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1.
Aust Endod J ; 46(1): 140-153, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31432612

RESUMO

The aim of this study was to systematically review the histological evidence of the neo-formed tissues inside the root canals of human teeth having previously received regenerative endodontic treatment. An electronic research was performed in the MEDLINE, Web of Science, Scopus and Cochrane Library databases using controlled vocabulary. The retrieved studies were screened by two reviewers according to the predetermined inclusion and extrusion criteria and were full-text-evaluated. Research resulted in 160 studies. Among them, twelve fitted the inclusion criteria and were critically appraised. The tissues formed in the root canals of immature human teeth treated with REP indicate repair or a combination of repair and regeneration. Pulp remnants and healthy periapical tissues seem to improve regeneration. The level of available evidence was low. Further clinical studies are needed in order to establish the appropriate treatment protocol related to the pretreatment status of the dental pulp and the periapical tissues.


Assuntos
Periodontite Periapical , Endodontia Regenerativa , Necrose da Polpa Dentária , Dentição Permanente , Humanos , Tecido Periapical , Regeneração
2.
Int Endod J ; 53(4): 492-505, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31730263

RESUMO

AIM: To assess whether Epstein-Barr virus (EBV) reactivation is triggered by persistent apical periodontitis-related microbes using in vitro and ex vivo methodologies. METHODOLOGY: Surgically removed human periapical granulomas (n = 50) and healthy gingival tissues (n = 10) were analysed to determine the presence of EBV and seven persistent apical periodontitis-related microbes. In addition, real-time polymerase chain reaction was used to detect the mRNA expression of BZLF-1, an immediate-early gene of EBV. Expression of latent membrane protein (LMP)-1 and ZEBRA, an early lytic protein of EBV encoded by BZLF-1, was also examined using triple-colour immunofluorescence staining. n-Butyric acid produced by the microbes was quantified, and luciferase assays were performed in association with bacterial lysates. In addition, Daudi cells were cultured with bacterial lysates, and the expression levels of BZLF-1 mRNA and ZEBRA protein were determined. RESULTS: EBV DNA and BZLF-1 mRNA were detected in 47 out of 50 periapical granulomas, but not in healthy gingival tissues. The EBV DNA copy number and the number of Fusobacterium nucleatum were significantly positively correlated with BZLF-1 expression in periapical granulomas. The number of Prevotella intermedia was slightly correlated with BZLF-1 expression; however, the other microbes were not. CD79a-positive B cells in periapical granulomas, but not those in healthy gingival tissues, expressed both LMP-1 and ZEBRA. n-Butyric acid production was the highest in F. nucleatum and the lowest in P. intermedia. Enterococcus faecalis, Candida albicans and the other tested microbes did not produce n-butyric acid. An F. nucleatum lysate exhibited significantly increased BZLF-1-luciferase activity in the same manner of commercial butyric acid, whereas P. intermedia did not. F. nucleatum also induced the expression of BZLF-1 mRNA and ZEBRA protein by Daudi cells, indicating that EBV reactivation was induced. CONCLUSION: Among the persistent apical periodontitis-related bacteria that were tested, F. nucleatum most strongly reactivated latent EBV, whereas E. faecalis and C. albicans as well as the other microbes did not.


Assuntos
Herpesvirus Humano 4 , Periodontite Periapical , Gengiva , Humanos , Tecido Periapical , Reação em Cadeia da Polimerase em Tempo Real
3.
J Endod ; 46(2): 307-317, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31836137

RESUMO

Pulpal/periapical responses of human teeth that are treated successfully with tricalcium silicate-based materials are extremely difficult to obtain because of the typical unavailability of these teeth for histologic examination. The present case series reports histologic and histobacteriologic findings of 3 human teeth that had undergone pulpotomy, orthograde retreatment, and apicoectomy/root-end filling using tricalcium silicate-based endodontic materials. The teeth were extracted after 34 days, 7 weeks, and 20 months, respectively, because of unusual circumstances. The extracted teeth were processed, paraffin embedded, sectioned, stained with hematoxylin-eosin or the modified Brown and Brenn technique, and examined with light microscopy. The recurrent observation for the 3 cases presented was the absence of inflammatory or foreign body reactions of the host tissues in contact with tricalcium silicate-based materials after different observation periods despite the identification of bacteria in dentinal tubules close to the site of operation. Wound healing was rapid with repair/regeneration of lost tissues with cementum and new bone trabeculae. Although the level of evidence for a case series is low because of the anecdotal nature of the reported episodes, the histologic results reported in the present case series illustrate the highly biocompatible and bioactive nature of the tricalcium silicate-based materials used in treating these cases.


