RESUMEN
OBJECTIVE: To investigate the influence of chronic stress and adrenergic blockade in a rat model of apical periodontitis. METHODS: Thirty-two Wistar rats were submitted to an animal model of periapical lesion and randomly divided into 4 groups (nâ¯=â¯8): no stress (NS); stressâ¯+â¯saline solution (SS); stress + ß-adrenergic blocker (Sß); stress + α-adrenergic blocker (Sα). The SS, Sß and Sα groups were submitted to an animal model of chronic stress for 28 days and received daily injections of saline solution, propranolol (ß adrenergic blocker) and phentolamine (α adrenergic blocker), respectively. After 28 days the animals were euthanized and the following analyses were carried out: a) serum corticosterone levels through Radioimmunoassay; b) measurement of serum levels of IL-1B, IL-6, IL-10 and IL-17 by enzyme-linked immunosorbent assay (ELISA); c) volume of periapical bone resorption by micro-computed tomography; d) histomorphometric analysis by staining with hematoxylin and eosin; e) expression of ß-AR, α-AR, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) by immunohistochemistry; f) tartrate-resistant acid phosphatase (TRAP) staining; g) ex-vivo cytokine release followed by the stimulation with LPS in superfusion system, by ELISA. RESULTS: SS group displayed significantly higher corticosterone levels than NS group (non-stressed). Higher IL-1ß serum level was observed in the NS group (pâ¯<â¯.05); compared to all stressed groups. Other cytokines were present in similar amounts in the serum of all groups. All groups presented similar periapical lesions. All groups presented moderate inflammatory infiltrate, without statistically significant differences between them. No differences were observed regarding ß-AR, α-AR, Rank-L and OPG expression. The number of TRAP-positive cells was significantly decreased in the groups that received daily injections of adrenergic blockers. The IL-1ß release followed LPS stimulation was significantly suppressed when the superfusion media contained propranolol (pâ¯<â¯.05). Perfusion containing phentolamine induced a greater release of IL-10. TGF-ß was significantly suppressed by phentolamine perfusion in the NS group (pâ¯<â¯.05). CONCLUSIONS: Chronic stress can significantly change the inflammatory cytokines release. Rank-L/OPG system and periapical lesion volume were not affected following the current method applied. The administration of adrenergic blockers was not able to modulate the inflammatory response but presented effectivity in reducing the number of osteoclasts in the periapical region.
Asunto(s)
Resorción Ósea , Inflamación , Periodontitis Periapical , Receptores Adrenérgicos , Estrés Fisiológico , Adrenérgicos , Animales , Osteoprotegerina , Estrés Oxidativo , Periodontitis Periapical/fisiopatología , Ligando RANK , Ratas , Ratas Wistar , Receptores Adrenérgicos/fisiología , Microtomografía por Rayos XRESUMEN
OBJECTIVE: Because the impact of conditioned fear stress on apical bone resorption is unknown, the aim of the current studywas to use a rat model to evaluate the impact of conditioned fear stress on the bone resorption of inflammatory apical periodontitis lesions. METHODS: Twenty-five animals were divided into two groups. They underwent a surgical procedure in the first left lower molar tooth to expose the dental pulp and induce inflammatory apical periodontitis lesions through the retention of contamination (bacterial infection) during a 56-day period. The animals in the case group were stressed daily by using electrical stimuli (1.10 mA), whereas the animals in the control group were absent from the stressful stimuli (shocks). The open field test was performed to validate the stress methodology. The jaws were removed and collected for histological and radiographic analyses. RESULTS: Stressed animals presented increased levels of bone loss and inflammatory cells in the root apex in comparison with the control group (P = 0.0001). However, no radiographic differences were observed between the groups (P > 0.05). CONCLUSIONS: Our results demonstrated that conditioned fear stress could modify a periapical lesion by increasing the size of bone loss there. Conditioned fear stress also increased the total number of inflammatory cells compared with the control group. Studies evaluating the impact of conditioned fear stress on human periapical inflammatory lesions should be encouraged.
