 induced more biomineralization than Sealer Plus and Dia-ProSeal.

Effect of two methods of irrigant agitation on the temperature and cleanliness of sodium hypochlorite associated or not with a chelator: irrigant agitation and influence in temperature

Aim: This study investigated the influence in vitro of different sodium hypochlorite (NaOCl) agitation protocols associated or not with DualRinse (HEDP) on the temperature of the solution. Methods: Forty-eight premolars were instrumented and their apical third sealed to allow a closed irrigation system. The teeth remained immersed in a basin of warm water (37°C). The teeth were divided into the groups: G1 (NaOCl+Passive Ultrasonic Irrigation (PUI)), G2 (NaOCl/HEDP + PUI), G3 (NaOCl + EasyClean (EC)) and G4 (NaOCl/HEDP + EC). The canals were filled with the respective solutions and after 180 seconds the first temperature measurement was taken (T0). Then, the solutions were agitated, following the different protocols, for 60 seconds and a new measurement was performed (T60). The temperature was measured using a digital thermometer for type "K" sensors that was inserted into the middle third of the teeth. At the end of the measurements, the teeth were sectioned and prepared for scanning electron microscopy. The dentinal wall of middle third was graded according to the amount of debris and smear layer remaining on the walls. The results were analyzed using ANOVA test and Tukey's multiple comparisons (p<0.05). Results: G1 and G2 had an average increase in temperature of 1.1°C and 1.65°C, respectively (p>0.05). EasyClean caused a decrease in the temperature of the solutions in both groups, without a significant statistical difference with T0 (p>0.05). Regarding cleaning, it was only possible to observe clean dentinal tubules in the groups with the chelator. PUI discretely increased the temperature of the solution, regardless of the solution. The opposite effect was observed after activation with EasyClean. Conclusion: The association of NaOCl with a chelating agent promoted the cleaning of the dentinal tubules

Effect of nonsteroidal anti-inflammatory drugs (NSAIDs) association on physicochemical and biological properties of tricalcium silicate-based cement

Abstract The aim of this study was to investigate the physicochemical and biological properties of an experimental tricalcium silicate-based repair cement containing diclofenac sodium (CERD). For the physicochemical test, MTA, Biodentine and CERD were mixed and cement disc were prepared to evaluate the setting time and radiopacity. Root-end cavity were performed in acrylic teeth and filled with cements to analyze the solubility up to 7 days. Polyethylene tubes containing cements were prepared and calcium ions and pH were measured at 3h, 24h, 72h and 15 days. For the biological test, SAOS-2 were cultivated, exposed to cements extracts and cell proliferation were investigated by MTT assay at 6h, 24h and 48h. Polyethylene tubes containing cements were implanted into Wistar rats. After 7 and 30 days, the tubes were removed and processed for histological analyses. Parametric and nonparametric data were performed. No difference was identified in relation to setting time, radiopacity and solubility. Biodentine released more calcium ion than MTA and CERD; however, no difference between MTA and CERD were detected. Alkaline pH was observed for all cements and Biodentine exhibited highest pH. All cements promoted a raise on cell proliferation at 24h and 48h, except CERD at 48h. Biodentine stimulated cell metabolism in relation to MTA and CERD while CERD was more cytotoxic than MTA at 48h. Besides, no difference on both inflammatory response and mineralization ability for all cement were found. CERD demonstrated similar proprieties to others endodontic cements available.