Assuntos
Compostos de Cálcio , Polpa Dentária , Tecido Periapical , Materiais Restauradores do Canal Radicular , Silicatos , Polpa Dentária/efeitos dos fármacos , Humanos , Tecido Periapical/efeitos dos fármacos
4.
J Appl Oral Sci ; 27: e20180693, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596370

RESUMO

OBJECTIVES: To compare the sealing ability and biocompatibility of Biodentine with mineral trioxide aggregate (MTA) when used as root-end filling materials. METHODOLOGY: The Cell Counting Kit-8 (CCK-8) assay was used to compare the cytotoxicity of MTA and Biodentine. Twenty-one extracted teeth with a single canal were immersed in an acidic silver nitrate solution after root-end filling. Then, the volume and depth of silver nitrate that infiltrated the apical portion of the teeth were analyzed using micro-computed tomography (micro-CT). Seventy-two roots from 3 female beagle dogs were randomly distributed into 3 groups and apical surgery was performed. After six months, the volume of the bone defect surrounding these roots was analyzed using micro-CT. RESULTS: Based on the results of the CCK-8 assay, MTA and Biodentine did not show statistically significant differences in cytotoxicity (P>0.05). The volume and the depth of the infiltrated nitrate solution were greater in the MTA group than in the Biodentine group (P<0.05). The volume of the bone defect was larger in the MTA group than in the Biodentine group. However, the difference was not significant (P>0.05). The volumes of the bone defects in the MTA and Biodentine groups were smaller than the group without any filling materials (P<0.05). CONCLUSIONS: MTA and Biodentine exhibited comparable cellular biocompatibility. Biodentine showed a superior sealing ability to MTA in root-end filling. Both Biodentine and MTA promoted periradicular bone healing in beagle dog periradicular surgery models.


Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Óxidos/farmacologia , Tecido Periapical/efeitos dos fármacos , Ligamento Periodontal/efeitos dos fármacos , Materiais Restauradores do Canal Radicular/farmacologia , Tratamento do Canal Radicular/métodos , Silicatos/farmacologia , Cicatrização/efeitos dos fármacos , Adolescente , Animais , Regeneração Óssea/efeitos dos fármacos , Contagem de Células , Células Cultivadas , Cães , Combinação de Medicamentos , Humanos , Masculino , Teste de Materiais , Osteogênese/efeitos dos fármacos , Tecido Periapical/citologia , Tecido Periapical/diagnóstico por imagem , Ligamento Periodontal/diagnóstico por imagem , Reprodutibilidade dos Testes , Fatores de Tempo , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/cirurgia , Resultado do Tratamento , Microtomografia por Raio-X , Adulto Jovem
6.
BMC Oral Health ; 19(1): 174, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387578

RESUMO

BACKGROUND: This study evaluated the antibacterial efficiency and ability of propolis to promote regeneration of immature permanent non-vital dogs' teeth. METHODS: Ninety six immature permanent premolars teeth in 6 mongrel dogs were divided randomly into: experimental teeth (N = 72) and control teeth (N = 24). Periapical pathosis was induced in all experimental and positive control teeth. Experimental teeth were classified according to the used intra-canal medication into: group I (N = 36), propolis paste was used and group II (N = 36), triple antibiotic paste (TAP) was used. Bacteriologic samplings were collected before and after exposure to intra-canal medicaments. After the disinfection period (3 weeks), revascularization was induced in all experimental teeth. Each group was subdivided according to the root canal orifice plug into: subgroup A (N = 18), propolis paste was used and subgroup B (N = 18), mineral trioxide aggregates (MTA) was used. Each subgroup was further subdivided according to the evaluation period into 3 subdivisions (6 teeth each): subdivision 1; after 2 weeks, subdivision 2; after one month and subdivision 3; after 2 months. Positive control group had 12 teeth with induced untreated periapical pathosis. Negative control group had 12 untouched sound teeth. All teeth were evaluated with radiography and histology. The bacteriologic and radiographic data were analyzed using repeated measures ANOVA and post-hoc Tukey tests. The histologic data were analyzed using Kruskal-Wallis test, Mann-Whitney U test with Bonferroni's adjustment and Chi-square test. The significance level was set at P ≤ .05. RESULTS: There was no significant difference in the antibacterial effectiveness between TAP and propolis groups (P > .05). In all subdivisions, there was no significant difference between the experimental groups in terms of increase in root length and dentin thickness, decrease in apical closure, new hard tissue formation, vital tissue formation inside the pulp canal and apical closure scores (P > .05). CONCLUSION: Propolis can be comparable with TAP as a disinfection treatment option in regenerative endodontic. As a root canal orifice plug after revascularization of necrotic immature permanent teeth in dogs, propolis induces a progressive increase in root length and dentin thickness and a decrease in apical diameter similar to those of MTA.