Asunto(s)
Resorción Ósea/fisiopatología , Resorción Ósea/psicología , Condicionamiento Operante , Miedo , Periodontitis Periapical/fisiopatología , Periodontitis Periapical/psicología , Estrés Psicológico/fisiopatología , Estrés Psicológico/psicología , Animales , Masculino , Distribución Aleatoria , Ratas , Ratas WistarRESUMEN
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.
Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Pulpa Dental/efectos de los fármacos , Diabetes Mellitus/fisiopatología , Periodontitis Periapical/fisiopatología , Materiales de Obturación del Conducto Radicular/farmacología , Tejido Subcutáneo/efectos de los fármacos , Compuestos de Aluminio/farmacología , Compuestos de Calcio/farmacología , Enfermedades de la Pulpa Dental/fisiopatología , Combinación de Medicamentos , Humanos , Enfermedades Metabólicas/fisiopatología , Óxidos/farmacología , Factores de Riesgo , Silicatos/farmacologíaRESUMEN
Abstract: 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.
Asunto(s)
Humanos , Periodontitis Periapical/fisiopatología , Materiales de Obturación del Conducto Radicular/farmacología , Enfermedades Cardiovasculares/fisiopatología , Tejido Subcutáneo/efectos de los fármacos , Pulpa Dental/efectos de los fármacos , Diabetes Mellitus/fisiopatología , Óxidos/farmacología , Factores de Riesgo , Silicatos/farmacología , Compuestos de Calcio/farmacología , Compuestos de Aluminio/farmacología , Enfermedades de la Pulpa Dental/fisiopatología , Combinación de Medicamentos , Enfermedades Metabólicas/fisiopatologíaRESUMEN
AIM: To evaluate the association between chronic oral inflammatory burden (OIB) - as the combination of periodontal and endodontic disease load - and physical fitness. METHODOLOGY: One hundred and twelve nonsmoker male police officers who performed a standardized physical fitness test (PFT) were analysed. Participants underwent oral clinical and periapical radiographic examinations. Periodontal disease was assessed by probing depth (PD) and clinical attachment loss (AL). For radiographic analysis, both apical periodontitis (AP) and root canal treatment (RCT) variables were analysed. Endodontic Burden (EB) was calculated merging the total number of teeth with AP and/or RCT per individual. OIB was calculated combining EB and AL. The outcome of physical fitness was dichotomized according to whether the highest PFT score was 'achieved' or 'not-achieved'. Multivariable logistic regression models were adjusted for age, body mass index and frequency of daily exercise. RESULTS: There was no significant association between AP, RCT and EB with physical fitness whereas PD, AL and OIB were significantly associated with low physical fitness (P < 0.05). Multivariate regression analysis revealed that individuals with OIB = EB ≥ 3 and AL ≥ 4 mm had a 81% lower chance of reaching the highest PFT score (OR = 0.19, 95%CI = 0.04-0.87, P = 0.03) compared to individuals with EB < 3 and and no AL ≥ 4 mm. Individuals with unfavourable periodontal parameters but with low EB (OIB = EB < 3 & AL ≥ 4 mm) showed no significant differences on the chance to reach the highest PFT score compared to participants with favourable periodontal status and low EB (OIB = EB < 3 & no AL ≥ 4 mm). CONCLUSIONS: The OIB - higher levels of EB in periodontal patients - was independently associated with poor physical fitness in males.