Resumo O objetivo deste estudo foi investigar as propriedades físico-químicas e biológicas de um cimento reparador experimental à base de silicato de tricálcio contendo diclofenaco de sódio (CERD). Para o teste físico-químico, MTA, Biodentine e CERD foram manipulados e discos de cimentos foram preparados para avaliar o tempo de presa e a radiopacidade. Retrocavidades foram feitas em dentes de acrílico e preenchidas com cimentos para análise de solubilidade por 7 dias. Tubos de polietileno contendo cimentos foram preparados e os íons cálcio e o pH foram mensurados às 3h, 24h, 72h e 15 dias. Para o teste biológico, SAOS-2 foram cultivadas, expostas aos extratos de cimentos e a proliferação celular foi investigada pelo ensaio de MTT às 6h, 24h e 48h. Tubos de polietileno contendo cimentos foram implantados em ratos Wistar. Após 7 e 30 dias, os tubos foram removidos e processados para análises histológicas. Dados paramétricos e não paramétricos foram realizados. Nenhuma diferença foi identificada em relação ao tempo de presa, radiopacidade e solubilidade. Biodentine liberou mais íons de cálcio do que MTA e CERD; no entanto, nenhuma diferença entre MTA e CERD foi detectada. O pH alcalino foi observado para todos os cimentos e o Biodentine exibiu o pH mais alto. Todos os cimentos promoveram aumento na proliferação celular às 24h e 48h, exceto o CERD às 48h. Biodentine estimulou o metabolismo celular em relação ao MTA e CERD, enquanto CERD foi mais citotóxico do que MTA em 48h. Além disso, nenhuma diferença foi encontrada na resposta inflamatória e na capacidade de mineralização para todos os cimentos. CERD demonstrou propriedades semelhantes a outros cimentos endodônticos disponíveis.

Effect of nonsteroidal anti-inflammatory drugs (NSAIDs) association on physicochemical and biological properties of tricalcium silicate-based cement.

The aim of this study was to investigate the physicochemical and biological properties of an experimental tricalcium silicate-based repair cement containing diclofenac sodium (CERD). For the physicochemical test, MTA, Biodentine and CERD were mixed and cement disc were prepared to evaluate the setting time and radiopacity. Root-end cavity were performed in acrylic teeth and filled with cements to analyze the solubility up to 7 days. Polyethylene tubes containing cements were prepared and calcium ions and pH were measured at 3h, 24h, 72h and 15 days. For the biological test, SAOS-2 were cultivated, exposed to cements extracts and cell proliferation were investigated by MTT assay at 6h, 24h and 48h. Polyethylene tubes containing cements were implanted into Wistar rats. After 7 and 30 days, the tubes were removed and processed for histological analyses. Parametric and nonparametric data were performed. No difference was identified in relation to setting time, radiopacity and solubility. Biodentine released more calcium ion than MTA and CERD; however, no difference between MTA and CERD were detected. Alkaline pH was observed for all cements and Biodentine exhibited highest pH. All cements promoted a raise on cell proliferation at 24h and 48h, except CERD at 48h. Biodentine stimulated cell metabolism in relation to MTA and CERD while CERD was more cytotoxic than MTA at 48h. Besides, no difference on both inflammatory response and mineralization ability for all cement were found. CERD demonstrated similar proprieties to others endodontic cements available.

Influence of the Vehicle on the Tissue Reaction and Biomineralization of Fast Endodontic Cement

ABSTRACT Objective: To investigate the tissue response and the biomineralization ability of CER prepared with epoxy resin or water compared to Mineral Trioxide Aggregate (MTA). Material and Methods: Polyethylene tubes containing materials or empty tubes for control were inserted into the subcutaneous tissues of 30 rats. After 7, 15, 30, 60, and 90 days, the rats were killed and the tubes were removed for analysis using hematoxylin-eosin staining, von Kossa staining, and under polarized light. Inflammation was graded through a score system; the thickness of the fibrous capsule was classified as thin or thick; the biomineralization ability was recorded as present or absent. The results were statistically analyzed using the Kruskal-Wallis test (p<0.05). Results: Histologic analysis performed after 7 and 15 days for CER prepared with epoxy resin or water and for MTA showed moderate inflammation and a thick fibrous capsule (p>0.05). After 30, 60, and 90 days, mild inflammation, and a thin fibrous capsule were observed in all groups (p>0.05). Conclusion: All materials had structures positive for von Kossa and birefringent to polarized light. CER epoxy resin showed biocompatibility and biomineralization similar to CER water and MTA.

Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1ß and TNF-α promoted by a new bioceramic cement.

Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA. Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1ß and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in µm2 and semiquantitative immunolabeling analyses of IL-1ß and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level. Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1ß and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05). Conclusion BIO-C PULPO was biocompatible and induced mineralization similar to MTA.

Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1β and TNF-α promoted by a new bioceramic cement

Abstract Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA. Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1β and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in μm2 and semiquantitative immunolabeling analyses of IL-1β and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level. Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1β and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05). Conclusion BIO-C PULPO was biocompatible and induced mineralization similar to MTA.

Cytotoxicity, Biocompatibility and Biomineralization of a New Ready-for-Use Bioceramic Repair Material.

New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and » dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the » dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials' cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

Cytotoxicity, biocompatibility and biomineralization of a new ready-for-use bioceramic repair material

Abstract New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and » dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the » dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials' cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

Resumo Novas formulações de agregado de trióxido mineral (MTA) são constantemente introduzidas no mercado, geralmente em forma de pó e líquido. O Biocerâmico (Bio-C) Reparador (Repair) é um material pronto para uso sugerido como substituto do MTA, mas suas propriedades precisam ser estudadas. Este estudo avaliou a citotoxicidade, biocompatibilidade e biomineralização do Bio-C Repair comparado ao MTA-High Plasticity (MTA-HP) e MTA branco da Angelus (MTA-Ang). Fibroblastos L929 foram expostos a extratos dos materiais (não diluído, ½ e » diluições; 6, 24 e 48 h). Tubos de polietileno contendo os materiais ou vazios (controle) foram implantados no tecido subcutâneo de ratos. Após 7 e 30 dias (n=8), os espécimes foram removidos para análises (hematoxilina-eosina, von Kossa e luz polarizada). Os dados da citotoxicidade foram analisados estatisticamente pelo teste de two-way ANOVA, e os dados da biocompatibilidade pelos testes de Kruskal-Wallis e Dunn (p<0,05). As células expostas aos materiais apresentaram maior viabilidade celular na maior parte dos períodos, comparados com o controle (p<0,05). O extrato não diluído e ½ diluição do MTA-HP apresentaram maior citocompatibilidade do que Bio-C Repair às 6h, e com » diluição às 24h (p<0,05); o MTA-Ang branco apresentou maior citocompatibilidade do que o Bio-C Repair na maior parte dos períodos (p<0,05). O extrato não diluído do MTA-Ang branco apresentou maior citocompatibilidade às 6 e 24 h comparado ao MTA-HP, e com ½ diluição às 24h (p<0,05). A citocompatibilidade dos materiais foi semelhante às 48 h para a maior parte das diluições (p>0,05). Aos 7 e 30 dias, os grupos apresentaram inflamação moderada e leve, respectivamente (p>0,05). Todos os materiais mostraram estruturas positivas para von Kossa e luz polarizada. Em conclusão, o Bio-C Repair teve citocompatibilidade semelhante aos materiais à base de MTA, é biocompatível e induz à biomineralização.

Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials.

Endodontic medicine, which addresses the bidirectional relationship between endodontic infections and systemic diseases, has gained prominence in the field of endodontics. There is much evidence showing that while systemic disease may influence the pathogenesis of endodontic infection, endodontic infection can also cause systemic alterations. These alterations include more severe bone resorption and inflammation in the periapical area as well as enhanced systemic disease symptoms. Similarly, many reports have described the impact of systemic diseases on the tissue responses to dental materials. Conversely, the local use of dental materials may show systemic effects in the form of altered production of biomarkers. Thus, studies to better understand the mechanisms related to those connections are extremely important. In this context, the objective of this review was to analyze and discuss the current literature regarding the connections among these three factors-systemic diseases, endodontic infection, and endodontic dental materials-and determine how these connections may interfere in the systemic health status and the endodontic treatment outcomes, which are represented by periapical wound healing.

Factors affecting the periapical healing process of endodontically treated teeth.

Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.

Factors affecting the periapical healing process of endodontically treated teeth

Abstract Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.

Rat tissue reaction and cytokine production induced by antimicrobial photodynamic therapy.