Assuntos
Antibacterianos/administração & dosagem , Necrose da Polpa Dentária/tratamento farmacológico , Polpa Dentária/efeitos dos fármacos , Dentina/efeitos dos fármacos , Própole/administração & dosagem , Endodontia Regenerativa/métodos , Tratamento do Canal Radicular/métodos , Raiz Dentária/efeitos dos fármacos , Animais , Antibacterianos/uso terapêutico , Polpa Dentária/irrigação sanguínea , Polpa Dentária/fisiologia , Dentina/irrigação sanguínea , Dentina/fisiologia , Cães , Tecido Periapical/irrigação sanguínea , Tecido Periapical/efeitos dos fármacos , Tecido Periapical/fisiologia , Própole/uso terapêutico , Distribuição Aleatória , Irrigantes do Canal Radicular/uso terapêutico , Ápice Dentário/patologia , Raiz Dentária/irrigação sanguínea , Raiz Dentária/fisiologia , Resultado do Tratamento
7.
Br Dent J ; 226(12): 951-954, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31253916

RESUMO

Objectives A study of hospital admissions for diseases of pulp and periapical tissues in NHS Grampian and the effects of socioeconomic, geographic location and primary dental care availability on hospital admissions.Design Retrospective analysis of hospitalisation data from NHS Grampian Health Intelligence database for the five-year period (1 January 2011 to 31 December 2015), if their primary diagnosis was disease of the pulp or periapical tissues. The influence of the Scottish Index of Multiple Deprivation (SIMD) scores on hospital admissions for pulp or periapical diseases were assessed and compared. Data from general dental practitioners (GDPs) providing primary care were obtained from the National Services Scotland practitioner services board.Results There were 963 admissions to NHS Grampian hospitals over the five-year period. The most frequent hospitalisation admission code was K047 'periapical abscess without sinus', accounting for 59.3% of all admissions. Hospital admissions decreased from 185 in 2011 to 122 in 2015, and coincided with a 50% rise in the number of GDPs providing primary care dentistry within the region (171 in 2011 to 256 in 2015). SIMD 5 (least deprived) had the greatest number of admissions (68) in 2011 compared with the most deprived (11). In 2015, SIMD 4 had the most admissions (41) compared to SIMD 1 (12).Conclusion A reduction in hospital admissions for pulp/periapical abscesses appears to coincide with an increase in GDPs providing primary care dental services. Barriers to providing dental treatment in primary care should be minimised to reduce the burden of care on NHS hospitals for preventable dental diseases such as periapical abscesses.


Assuntos
Tecido Periapical , Medicina Estatal , Hospitalização , Humanos , Atenção Primária à Saúde , Estudos Retrospectivos , Escócia , Fatores Socioeconômicos
8.
J Appl Oral Sci ; 27: e20180641, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166414

RESUMO

OBJECTIVES: Infection, inflammation and bone resorption are closely related events in apical periodontitis development. Therefore, we sought to investigate the role of cyclooxygenase (COX) in osteoclastogenesis and bone metabolism signaling in periapical bone tissue after bacterial lipopolysaccharide (LPS) inoculation into root canals. METHODOLOGY: Seventy two C57BL/6 mice had the root canals of the first molars inoculated with a solution containing LPS from E. coli (1.0 mg/mL) and received selective (celecoxib) or non-selective (indomethacin) COX-2 inhibitor. After 7, 14, 21 and 28 days the animals were euthanized and the tissues removed for total RNA extraction. Evaluation of gene expression was performed by qRT-PCR. Statistical analysis was performed using analysis of variance (ANOVA) followed by post-tests (α=0.05). RESULTS: LPS induced expression of mRNA for COX-2 (Ptgs2) and PGE2 receptors (Ptger1, Ptger3 and Ptger4), indicating that cyclooxygenase is involved in periapical response to LPS. A signaling that favours bone resorption was observed because Tnfsf11 (RANKL), Vegfa, Ctsk, Mmp9, Cd36, Icam, Vcam1, Nfkb1 and Sox9 were upregulated in response to LPS. Indomethacin and celecoxib differentially modulated expression of osteoclastogenic and other bone metabolism genes: celecoxib downregulated Igf1r, Ctsk, Mmp9, Cd36, Icam1, Nfkb1, Smad3, Sox9, Csf3, Vcam1 and Itga3 whereas indomethacin inhibited Tgfbr1, Igf1r, Ctsk, Mmp9, Sox9, Cd36 and Icam1. CONCLUSIONS: We demonstrated that gene expression for COX-2 and PGE2 receptors was upregulated after LPS inoculation into the root canals. Additionally, early administration of indomethacin and celecoxib (NSAIDs) inhibited osteoclastogenic signaling. The relevance of the cyclooxygenase pathway in apical periodontitis was shown by a wide modulation in the expression of genes involved in both bone catabolism and anabolism.