Asunto(s)
Periodontitis Periapical/fisiopatología , Enfermedades Periodontales/fisiopatología , Índice Periodontal , Aptitud Física/fisiología , Adulto , Estudios Transversales , Humanos , Masculino , Periodontitis Periapical/cirugía , Enfermedades Periodontales/cirugía , Factores de Riesgo , Tratamiento del Conducto Radicular , Adulto JovenRESUMEN
Revascularization of immature teeth with necrotic pulps traditionally involves the use of triple antibiotic paste, which may sometimes lead to undesirable complications. The objective of this study was to assess tissue repair in immature dog teeth with apical periodontitis subjected to revascularization, comparing two different pastes used for root canal disinfection. Apical periodontitis was induced in 30 dog premolars. Teeth were randomly divided into three experimental groups: root canals filled with triple antibiotic paste (n = 10); root canals filled with 1% propolis paste (n = 10); and no medication (n = 10). An additional group (n = 10, no intervention) was used as control. After 7 months, the jaws were histologically evaluated for the following variables: newly formed mineralized tissue (present/absent); vital tissue in the canal space (absent/periodontal ligament-like/pulp-like); apical extension of root (present/absent); and severity of inflammatory process (absent/mild/moderate/severe). There were no statistically significant differences among the experimental groups in new mineralized tissue formation and apical root development. The formation of vital tissue in the canal space, in turn, was statistically different between the triple paste and propolis groups: vital tissues were present in all revascularized teeth disinfected with propolis paste (100%), compared to 71% of those disinfected with the triple paste. Severity of inflammatory process was different between the triple paste and no medication groups. The new tissues formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively. Propolis may have some advantages over the triple paste for the revascularization of immature teeth.
Asunto(s)
Antiinfecciosos/farmacología , Necrosis de la Pulpa Dental/tratamiento farmacológico , Regeneración Tisular Dirigida/métodos , Neovascularización Fisiológica/efectos de los fármacos , Periodontitis Periapical/tratamiento farmacológico , Própolis/farmacología , Irrigantes del Conducto Radicular/farmacología , Diente/irrigación sanguínea , Animales , Antiinfecciosos/uso terapéutico , Pulpa Dental/efectos de los fármacos , Pulpa Dental/fisiopatología , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/fisiopatología , Necrosis de la Pulpa Dental/fisiopatología , Dentina/efectos de los fármacos , Perros , Pomadas , Periodontitis Periapical/fisiopatología , Ligamento Periodontal/efectos de los fármacos , Própolis/uso terapéutico , Distribución Aleatoria , Reproducibilidad de los Resultados , Irrigantes del Conducto Radicular/uso terapéutico , Factores de Tiempo , Ápice del Diente/efectos de los fármacos , Ápice del Diente/fisiopatología , Remineralización Dental/métodos , Resultado del TratamientoRESUMEN
Abstract Revascularization of immature teeth with necrotic pulps traditionally involves the use of triple antibiotic paste, which may sometimes lead to undesirable complications. The objective of this study was to assess tissue repair in immature dog teeth with apical periodontitis subjected to revascularization, comparing two different pastes used for root canal disinfection. Apical periodontitis was induced in 30 dog premolars. Teeth were randomly divided into three experimental groups: root canals filled with triple antibiotic paste (n = 10); root canals filled with 1% propolis paste (n = 10); and no medication (n = 10). An additional group (n = 10, no intervention) was used as control. After 7 months, the jaws were histologically evaluated for the following variables: newly formed mineralized tissue (present/absent); vital tissue in the canal space (absent/periodontal ligament-like/pulp-like); apical extension of root (present/absent); and severity of inflammatory process (absent/mild/moderate/severe). There were no statistically significant differences among the experimental groups in new mineralized tissue formation and apical root development. The formation of vital tissue in the canal space, in turn, was statistically different between the triple paste and propolis groups: vital tissues were present in all revascularized teeth disinfected with propolis paste (100%), compared to 71% of those disinfected with the triple paste. Severity of inflammatory process was different between the triple paste and no medication groups. The new tissues formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively. Propolis may have some advantages over the triple paste for the revascularization of immature teeth.