BACKGROUND: The antimicrobial photodynamic therapy (aPDT) inactivates the target cell via reactions among the photosensitizer (PS), Laser or Led and O2. The aim of this study was to evaluate the tissue reaction and cytokine production promoted by aPDT with curcumin photosensitizer. METHODS: Polyethylene tubes containing saline solution (control), 5% sodium hypochlorite (NaOCl) and aPDT with curcumin PS 500mg/L, were implanted into dorsal connective tissue of Wistar rats. After 7, 15, 30, 60 and 90days of implantation, the animals were euthanized and the tubes with surrounding tissues were removed. The specimens were divided in two part, one half was processed, fixed and prepared for histological analysis by staining with hematoxylin and eosin. The other half was collected for IL-1ß and IL-6 cytokine production using ELISA assay. The results were statistically analyzed by Kruskal-Wallis test followed by Dunn test (p<0.05) for tissue reaction and ANOVA followed by Bonferroni's correction (p<0.05) for ELISA. RESULTS: All groups showed severe tissue reactions at 7days, whilst a significantly decrease by time was observed. Regarding to cytokine production, aPDT increases the IL-1ß levels in all periods of time (p<0.05). However, for IL-6 levels, the highest value was observed with aPDT on the 90th day (p<0.05). CONCLUSIONS: aPDT with curcumin PS 500mg/L demonstrated biocompatibility similar to saline solution and induced the IL-1ß and IL-6 cytokines production.

Análise de propriedades biológicas do MTA em condição normal e hiperglicêmica / Analysis of biological properties of MTA in normal and hyperglycemic conditions

O objetivo deste estudo foi analisar as propriedades biológicas do MTA em condição normal e hiperglicêmica. Para tanto, esse trabalho foi dividido em duas partes, sendo que a primeira teve como objetivo avaliar o efeito do MTA no processo de reparo do Ligamento Periodontal (PDL) e na diferenciação de células mesenquimais progenitoras do PDL (PDSCs) e da Medula Óssea (BMSCc) após injuria dental. Uma perfuração na região de furca do primeiro molar superior de camundongos transgênicos (αSMACreERT2/Ai9/Col2.3GFP) foi realizada e os efeitos do MTA após 2, 17 e 30 dias de lesão, foram examinados e comparados com resina composta (AS) utilizando análise histológica e epifluorescência. Além disso, BMSCs e PDSCs desses camundongos foram isoladas, cultivadas e os efeitos do MTA na proliferação celular e diferenciação osteogênica foram avaliados. Os resultados indicaram que o MTA promoveu a regeneração do PDL e do osso alveolar na área da injuria dental. No entanto, demonstrou efeitos negativos na diferenciação osteogênica de PDSCs e BMSCc. A segunda parte, teve como objetivo avaliar a influência da Diabetes Mellitus na proliferação celular, produção de citocinas, resposta tecidual, capacidade de mineralização e na expressão local e sistêmica de marcadores ósseos. Para alcançar esses objetivos, células de linhagem fibroblásticas L929 foram cultivadas em alta concentração de glicose e a influência do MTA na proliferação celular e na produção de citocinas das IL-1ß, IL-6 e TNF-α foram observados às 6, 24, 48 e 72 horas; tubos de polietileno foram implantados no tecido subcutâneo de ratos normais e diabéticos (induzidos pelo Aloxano) e a influência do MTA na resposta tecidual, produção de citocinas e na capacidade de mineralização em condição diabética foram observadas através de técnicas histológicas e imunoistoquímicas aos 07 e 30 dias; analises bioquímicas para Cálcio, Fósforo e Fosfatase Alcalina e imunoistoquímica para osteocalcina e osteopontina, aos 07 e 30 dias, também foram realizadas com a finalidade de verificar a influência do MTA na expressão local e sistêmica de marcadores ósseos. O quadro hiperglicêmico promoveu, in vitro, um aumento da produção de IL-6 e comprometeu a proliferação celular após 72hs. Independente da condição diabética, a resposta tecidual e a capacidade de produção de IL-1ß, IL-6 e TNF-α de ambos MTA não foi alterada, embora uma redução na intensidade de fluorescência do MTA Branco foi observada aos 14 dias em animais diabéticos. Por outro lado, o quadro hiperglicêmico inibiu a produção local de osteocalcina e osteopontina na presença dos dois MTA e aumentou os níveis séricos de Fósforo e Fosfatase Alcalina. Assim, concluiu-se que, o MTA promoveu a regeneração do PDL e do osso alveolar na área da injuria dental, contudo, apresentou um efeito negativo com relação à diferenciação osteogênica e, que em condições hiperglicêmicas, o MTA Cinza melhores resultados biológicos quando comparado ao MTA Branco(AU)