Assuntos
Inibidores de Ciclo-Oxigenase/farmacologia , Cavidade Pulpar/metabolismo , Lipopolissacarídeos/farmacologia , Osteogênese/fisiologia , Tecido Periapical/efeitos dos fármacos , Tecido Periapical/metabolismo , Prostaglandina-Endoperóxido Sintases/fisiologia , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Reabsorção Óssea/metabolismo , Celecoxib/farmacologia , Ciclo-Oxigenase 2/análise , Escherichia coli/metabolismo , Expressão Gênica , Indometacina/farmacologia , Lipopolissacarídeos/análise , Masculino , Camundongos Endogâmicos C57BL , Osteogênese/efeitos dos fármacos , Prostaglandina-Endoperóxido Sintases/análise , Prostaglandina-Endoperóxido Sintases/efeitos dos fármacos , Receptores de Prostaglandina E/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , Regulação para Cima
9.
J Endod ; 45(7): 890-897, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31153660

RESUMO

INTRODUCTION: The aim was to assess the association of inducible costimulator (ICOS) and ICOS ligand with bone destruction in apical periodontitis (AP). METHODS: Specimens from patients presenting with AP were obtained during apicoectomy and subjected to histopathologic analysis and molecular assessment of ICOS/ICOS ligand. In addition, the experimental AP was induced by exposing the pulp of first mandibular molars of rats. Histologic and radiographic examinations were performed to validate the periapical lesions. The immunolocalization and messenger RNA expression of ICOS/ICOS ligand were evaluated by immunofluorescence staining and quantitative real-time polymerase chain reaction. The osteoclastic activities in periapical lesions, including the lesion size and the expression of tartrate-resistant acid phosphatase and the receptor activator of nuclear factor kappa B ligand, were recorded and followed by correlation analysis with ICOS/ICOS ligand expression. RESULTS: In excisional specimens from AP patients, a significantly increased expression of ICOS/ICOS ligand was found compared with the healthy control. In the experimental AP samples, the expression of ICOS/ICOS ligand, tartrate-resistant acid phosphatase, and receptor activator of nuclear factor kappa B ligand was significantly elevated in inflamed periapical tissues (AP group) when compared with the healthy control. The number of ICOS+/ICOS ligand+ cells was highly correlated with the periapical lesion size (r = 0.892, P < .01 and r = 0.930, P < .01, respectively). CONCLUSIONS: The increased expression of ICOS/ICOS ligand in periapical lesions was associated with the inflammatory infiltration and alveolar bone destruction of AP.


Assuntos
Perda do Osso Alveolar , Proteína Coestimuladora de Linfócitos T Induzíveis , Inflamação , Periodontite Periapical , Animais , Humanos , Proteína Coestimuladora de Linfócitos T Induzíveis/metabolismo , Ligantes , Osteoclastos , Periodontite Periapical/metabolismo , Tecido Periapical , Proteínas , Ratos , Fosfatase Ácida Resistente a Tartarato
10.
Acta Odontol Scand ; 77(4): 269-274, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30623701

RESUMO

OBJECTIVE: To develop and assess a set of criteria to grade inflammation including relative area of inflammation in periapical lesions in endodontically treated teeth. MATERIAL AND METHODS: A set of criteria was developed, encompassing data on: Lymphocytes, denoting chronic inflammation, were graded 0 (occasional) to 4 (heavy/dense inflammation). Polymorphonuclear cells, denoting acute inflammation, were graded 0 (none) to 2 (many). The third parameter, area of inflammation, that is, the relative area of the specimen that was inflamed, was graded 0 (none) to 4 (76-100%). The criteria were tested on 199 consecutive biopsies from 180 patients (aged 31-75 years). Information about symptoms was retrieved from the referrals. Mann-Whitney's U-test was used to calculate possible differences in average values for the histopathological variables in the two groups of patients: symptomatic or asymptomatic. RESULTS: Using the criteria, varying grades of inflammation were seen in the biopsies. The majority showed few or no PMN cells. There was a correlation between symptoms and the extent of infiltration of lymphocytes and plasma cells (p = .001), PMN cells (p < .001) and the area of inflammation (p = .002): biopsies from the asymptomatic patients exhibited less pronounced and relatively smaller areas of inflammation. CONCLUSIONS: Using the criteria on a specific selection of root-filled teeth with persisting apical periodontitis, periapical inflammation was common, but varied in extent and severity. The inflammation was less pronounced and affected a relatively smaller area in asymptomatic teeth, although outliers in both directions were identified.


Assuntos
Periodontite Periapical/patologia , Tecido Periapical/patologia , Tratamento do Canal Radicular/métodos , Dente não Vital/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite Periapical/terapia , Obturação do Canal Radicular
11.
Int Endod J ; 52(2): 149-157, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30091243

RESUMO

AIM: To evaluate the mRNA expression levels of the cytokines interferon-γ, tumour necrosis factor-α, interleukin (IL)-1ß, IL-10, IL-6, VEGF, and AGT and the chemokine CCL2/MCP-1 in periapical interstitial fluid associated with root canal infections before and after the reduction of the bacterial load using a cleaning procedure. METHODOLOGY: The case group included 11 patients with chronic liver disease, and the control group included 11 healthy patients. Clinical samples were taken from teeth with pulp necrosis. After cleaning and drying the canal, three paper points were introduced into the root canal and passed through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later to characterize those gene expression levels using real-time PCR. The data were subjected to the Shapiro-Wilk and the Wilcoxon tests. RESULTS: In the control group, significantly increased expression of the pro-inflammatory cytokines IFN-γ and TNF-α was observed in teeth with restrained bacterial loads (day 7) (P < 0.05). Similarly, increased TNF-α expression was found on day 7 in the liver group (P < 0.05). No differences were observed in the expression levels of the IL-1ß, IL-10 and, IL-6, MCP-1/CCL-2 and VEGF between the first collection (day 0) and second collection (day 7), over time in either group. CONCLUSION: Chronic liver disease patients exhibited sufficient immunologic ability showing relatively similar expression levels of cytokines, chemokines and angiogenic factors in periapical samples compared with the responses from no-chronic liver disease patients. The outcomes of this study suggest that liver impairment did not compromise the periapical immune response.