Asunto(s)
Animales , Perros , Periodontitis Periapical/tratamiento farmacológico , Própolis/farmacología , Irrigantes del Conducto Radicular/farmacología , Diente/irrigación sanguínea , Neovascularización Fisiológica/efectos de los fármacos , Necrosis de la Pulpa Dental/tratamiento farmacológico , Regeneración Tisular Dirigida/métodos , Antiinfecciosos/farmacología , Pomadas , Periodontitis Periapical/fisiopatología , Ligamento Periodontal/efectos de los fármacos , Própolis/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Factores de Tiempo , Remineralización Dental/métodos , Distribución Aleatoria , Reproducibilidad de los Resultados , Resultado del Tratamiento , Necrosis de la Pulpa Dental/fisiopatología , Ápice del Diente/efectos de los fármacos , Ápice del Diente/fisiopatología , Pulpa Dental/efectos de los fármacos , Pulpa Dental/fisiopatología , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/fisiopatología , Dentina/efectos de los fármacos , Antiinfecciosos/uso terapéuticoRESUMEN
AIM: To characterize the formation and progression of experimentally induced periapical lesions in teeth of MyD88 knockout (MyD88 KO) mice compared with wild-type (WT) mice. METHODOLOGY: Periapical lesions were induced in the mandibular first molars of 30 WT and 30 MyD88 KO mice. After 7, 21 and 42 days, the animals were euthanized and the mandibles were subjected to histotechnical processing. Histological sections were stained with haematoxylin and eosin (HE), TRAP histoenzymology, Brown and Brenn staining and immunohistochemistry (RANK, RANKL, OPG). Data were subjected to statistical analysis by the nonparametric Mann-Whitney and Kruskal-Wallis tests and the Dunn post-test, using the SPSS software, version 17.0 (α = 0.05). RESULTS: Regarding the periapical lesion size, the MyD88 KO group had significantly higher values than the WT group in the periods of 7 (P = 0.001) and 21 days (P = 0.05). A larger number of neutrophils in the MyD88 KO group were observed (P = 0.01 at 7 days, P = 0.004 at 21 days and P < 0.001 at 42 days). Regarding the number of osteoclasts, no statistically significant difference was observed between the groups at any of the experimental periods (P = 0.884 at 7 days, P = 0.506 at 21 days and P = 0.211 at 42 days). CONCLUSIONS: In the absence of MyD88, the animals had larger periapical lesions, with a severe inflammatory infiltrate and a significantly larger number of neutrophils.
Asunto(s)
Factor 88 de Diferenciación Mieloide/fisiología , Neutrófilos/patología , Periodontitis Periapical/fisiopatología , Animales , Cavidad Pulpar/patología , Recuento de Linfocitos , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Microscopía Fluorescente , Factor 88 de Diferenciación Mieloide/genéticaRESUMEN
The aim of this review was to examine current knowledge of the role of interleukin-6 (IL-6) in apical periodontitis (AP) pathogenesis as an inflammatory or pro-inflammatory cytokine. It also looked at whether IL-6 could serve as a measure for differential diagnosis or as a biomarker that can further predict the progression of bone resorption. A systematic review relating to AP and IL-6 was made via PubMed, BIOSIS, Cochrane, EMBASE and Web of Science databases using keywords and controlled vocabulary. Two independent reviewers first screened titles and abstracts and then the full texts. The reference lists of the identified publications were examined for additional titles. Eighteen papers were studied in total. In vitro studies (n = 6) revealed that IL-6 is present in AP, and its levels are proportional to the size of the periapical lesions. Neutrophils and macrophages resident in these lesions can produce IL-6 in vitro after a bacterial stimulus. Animal studies (n = 5) showed that IL-6 is present in AP and that osteoblasts can produce IL-6 in vivo. On the other hand, two studies using IL-6 knockout mice revealed larger periapical lesions when compared with control groups, demonstrating IL-6's role as an anti-inflammatory cytokine. In human studies (n = 7), IL-6 was identified in AP, and its levels were higher in symptomatic, epithelialized and large lesions than in asymptomatic and small lesions. These data lead to the conclusion that IL-6 may play a pro-inflammatory role, increasing its levels and reabsorbing bone in the presence of infections. When IL-6 is not present, other cytokines such as IL-1 and TNF-α induce bone resorption. Further studies about the relationship between AP development and the cytokine network must be performed to establish the exact role of each cytokine in the inflammatory process.