The aim of this study was to analyze the biological properties of MTA in normal and hyperglycemic conditions. Therefore, this study were divided into two parts; the first part aim was to evaluate MTA effect on healing of periodontal ligament (PDL) and differentiation of mesenchymal progenitor cells in PDL (PDSCs) and bone marrow stromal cells (BMSCc) following dental injury. Perforation on the pulp floor in the furcation area in the first maxillary molars of transgenic mice (αSMACreERT2/Ai9/Col2.3GFP) were performed and the effects of MTA after 2, 17, 30 days of injury, were examined and compared to AS using histological and epifluorescence analysis. Additionally, BMSCs and PDSCs from these mice were isolated, cultured and the effects of MTA on cell proliferation and osteogenic differentiation were evaluated. The results indicated that MTA promoted regeneration of injured PDL and alveolar bone in the area of dental injury. However, it has demonstrated negative effects on the osteogenic differentiation of PDSCs and BMSCs. The aim of second part was to evaluate the influence of Diabetes Mellitus on cell proliferation, cytokine production, tissue response, mineralization ability and local and systemic expression of bone markers. To achieve these goals, L929 fibroblasts cell line were cultured under high glucose concentration and the influence of MTA on cell proliferation and production of cytokine IL-1ß, IL-6 and TNF-α were observed at 6, 24, 48 and 72 hours; polyethylene tubes were implanted in the subcutaneous tissue of normal and diabetic rats (induced by Alloxan) and the influence of MTA on tissue response, cytokines production and mineralization ability in diabetic condition were observed by histological and immunohistochemical techniques at 07 and 30 days; biochemical analysis for Calcium, Phosphorus and Alkaline Phosphatase and immunohistochemistry for osteocalcin and osteopontin were also performed, at 07 and 30 days, in order to verify the influence of MTA on the local and systemic expression of bone markers. The hyperglycemic state promoted an increase on IL-6 production and impaired L929 proliferation after 72hs. Independent of the diabetic condition, the tissue response and ability to produces IL-1ß, IL-6 and TNF-α by both MTA was not change, although a reduction on fluorescence intensity of White MTA was observed after 14 days in diabetic animals. Moreover, hyperglycemia state inhibited the local production of osteocalcin and osteopontin in the presence of both MTA and increased serum levels of Phosphorus and Alkaline Phosphatase. Thus, it was concluded that MTA promoted regeneration of PDL and alveolar bone in the area of dental injury, moreover, it had a negative effect in relation to osteogenic differentiation; and under hyperglycemic condition, Gray MTA showed better biological results when compared with White MTA(AU)

Antimicrobial action of calcium hydroxide-based endodontic sealers after setting, against E. faecalis biofilm.