Assuntos
Quimiocinas/metabolismo , Citocinas/metabolismo , Hepatopatias/complicações , Hepatopatias/imunologia , Doenças Periapicais/imunologia , Tratamento do Canal Radicular , Dente/imunologia , Adulto , Idoso , Carga Bacteriana , Quimiocina CCL2/metabolismo , Cavidade Pulpar/microbiologia , Necrose da Polpa Dentária/imunologia , Feminino , Humanos , Interferon gama/metabolismo , Interleucina-10/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Masculino , Pessoa de Meia-Idade , Tecido Periapical/imunologia , Tecido Periapical/microbiologia , RNA Mensageiro/metabolismo , Ápice Dentário , Fator de Necrose Tumoral alfa/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
12.
J Endod ; 44(12): 1783-1787, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477664

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the expression of cyclooxygenase-2 (COX-2) and tumor necrosis factor alpha (TNF-α) in periapical granuloma (PG) and radicular cyst (RC) samples and to correlate it with the type of lesion, the intensity of the inflammatory infiltrate, and the thickness of the epithelial lining. METHODS: A total of 51 cases of periapical lesions (25 PGs and 26 RCs) were subjected to morphologic analysis and immunohistochemical study. The anti-COX-2 and anti-TNF-α antibodies were applied using the immunoperoxidase technique. Data were analyzed by the Mann-Whitney test, Pearson chi-square test, Fisher exact test, and Spearman correlation. RESULTS: Analysis of the inflammatory infiltrate revealed that 80% of PGs exhibited a grade III infiltrate as opposed to a 19% rate in RCs (P < .001). Morphologic evaluation of the epithelial thickness of RCs revealed the presence of atrophic epithelium in 73% of cases. The majority of PGs had a score of 1 for COX-2 immunoexpression (n = 14, 54%) and a score of 2 for TNF-α expression (n = 16, 64%), whereas in cases of RCs a score of 1 was more prevalent for COX-2 and TNF-α expression (n = 17, 65%). Significant differences in the expression scores of COX-2 and TNF-α were detected in periapical lesions (P < .001). CONCLUSIONS: Based on these findings, we emphasize that RCs and PGs have a similar expression of inflammatory mediators (COX-2 and TNF-α) although the secretion of TNF-α by macrophages and of COX-2 by several cells was higher in PGs, indicating a greater inflammatory response in these lesions.


Assuntos
Ciclo-Oxigenase 2/metabolismo , Imuno-Histoquímica/métodos , Mediadores da Inflamação/metabolismo , Granuloma Periapical/metabolismo , Tecido Periapical/metabolismo , Cisto Radicular/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Ciclo-Oxigenase 2/genética , Feminino , Expressão Gênica , Humanos , Macrófagos/metabolismo , Masculino , Granuloma Periapical/patologia , Tecido Periapical/patologia , Cisto Radicular/patologia , Fator de Necrose Tumoral alfa/genética
13.
J Endod ; 44(12): 1796-1801, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477665

RESUMO

INTRODUCTION: Current pulp revascularization procedures in teeth with necrotic pulps and open apices have produced histologic evidence of connective tissue growth, cementum, and bone within the root canals of experimental animals. This study aims to investigate the effect of maintaining uninflamed residual apical pulp tissue on the histologic outcome of pulp-dentin complex regeneration after a revascularization procedure in immature ferret cuspid teeth. METHODS: Twenty-eight cuspid teeth from 7 young male ferrets were used in this experiment. Seven teeth were reserved to serve as positive control samples without any treatment. In another 7 teeth, the pulp was completely extirpated (negative control), whereas the pulp of the remaining 14 teeth were removed to either 1-2 mm short of the apex (7 samples) or 2-4 mm short of the apex (7 samples). Blood clots were covered with mineral trioxide aggregate at the cementoenamel junction level of each tooth. Three months later, block sections were removed for histologic evaluations, and the data were statistically analyzed with the chi-square test (P < .05). RESULTS: All teeth with complete pulp extirpation showed the presence of bone inside the root canal. In contrast, the root canals for most teeth with pulp amputation 1-4 mm from the radiographic apex were filled with normal pulp, which extended coronally to the mineral trioxide aggregate, where hard tissue bridges had formed. CONCLUSIONS: Based on these results, we concluded that regeneration of the pulp-dentin complex is possible when the apical 1-4 mm of the apical pulp remains intact in immature teeth.