Asunto(s)
Interleucina-6/fisiología , Periodontitis Periapical/fisiopatología , Animales , HumanosRESUMEN
INTRODUCTION: This study evaluated the development of periapical lesions in a rat model of type 2 diabetes and assessed the potential actions of the antioxidant agent tempol in this model. METHODS: Male Wistar rats were used; they received tap water (N = 5) or a 20% glucose solution (N = 15) during a period of 9 weeks. At the sixth week, periapical lesions were induced on the first mandibular molars, and the animals were subdivided into 4 groups. The subgroup 1 was composed of nondiabetic rats orally receiving saline solution (10 mL/kg). Chronically glucose-fed rats were divided into the following subgroups: (2) saline-treated animals (10 mL/kg by oral route), and animals treated with tempol by gavage at doses of (3) 50 mg/kg or (4) 100 mg/kg. The body weight was monitored thoroughly. After 21 days of apical periodontitis induction, the animals were killed, and the mandibles were collected and submitted to radiographic and histologic analysis. The livers were collected to determine free radicals, and the blood plasma was used to measure insulin levels. RESULTS: Type 2 diabetic rats displayed a significant decrease of body weight gain and a slight increase of insulin levels, which were allied to reduced levels of the antioxidant components catalase and reduced glutathione; these alterations were reversed by tempol. Concerning the periapical lesions, neither radiographic nor histologic analysis revealed any significant difference between control and type 2 diabetic rats. In diabetic rats, the apical periodontitis was refractory to tempol treatment. CONCLUSIONS: The extent and cellularity of periapical lesions in glucose-fed type 2 diabetic rats were similar to those seen in control rats. Despite affecting other parameters related to diabetes, tempol failed to improve the outcome of endodontic lesions in type 2 diabetic animals.
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Antioxidantes/uso terapéutico , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Periodontitis Periapical/fisiopatología , Animales , Antioxidantes/administración & dosificación , Peso Corporal , Catalasa/análisis , Catalasa/efectos de los fármacos , Óxidos N-Cíclicos/administración & dosificación , Óxidos N-Cíclicos/uso terapéutico , Modelos Animales de Enfermedad , Radicales Libres/análisis , Glutatión/análisis , Glutatión/efectos de los fármacos , Insulina/sangre , Resistencia a la Insulina/fisiología , Hígado/metabolismo , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Estrés Oxidativo/fisiología , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/patología , Radiografía , Ratas , Ratas Wistar , Marcadores de Spin , Resultado del TratamientoRESUMEN
AIM: To monitor radiographically the progress of bone repair within chronic periapical lesions after root canal treatment using digital subtraction radiography (DSR). METHODOLOGY: Twelve patients with 17 single-rooted teeth with chronic apical periodontitis associated with an infected necrotic pulp were selected for root canal treatment. Periapical radiographs were taken before treatment (baseline) and immediately post-treatment, 45, 90, 135 and 180 days after treatment. The radiographic protocol included the use of individualized film holders with silicone bite blocks. The six radiographic images were digitized and submitted to digital subtraction using DSR software, resulting in five subtracted images (SI). Quantitative analysis of these SI was performed using Image Tool software to assess pixel value changes, considering a step-wedge as the gold standard and a cut-off value of 128 pixels. The aim was to identify any increase or decrease in mineral density in the region of the periapical lesion. RESULTS: A minor decrease in mineral density at the canal filling session and a significant progressive mineral gain in the following evaluations (P < 0.001) occurred. Pairwise comparison of pixel grey values revealed that only the 180-day follow-up differed significantly from the previous SI. CONCLUSION: Digital subtraction radiography is a useful method for evaluating the progress of bone repair after root canal treatment. Noticeable mineral gain was observed approximately 90 days after root canal filling and definite bone repair after 180 days.