Enterococcus faecalis are gram positive bacteria that can mostly resist endodontic therapy, inducing persistent infection in the root canal system. Endodontic sealers with antimicrobial activity may help eliminate residual microorganisms that survive endodontic treatment. The present study aimed at comparing the antimicrobial activity of Acroseal, Sealapex and AH Plus endodontic sealers in an in vitro biofilm model. Bovine dentin specimens (144) were prepared, and twelve blocks for each sealer and each experimental time point (2, 7 and 14 days) were placed and left in contact with plates containing inoculum of E. faecalis (ATCC 51299), to induce biofilm formation. After 14 days, the samples were transferred to another plate with test sealers and kept at 37°C and 5% CO2 for 2, 7 and 14 days. The specimens without sealers were used as a control for each period. The samples were agitated in a sonicator after each experiment. The suspensions were agitated in a vortex mixer, serially diluted in saline, and triple plated onto m-Enterococcus agar. Colonyforming units were counted, and the data were statistically analyzed using ANOVA, Shapiro-Wilk and Kruskal-Wallis one-way tests (p < 0.05) to determine antimicrobial potential. Sealapex showed significant differences at all the experimental time points, in comparison with all the other groups. AH Plus and Acroseal showed antimicrobial activity only on the 14th experimental day. Neither of the sealers tested were able to completely eliminate the biofilm. Sealapex showed the highest antimicrobial activity in all the experimental periods. The antimicrobial activity of all the sealers analyzed increased over time.

Influence of diabetes mellitus on the mineralization ability of two endodontic materials.

The aim of this study was to evaluate the influence of diabetes mellituson tissue response and mineralization ability of Sealapex®and MTA Fillapex® sealers. Twenty-four Wistar rats were divided into two groups: diabetic and non-diabetic. The materials were placed in polyethylene tubes and implanted into dorsal connective tissue of rats for 7 and 30 days. Six animals from each group received injection of calcein, alizarin, and oxytetracycline on days 7, 14, and 21, respectively. The animals were killed after 7 and 30 days and specimens were prepared for histologic analysis by staining with hematoxylin and eosin or Von Kossa or left unstained for polarized light or fluorescence microscopy. On day 7, inflammatory reactions were characterized. Moderate inflammatory responses were observed for all groups and on day 30, a mild inflammatory response against MTA Fillapex® and a moderate inflammatory response against Sealapex® were observed. Von Kossa-positive structures were observed in response to both materials and birefringent structures were observed upon polarized light analysis; these had no relation to the diabetic condition (p > 0.05). The fluorescence intensity was unaffected in diabetic rats (p > 0.05). In conclusion, diabetes mellitus did not influence the tissue response or mineralization stimulated by Sealapex® or MTA Fillapex®.

Influence of diabetes mellitus on the mineralization ability of two endodontic materials

Abstract The aim of this study was to evaluate the influence of diabetes mellituson tissue response and mineralization ability of Sealapex®and MTA Fillapex® sealers. Twenty-four Wistar rats were divided into two groups: diabetic and non-diabetic. The materials were placed in polyethylene tubes and implanted into dorsal connective tissue of rats for 7 and 30 days. Six animals from each group received injection of calcein, alizarin, and oxytetracycline on days 7, 14, and 21, respectively. The animals were killed after 7 and 30 days and specimens were prepared for histologic analysis by staining with hematoxylin and eosin or Von Kossa or left unstained for polarized light or fluorescence microscopy. On day 7, inflammatory reactions were characterized. Moderate inflammatory responses were observed for all groups and on day 30, a mild inflammatory response against MTA Fillapex® and a moderate inflammatory response against Sealapex® were observed. Von Kossa-positive structures were observed in response to both materials and birefringent structures were observed upon polarized light analysis; these had no relation to the diabetic condition (p > 0.05). The fluorescence intensity was unaffected in diabetic rats (p > 0.05). In conclusion, diabetes mellitus did not influence the tissue response or mineralization stimulated by Sealapex® or MTA Fillapex®.

Antimicrobial action of calcium hydroxide-based endodontic sealers after setting, against E. faecalis biofilm