Assuntos
Cavidade Pulpar/anatomia & histologia , Polpa Dentária/fisiologia , Dentina/fisiologia , Tecido Periapical/fisiologia , Regeneração , Ápice Dentário/anatomia & histologia , Animais , Remodelação Óssea , Dente Canino , Cemento Dentário , Polpa Dentária/anatomia & histologia , Dentinogênese , Furões , Masculino , Odontogênese , Tecido Periapical/anatomia & histologia
14.
Clin Implant Dent Relat Res ; 20(6): 988-996, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30328283

RESUMO

OBJECTIVES: To analyze the effect of veneering of the submucosal part of zirconia abutments and the type of retention (cemented vs screw-retained) on clinical, microbiological, and histological outcomes of single-tooth implant crowns. MATERIAL AND METHODS: A total of 44 patients with a single missing tooth to be replaced by an implant in the anterior region participated in the study. Implants were randomly assigned to receive zirconia-based CAD/CAM reconstructions using either one of four treatment modalities: cement-retained with submucosal veneering (CR-P), cement-retained without submucosal veneering (CR-W), screw-retained with submucosal veneering (SR-P), and screw-retained without submucosal veneering (SR-W). Clinical parameters were assessed at baseline (after crown insertion), at 6 and 12 months. Histological and microbiological analyses were performed at 6 months. Descriptive statistics and the Kruskal-Wallis test were applied. RESULTS: The clinical evaluation revealed, in general, stable peri-implant soft tissues with minimal differences for all measured parameters between the four groups, except for bleeding on probing with the two cemented groups exhibiting higher values at 12 months (35.0% ± 26.5% for CR-W and 25.0% ± 38.8% for CR-P versus 13.1 ± 14.8 for SR-W and 13.0 ± 18.2 for SR-P). The descriptive and semi-quantitative histology showed a trend for a higher inflammatory reaction in the two cemented (a medium to high number of inflammatory cells) compared to the screw-retained groups (low number of inflammatory cells) at 6 months. The microbiological test demonstrated low bacterial counts and a similar distribution in between the groups except for two species (Tannerella forsythia and Peptostreptococcus micros) that were found in higher counts in the cemented groups at 6 months. CONCLUSION: Submucosal veneering of zirconia abutments did not negatively affect the health of the peri-implant tissues. The cemented groups, though, did show a clinical and histological trend to higher levels of inflammation.


Assuntos
Coroas , Dente Suporte , Projeto do Implante Dentário-Pivô , Facetas Dentárias/efeitos adversos , Zircônio , Adulto , Idoso , Idoso de 80 Anos ou mais , Carga Bacteriana , Desenho Assistido por Computador , Dente Suporte/efeitos adversos , Cimentos Dentários/efeitos adversos , Implantes Dentários para Um Único Dente , Índice de Placa Dentária , Feminino , Humanos , Inflamação/etiologia , Masculino , Pessoa de Meia-Idade , Tecido Periapical/microbiologia , Tecido Periapical/patologia , Índice Periodontal
15.
Cell Physiol Biochem ; 49(3): 884-898, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30184545

RESUMO

BACKGROUND/AIMS: Periapical periodontitis is caused by bacterial infection and results in both one destruction and tooth loss. Osteopontin (OPN) is a secreted phosphorylated glycoprotein that participates in bone metabolism. METHODS: Thirty-three patients with chronic periapical periodontitis and 10 patients who had undergone the orthodontic removal of healthy tooth tissue (control) at the periodontal ligament were investigated, and an animal model of mouse periapical periodontitis was established for an in vivo analysis. The relationship between OPN and bone destruction during periapical periodontitis was analyzed. Osteoblasts and osteoclasts were cultured in vitro and treated with lipopolysaccharide. An inhibitor of NF-κB was used to pretreat the transfected cells. RESULTS: OPN increased osteoclast proliferation and differentiation, but reduced osteoblasts proliferation and differentiation. OPN activated the NF-κB pathway during periapical periodontitis and accelerated the transfer and phosphorylation of P65 from the cytoplasm to the nucleus. CONCLUSION: This study demonstrated that OPN played important roles in the progression of periapical periodontitis, and a dual role in bone metabolism during periapical periodontitis, linking osteoclasts and osteoblasts. The underlying mechanism may be related to the NF-κB pathway.