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Pérdida de Hueso Alveolar/fisiopatología , Regeneración Ósea/fisiología , Periodontitis Periapical/fisiopatología , Radiografía Dental Digital/métodos , Técnica de Sustracción , Adolescente , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Periodontitis Crónica/diagnóstico por imagen , Periodontitis Crónica/fisiopatología , Necrosis de la Pulpa Dental/diagnóstico por imagen , Necrosis de la Pulpa Dental/fisiopatología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Periodontitis Periapical/diagnóstico por imagen , Tratamiento del Conducto Radicular , Adulto JovenRESUMEN
As doenças bucais inflamatórias crônicas, como a doença periodontal, estão relacionadas com a etiopatogênese das doenças arteriais coronarianas, causando danos endoteliais e facilitando a formação das placas ateromatosas. As doenças inflamatórias do periápice, assim como a doença periodontal, são doenças bacterianas que ativam a produção localizada de citocinas e outros mediadores próinflamatórios, como a proteína C-reativa (PCR). Essa proteína tem sido utilizada como um marcador sistêmico da inflamação, infecção e da lesão celular. Suas concentrações podem detectar doenças ocultas no organismo e monitorar a resposta ao tratamento de certos processos inflamatórios e infecciosos. O objetivo desse trabalho foi avaliar se as lesões periapicais crônicas podem ativar a resposta inflamatória, gerando repercussões sistêmicas e determinar se o método da PCR altamente sensível (PCR-as) por imunoturbidimetria pode ser utilizado para o diagnóstico e monitoramento do tratamento endodôntico destas lesões. Assim, comparou-se os níveis plasmáticos da PCR entre 13 indivíduos portadores e 13 indivíduos não portadores de lesão periapical crônica. Foram comparados também os níveis da PCR dos indivíduos portadores de lesão periapical crônica antes e após o tratamento do dente em questão. Não foi possível observar diferenças estatisticamente significantes entre os valores da PCR dos pacientes portadores de lesão periapical crônica antes e após os tratamentos (p=0,9203 com o teste t para amostras emparelhadas e p=0,94427 com o teste Wilcoxon), nem mesmo quando comparou-se os pacientes com lesão periapical crônica com os pacientes controles (p=0,1012 com o teste t para amostras independentes e p=0,1585 com o teste Mann Whitney). Pode-se concluir, com base na metodologia adotada, que as lesões periapicais crônicas não são capazes de induzir uma resposta inflamatória de repercussão sistêmica e o método da PCR-as por imunoturbidimetria não pode ser utilizado para o diagnóstico...
Inflammatory effects from periodontal disease can cause oral bacterial by products to enter the bloodstream. These effects may cause blood clots that contribute to a coronary heart disease risk factor. Chronic apical periodontitis are also bacterial diseases that stimulate the production of cytokines and other cell-mediated inflammatory factors such as C-reactive protein (CRP). CRP is one of the acute phase proteins that increase during systemic inflammation. Its been suggested that testing CRP levels in the blood may be an additional way to assess cardiovascular disease risk. The aim of this study was to evaluate if chronic apical periodontitis can ativate inflammatory response leading to systemic effects and to determine if a highly sensitive CRP (hs-CRP) assay is available to diagnose and track the endodontic treatment of these lesions. Plasma levels of hs-CRP were compared in blood of 13 individuals with chronic apical periodontitis and 13 healthy controls. CRP levels were also compared in the individuals with chronic apical periodontitis before and after treatment of the tooth. There was no statistical association among CRP levels of individual with or without chronic apical periodontitis (p=0,1012 for t test and p=0,1585 for Mann Whitney test). There was no statistical association among CRP levels of individual with chronic apical periodontitis before and after dental treatments (p=0,9203 for t test and p=0,94427 for Wilcoxon test). In conclusion, these results suggest that chronic apical periodontitis can not ativate inflammatory response leading to systemic effects and even a highly sensitive CRP (hs-CRP) assay is not available to diagnose and track the endodontic treatment of these lesions.
