Effectiveness of antimicrobial photodynamic therapy mediated by butyl toluidine blue in preventing medication-related osteonecrosis of the jaws in rats.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) is difficult to treat, therefore, prevention would be the ideal clinical approach. This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT), mediated by butyl toluidine blue (BuTB) in the prevention of MRONJ-like lesions after tooth extraction in rats. METHODS: Twenty-eight senescent female rats were distributed in groups: VEH and VEH-aPDT, treated with vehicle, ZOL and ZOL-aPDT, treated with 100 µg/Kg of zoledronate, both treatments every three days over seven weeks. After three weeks from the commencement of treatment, the mandibular first molar was extracted. For the VEH and ZOL groups, no local treatment was performed, while with the VEH-aPDT and ZOL-aPDT groups, photodynamic treatment was carried out at 0, 2, and 4 days after extraction. For aPDT, 500µl of BuTB solution was deposited on the dental extraction site (0.5 mg/ml; 60 s), followed by irradiation with low-level laser (InGaAIP; 660 nm; 35 mW; 74.2 J/cm²; 60 s). After 28 postoperative days, euthanasia was performed. The hemimandibles were processed to: (1) histological analysis of tissue repair; (2) histometric analysis of the percentage of newly formed bone tissue (PNFBT) and percentage of non-vital bone tissue (PNVBT); (3) immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). RESULTS: The ZOL and ZOL-aPDT groups showed less TRAP-positive cells when compared with VEH and VEH-aPDT. The ZOL group demonstrated great compromise in the tissue repair process, consistent with MRONJ-like lesions. VEH, VEH-aPDT and ZOL-aPDT presented a favorable tissue repair process. PNFBT in the ZOL group was lower than in the VEH, VEH-aPDT and ZOL-aPDT groups, whereas PNVBT in the ZOL group was higher than in the VEH, VEH-aPDT and ZOL-aPDT groups. CONCLUSION: aPDT mediated by BuTB prevented the occurrence of MRONJ-like lesions after tooth extraction in rats.

Effect of photodynamic therapy on the mechanical properties and bond strength of glass-fiber posts to endodontically treated intraradicular dentin.

STATEMENT OF PROBLEM: The use of photosensitizers in photodynamic therapy promotes intraradicular microbial reduction during nonsurgical endodontic therapy. However, studies are lacking on the consequences of the application of these agents on the mechanical properties of intraradicular dentin and on the bond strength of glass-fiber posts. PURPOSE: The purpose of this in vitro study was to evaluate the influence of photodynamic therapy on the bond strength of glass-fiber posts using a push-out test and, additionally, to measure the Martens hardness (MH) and elastic indentation modulus (Eit) of intraradicular dentin when different photosensitizers are used. MATERIAL AND METHODS: Eighty bovine teeth were used to simulate experimental endodontic treatments. Biomechanical instrumentation was performed for all root canals, and the teeth were distributed into 5 groups: control-deionized water; methylene blue 50 mg/L + red laser; methylene blue 100 mg/L + red laser; curcumin 500 mg/L + blue LED; and curcumin 1000 mg/L + blue LED. The MH and Eit of intraradicular dentin were measured using an ultramicrohardness tester under a load of 3 mN (n=8). The push-out bond strength of glass-fiber posts to dentin was measured using a universal testing machine (n=8). Mechanical properties and bond strength data were subjected to the Kruskal-Wallis test, ANOVA, and Fisher least significant difference test (α=.05). Images of representative specimens were obtained using a scanning electron microscope. RESULTS: The MH, Eit, and bond strength of intraradicular dentin were influenced by the photosensitizer used. In general, curcumin promoted lower mechanical properties values but higher bond strength values. CONCLUSIONS: Photosensitizers influenced the mechanical properties of intraradicular dentin and the bond strength of glass-fiber posts, and methylene blue at 50 mg/L had no marked effect on the mechanical properties of the dentin or the bond strength values.

Histopathological condition of the remaining tissues after endodontic infection of rat immature teeth.

INTRODUCTION: Recently, case reports have shown that immature teeth diagnosed with necrotic pulp and periapical periodontitis can be repaired through a regenerative endodontic procedure. True regeneration depends on the presence of stem cells in the remaining vital tissues. The aim of this study was to evaluate the histologic condition of the pulp tissue, root apical papilla, and periapical tissues after inducing endodontic infection in immature rat teeth for different periods. METHODS: This study evaluated 18 first upper rat molars (36 roots). Periapical lesions were induced and were confirmed radiographically, and the animals were divided into 3 groups according to the days of pulp exposure for endodontic infection induction: 30, 60, and 90 days. Histologic analysis was performed in 5 different areas (ie, cervical, middle, and apical root canal thirds; the apical papilla; and the periapex surrounding the apical papilla). RESULTS: At 30 days, one third of the specimens still showed vital but intensely inflamed pulp tissue in the apical third and vital apical papilla with varying degrees of inflammation. After 60 days, the results were similar with respect to the apical pulp tissue and apical papilla. Completely necrotic pulp tissue in the space canal and vital apical papilla were observed in about 67% of the cases after 90 days. CONCLUSIONS: Vital pulp tissue was observed in the apical third until 60 days and in the vital apical papilla until 90 days of infection in a rat model.