Assuntos
NF-kappa B/metabolismo , Osteopontina/metabolismo , Periodontite Periapical/patologia , Transdução de Sinais , Animais , Catepsina K/genética , Catepsina K/metabolismo , Diferenciação Celular/efeitos dos fármacos , Modelos Animais de Doenças , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Lipopolissacarídeos/farmacologia , Masculino , Mandíbula/diagnóstico por imagem , Camundongos , Camundongos Endogâmicos C57BL , Osteopontina/antagonistas & inibidores , Osteopontina/genética , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/metabolismo , Tecido Periapical/diagnóstico por imagem , Tecido Periapical/metabolismo , Ligamento Periodontal/metabolismo , Células RAW 264.7 , Interferência de RNA , RNA Interferente Pequeno/metabolismo
16.
J Endod ; 44(9): 1389-1395, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30144833

RESUMO

INTRODUCTION: NeoMTA Plus (Avalon Biomed Inc, Bradenton, FL) is a tricalcium silicate material similar to the first mineral trioxide aggregate product, ProRoot MTA (Dentsply Sirona, York, PA), but with improvements such as decreased setting time, increased ion release, increased water sorption, and nonstaining radiopacifiers. Quick-Set2 (Avalon Biomed Inc) is a newly formulated calcium aluminosilicate material that has a faster setting time and increased acid resistance and is nonstaining. The purpose of this study was to compare the healing of pulpal and periapical tissues in dogs after exposure to NeoMTA Plus and Quick-Set2 after pulpotomy and root-end surgery procedures. METHODS: Seventy-two teeth (36 for each procedure) in 6 beagle dogs received pulpotomy or root-end surgery using either NeoMTA Plus or Quick-Set2. The dogs were sacrificed at 90 days, and the teeth and surrounding tissues were prepared for histologic evaluation. Sixty teeth were evaluated and scored histologically (29 with pulpotomies and 31 with root-end resections). Specimens were scored for inflammation, quality and thickness of dentin bridging, pulp tissue response, cementum and periodontal ligament formation, and apical bone healing. RESULTS: Both materials displayed favorable healing at 90 days. The only significant difference was the quality of dentin bridge formation in pulpotomies using NeoMTA Plus compared with Quick-Set2. CONCLUSIONS: Quick-Set2 and NeoMTA Plus had similar effects on inflammation, pulp response, periodontal ligament and cementum formation, and apical tissue healing in dogs. NeoMTA Plus had superior dentin bridge quality compared with Quick-Set2.


Assuntos
Compostos de Alumínio , Silicatos de Alumínio , Aluminossilicato de Cálcio , Compostos de Cálcio , Cimentos Dentários , Polpa Dentária/patologia , Polpa Dentária/fisiologia , Óxidos , Tecido Periapical/patologia , Tecido Periapical/fisiologia , Pulpotomia , Materiais Restauradores do Canal Radicular , Silicatos , Raiz Dentária/patologia , Raiz Dentária/cirurgia , Cicatrização , Animais , Cemento Dentário/patologia , Cães , Combinação de Medicamentos , Modelos Animais , Ligamento Periodontal/patologia , Ápice Dentário/patologia
17.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(7): 459-465, 2018 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-29996363

RESUMO

Objective: To evaluate the effect of exogenous stem cells from apical papillae (SCAP) in the pulp revascularization treatment for the immature permanent tooth with periapical periodontitis in animal model. Methods: After the SCAP were isolated and cultured from the Beagle dogs, stem cell properties of these cells were characterized by analyzing their colony-forming ability, the expression of mesenchymal stem cell markers and the multidifferentiation characteristics including osteogenic, adipogenic, and chondrogenic potentials. Models of young permanent tooth with periapical periodontitis were established in dogs and the infection in each of the model tooth was eliminated by root canal irrigation and intracanal medication. After that, all of the model teeth were randomly divided into 4 groups: Group 1: normal developing teeth with no treatment applied;Group 2: teeth that periapical tissues were irritated to induce blood flowing into the root canals;Group 3: teeth that peripheral blood was delivered into the root canals;Group 4: teeth that SCAP were resuspended in peripheral blood and delivered into the root canals. In Group 2-4, firm coronal seal was performed after revascularization procedure and radiographs were taken periodically in order to observe the development of roots. After a 12-week-period, alveolar samples were collected and observed histologically. Results: The isolated SCAP showed clonogenic ability and multilineage differentiation ability including osteogenic, adipogenic and chondrogenic potentials. These cells also expressed the mesenchymal stem cell markers such as STRO-1 and CD146, while no cytokeratin was detected. The thickening of canal wall was observed radiographically 12 weeks after procedures of infection control and revascularization. Histologically, the newly formed tissues on the inner canal wall were found bone lacuna like structure in Group 2 and 3, and the new tissue formed in the Group 3 seemed easy to separate from the canal wall. The newly formed tissues in Group 4 were much thicker compare to those in the Group 2 and 3, and the dentine tubule like structure instead of bone lacuna was noticed although the orientation of these tubules were various. Conclusions: SCAP seem to play an important role in the tissue regeneration procedure when infection is well controlled in young permanent teeth with periapical periodontitis. It is difficult to achieve real tissue regeneration due to the lack of endogenous SCAP in apical area, therefore delivering adequate exogenous SCAP isolated and cultured in vitro could be a promising approach to overcome the challenge.