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Humanos , Masculino , Femenino , Adulto , Periodontitis Periapical/complicaciones , Periodontitis Periapical/fisiopatología , Proteína C-Reactiva/análisis , Infecciones Bacterianas , Biomarcadores , Periodontitis Periapical/microbiología , Estadísticas no ParamétricasAsunto(s)
Humanos , Masculino , Adolescente , Adulto , Femenino , Persona de Mediana Edad , Anciano , Proteínas de Choque Térmico/efectos adversos , Enfermedades Periapicales/etiología , Periodontitis Periapical/etiología , Periodontitis Periapical/fisiopatología , Enfermedades de la Pulpa Dental/etiología , Enfermedades de la Pulpa Dental/fisiopatología , Técnicas para Inmunoenzimas/métodos , Técnicas de Tipificación Bacteriana , Tejido Periapical/ultraestructura , Microscopía , Inmunoadhesinas CD4 , Antígenos Bacterianos/aislamiento & purificación , Sueros Inmunes , Macrófagos/fisiología , Linfocitos/fisiología , Neutrófilos/fisiología , Enfermedades Periapicales/inmunología , Proteínas de Choque Térmico/fisiología , Enfermedad CrónicaRESUMEN
The study the effect of chronically infected sites on the immediate placement of implants, periapical lesions were induced in the third and fourth premolars of four dogs and the contralateral teeth were used as controls. Nine months after the induction of periapical lesions, experimental and control teeth were extracted, and 28 IMZ implants were immediately placed. After a healing period of 12 weeks, the animals were sacrificed, the hemimandibles were removed, and specimens were prepared to be hard-sectioned and stained with toluidine blue. All areas healed without inflammation or exudation and all implants were clinically immobile and were radiographically determined to be surrounded by normal-appearing bone. Histologically, there were no signs of infection, and the histomorphometric analyses revealed that 28.6% and 38.7% had osseointegrated for the experimental and control implants, respectively. The difference was not statistically significant. It was concluded that chronically infected sites, such as those showing signs of periapical pathosis, may not be a contraindication for immediate implants, if certain clinical measures and preoperative and postoperative care are taken.
Asunto(s)
Infecciones Bacterianas/fisiopatología , Implantación Dental Endoósea , Oseointegración , Periodontitis Periapical/fisiopatología , Animales , Antibacterianos/administración & dosificación , Infecciones Bacterianas/tratamiento farmacológico , Contraindicaciones , Implantes Dentales , Perros , Eritromicina/administración & dosificación , Inyecciones Intramusculares , Penicilinas/administración & dosificación , Periodontitis Periapical/tratamiento farmacológico , Periodontitis Periapical/patologíaRESUMEN
Dogs' teeth with induced chronic periapical periodontitis were treated endodontically by two different methods, and the results were compared. A total of 40 root canals from the upper and lower premolars of two dogs were prepared chemomechanically. In method 1, a high-concentration (5.25%) hypochlorite solution was used during the instrumentation of the root canal, and an antibacterial dressing was applied between sessions, followed by filling of the root canal. In method 2, a low-concentration (0.5%) sodium hypochlorite solution was used as an adjunct to mechanical debridement, and the root canal was filled during the same session. The histopathological results showed that method 1 led to better periapical repair than method 2.
Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Periodontitis Periapical/terapia , Tejido Periapical/fisiopatología , Irrigantes del Conducto Radicular/administración & dosificación , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/administración & dosificación , Cicatrización de Heridas/efectos de los fármacos , Animales , Hidróxido de Calcio/uso terapéutico , Cemento Dental/fisiología , Perros , Ácido Edético/uso terapéutico , Periodontitis Periapical/fisiopatología , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/instrumentación , Hipoclorito de Sodio/uso terapéutico , Factores de Tiempo , Resultado del TratamientoRESUMEN
Root canals of dogs' premolar teeth were exposed to contamination and to the development of periapical inflammation over a period of 45 days. Root canals were overinstrumented 2 mm beyond the apical foramen with file No. 60 and were underfilled by 2 to 3 mm short of the roentgenographic apex. Ninety days after endodontic treatment, healing and ingrowth of connective tissue into the root canal occurred in 67.8% of the cases. These results suggest that the diameter of the apical foramen and the intensity of the canal contamination are determining factors for periapical tissue repair in cases of pulpal necrosis.