Abstract Enterococcus faecalis are gram positive bacteria that can mostly resist endodontic therapy, inducing persistent infection in the root canal system. Endodontic sealers with antimicrobial activity may help eliminate residual microorganisms that survive endodontic treatment. The present study aimed at comparing the antimicrobial activity of Acroseal, Sealapex and AH Plus endodontic sealers in an in vitro biofilm model. Bovine dentin specimens (144) were prepared, and twelve blocks for each sealer and each experimental time point (2, 7 and 14 days) were placed and left in contact with plates containing inoculum of E. faecalis (ATCC 51299), to induce biofilm formation. After 14 days, the samples were transferred to another plate with test sealers and kept at 37°C and 5% CO2 for 2, 7 and 14 days. The specimens without sealers were used as a control for each period. The samples were agitated in a sonicator after each experiment. The suspensions were agitated in a vortex mixer, serially diluted in saline, and triple plated onto m-Enterococcus agar. Colonyforming units were counted, and the data were statistically analyzed using ANOVA, Shapiro-Wilk and Kruskal-Wallis one-way tests (p < 0.05) to determine antimicrobial potential. Sealapex showed significant differences at all the experimental time points, in comparison with all the other groups. AH Plus and Acroseal showed antimicrobial activity only on the 14th experimental day. Neither of the sealers tested were able to completely eliminate the biofilm. Sealapex showed the highest antimicrobial activity in all the experimental periods. The antimicrobial activity of all the sealers analyzed increased over time.

Influência da hipertensão em infecções bucais e no tratamento endodôntico / Influence of hypertension on oral infections and endodontic treatment

A hipertensão arterial é caracterizada pelo aumento da resistência vascular periférica, fazendo com que a pressão do sangue nas artérias seja maior que o normal, com várias alterações sistêmicas observadas, que podem ter influências negativas no estado de saúde bucal. Assim, o objetivo do presente trabalho foi realizar uma revisão de literatura acerca da influência da hipertensão em problemas bucais e no tratamento endodôntico. Os vasos sanguíneos, o cérebro e os rins são os principais órgãos acometidos por essa morbidade. Um estado hipertensivo pode levar a um aumento do nível de hormônios da paratireoide, metabolismo anormal da vitamina D, redução da concentração de cálcio ionizado e diminuição da absorção de cálcio. A partir de todas essas alterações sistêmicas que a hipertensão acarreta, pode-se inferir que ela pode ter uma íntima associação com problemas bucais, como, por exemplo, doenças periodontais, perda tardia de implantes, dificuldades na cicatrização óssea, diminuição do fluxo salivar e da concentração de proteínas na saliva, aumento da quantidade de neutrófilos e, como consequência, o favorecimento do processo inflamatório. Tem sido sugerido, ainda, que o índice de sucesso do tratamento endodôntico em pessoas hipertensas é menor que nos demais. A resposta do tratamento endodôntico, das medicações intracanais utilizadas, assim como dos cimentos obturadores em pacientes hipertensos, deve ser mais bem estudada para que se proporcione um conhecimento sobre as alterações, falhas e sucessos durante o tratamento endodôntico.

Influência da menopausa no tratamento endodôntico / Influence of menopause in endodontic treatment

A menopausa é uma das mudanças fisiológicas caracterizadas pelo encerramento dos ciclos menstrual e ovulatório, ocorrendo nas mulheres entre a quarta e a quinta década de vida. Com ela, ocorre uma diminuição na produção de estrógeno, um importante hormônio que atua em muitos processos fisiológicos do indivíduo, como a regulação do sistema esquelético. O declínio nos níveis de estrógeno resulta em perda de densidade mineral óssea, aumento do risco de fratura, bem como no aparecimento de doenças ósseas, como a osteoporose, um processo patológico onde há o aumento na reabsorção de cavidades que não são completamente preenchidas por osso neoformado. Além disso, a deficiência de estrógeno pode causar muitas mudanças na saúde bucal do indivíduo. Na presença de uma infecção bacteriana no tecido pulpar, essa deficiência pode agravar a periodontite apical. Vários medicamentos têm sido estudados como potenciais agentes terapêuticos para suprir a deficiência de estrógeno. Essas drogas têm como objetivo reduzir o risco de fraturas e prevenir a perda óssea e distúrbios cardiovasculares e mentais resultantes de deficiência hormonal pós-menopausa. O raloxifeno (RLX), é uma das drogas terapêuticas mais estudadas, demonstrando prevenir a perda óssea. Mesmo com a indicação e benefícios do raloxifeno no metabolismo ósseo e na manutenção da densidade óssea, estudos sobre o seu papel na infecção endodôntica em organismos osteopênicos precisam ser realizados.