Assuntos
Diferenciação Celular , Periodontite Periapical/fisiopatologia , Tecido Periapical/irrigação sanguínea , Ápice Dentário/citologia , Animais , Dentina , Cães , Tecido Periapical/fisiologia , Distribuição Aleatória , Regeneração/fisiologia , Irrigantes do Canal Radicular , Células-Tronco/fisiologia , Dente
18.
J Endod ; 44(8): 1308-1316, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30053937

RESUMO

This article describes a case of large persistent posttreatment apical periodontitis associated with 2 maxillary incisors, which was successfully managed by periradicular surgery. Histobacteriologic analysis revealed that the lesion was a granuloma that contained in its body a very large actinomycoticlike colony surrounded by accumulations of polymorphonuclear leukocytes and showing no direct communication with the root canal systems from both teeth. One incisor had no evidence of persistent intraradicular infection, whereas the other exhibited some residual dentinal tubule infection in the apical canal, which may have not significantly contributed to persistent inflammation given the organization and agglomeration of inflammatory cells around the large extraradicular bacterial colony. Findings showed that the main cause of persistent disease was the extraradicular infection in the form of a large bacterial floc, apparently independent of an intraradicular infection and as such only solved by surgery.


Assuntos
Periodontite Periapical/microbiologia , Adolescente , Feminino , Humanos , Incisivo/microbiologia , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/cirurgia , Tecido Periapical/microbiologia , Tecido Periapical/patologia , Radiografia Dentária , Tratamento do Canal Radicular/métodos
19.
J Endod ; 44(7): 1105-1109, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29941110

RESUMO

INTRODUCTION: The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts. METHODS: Thirty-one lesions (5 granulomas, 15 periapical cysts, and 11 residual cysts) were selected. Histologic sections in silanized slides were used for the immunohistochemical reactions. The analysis of the images was performed by using an optical microscope, and data were analyzed with 5% significance (P < .05). RESULTS: Cysts presented atrophic and hyperplastic epithelium in 11 cases (35.5%) and 15 cases (48.8%), respectively (P > .05). The intensity of the inflammatory infiltrate was similar when comparing the 3 groups (P > .05). CD34 and podoplanin expression and the presence of mast cells were similar when comparing the 3 groups; ICAM-1 expression was more intense in granulomas than cysts (P < .05). There were no statistically significant differences associated with the expression of the evaluated markers according to the intensity of the inflammatory infiltrate. CONCLUSIONS: There were no differences in the expression of CD34 and podoplanin and in the presence of mast cells when the 3 groups were compared. ICAM-1 expression was more common in periapical granulomas.


Assuntos
Antígenos CD34/metabolismo , Molécula 1 de Adesão Intercelular/metabolismo , Mastócitos/metabolismo , Glicoproteínas de Membrana/metabolismo , Doenças Periapicais/metabolismo , Granuloma Periapical/metabolismo , Cisto Radicular/metabolismo , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Mastócitos/patologia , Pessoa de Meia-Idade , Doenças Periapicais/patologia , Granuloma Periapical/patologia , Tecido Periapical/metabolismo , Tecido Periapical/patologia , Cisto Radicular/patologia , Estudos Retrospectivos , Adulto Jovem
20.
J Endod ; 44(8): 1276-1282, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29935870

RESUMO

INTRODUCTION: Interferon regulatory factor 8 (IRF8) is a critical transcription factor in innate immune responses that regulates the development and function of myeloid cells. Human periapical lesions are caused by endodontic microbial infections. However, the presence of IRF8 in human periapical lesions remains elusive. This study aims to explore the expression of IRF8 in human periapical lesions and the possible association of IRF8 with macrophages, nuclear factor kappa B (NF-κB) signaling, and the autophagy process. METHODS: Thirty-nine human periapical tissues, including healthy control tissues (n = 15), radicular cysts (RCs, n = 11), and periapical granulomas (PG, n = 13), were examined. Tissues were fixed in paraformaldehyde and analyzed. The inflammatory infiltrates of lesions were evaluated by hematoxylin-eosin, and the expression of IRF8 was analyzed by immunohistochemistry. Double immunofluorescence assessment was performed to colocalize IRF8 with CD68, NF-κB p65, and LC3B. RESULTS: The expression of IRF8 was significantly higher in RCs and PGs than in the healthy control group, but no significant difference was found between RCs and PGs. There were significantly more IRF8-CD68 double-positive cells in RCs and PGs than in the healthy control group, but no significant difference was observed between RCs and PGs. Double-labeling analysis of IRF8 with NF-κB and LC3B indicated that IRF8 expression is associated with NF-κB signaling and the autophagy process during periapical lesions. CONCLUSIONS: IRF8 could be observed and might possibly be involved in macrophages in the development of periapical lesions.


Assuntos
Fatores Reguladores de Interferon/metabolismo , Doenças Periapicais/metabolismo , Tecido Periapical/metabolismo , Adulto , Estudos de Casos e Controles , Feminino , Imunofluorescência , Humanos , Macrófagos/metabolismo , Masculino , Pessoa de Meia-Idade , NF-kappa B/metabolismo , Doenças Periapicais/patologia , Granuloma Periapical/metabolismo , Granuloma Periapical/patologia , Tecido Periapical/patologia , Cisto Radicular/metabolismo , Cisto Radicular/patologia , Adulto Jovem
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