RESUMO
Abstract Objective: To evaluate the periapical healing following root canal treatment in teeth with apical periodontitis (in vivo) and the cytotoxic potential of root canal sealers in vitro. Material and Methods: Apical periodontitis was induced in 60 dogs' teeth and root canals were filled with Sealapex (40 roots), EndoREZ (40 roots), intracanal dressing (20 roots), or left untreated (20 roots). After 30 and 90 days, histopathological analyses were made. In vitro, J774.1 macrophages were stimulated with root canal sealers extracts, cytotoxicity was assessed using lactate dehydrogenase assay, and qRT-PCR was used to analyze TNF-α gene expression. Results: In vivo, smaller apical periodontitis and lower inflammatory cell infiltrate were found in teeth treated with Sealapex compared to EndoREZ. In vitro, EndoREZ was cytotoxic and induced TNF-α gene expression by macrophages differently from Sealapex. Conclusion: Sealapex allowed improved tissue repair following root canal treatment in teeth with apical periodontitis compared to EndoREZ. Synthesis of TNF-α induced by LPS was enhanced by EndoREZ, whereas Sealapex prevented pro-inflammatory gene expression (AU).
Assuntos
Animais , Cães , Periodontite Periapical , Obturação do Canal Radicular , Técnicas In Vitro , Cavidade Pulpar , Endodontia , Análise de VariânciaRESUMO
Objective: To evaluate the pulpal and periapical response of dogs' teeth after pulpotomy and use of Enamel Matrix Derivative (EMD) as capping agent. Methods: Pulpotomy was performed in 40 teeth from 4 dogs and the remaining pulp tissue was recovered with the following materials: Groups I and IV: EMD (Emdogain®); Groups II and V: calcium hydroxide; Groups III and VI: zinc oxide and eugenol cement. After 7 days (Groups I, II, and III) and 70 days (Groups IV, V, and VI), the animals were euthanized and the teeth were removed and processed for histological analysis; were analyzed using Kruskal-Wallis test followed by Dunn test or Mann Whitney test ( =0.05). Results: 7-day period: in Group I, it was observed a mild to moderate inflammatory infiltrate and intense vascular proliferation while Group II presented a mild inflammatory infiltrate and an intact pulp tissue (p < 0.05). Group III presented a moderate to severe inflammatory infiltrate. 70- day period: Groups IV and VI showed no dentin bridge formation, the remaining pulp tissue presented necrotic areas with inflammatory cells in the periapical region and bone and cementum resorption (p > 0.05). In Group V, there was dentin bridge formation, absence of inflammation and absence of mineralized tissue resorption (p < 0.05). Conclusion: EMD as a capping material after pulpotomy did not show either satisfactory tissue response or capacity of inducing deposition of mineralized tissue in dental pulp.
Objetivo: Avaliar a resposta pulpar e periapical de dentes de cães após pulpotomia e uso de Derivados de Matriz de Esmalte (EMD) como agente de capeamento. Métodos: A pulpotomia foi realizada em 40 dentes de 4 cães e o tecido pulpar remanescente foi recuperado com os seguintes materiais: Grupos I e IV: EMD (Emdogain®); Grupos II e V: hidróxido de cálcio; Grupos III e VI: cimento de óxido de zinco e eugenol. Após 7 dias (Grupos I, II e III) e 70 dias (Grupos IV, V e VI), os animais foram eutanásiados e os dentes foram removidos e processados para análise histológica; foram analisados pelo teste de Kruskal-Wallis, seguido pelo teste de Dunn ou Mann Whitney ( = 0,05). Resultados: Período de 7 dias: no Grupo I, observou-se infiltrado inflamatório leve a moderado e intensa proliferação vascular, enquanto o Grupo II apresentou infiltrado inflamatório leve e tecido pulpar intacto (p <0,05). O grupo III apresentou infiltrado inflamatório moderado a grave. Período de 70 dias: os grupos IV e VI mostraram, na formação da ponte de dentina, que o tecido pulpar remanescente apresentava áreas necróticas com células inflamatórias na região periapical, reabsorção óssea e de cemento (p> 0,05). No Grupo V, houve formação de ponte de dentina, ausência de inflamação e ausência de reabsorção tecidual mineralizada (p <0,05). Conclusão: O EMD como material de cobertura após pulpotomia não mostrou resposta tecidual satisfatória ou capacidade de induzir deposição de tecido mineralizado na polpa dentária.
Assuntos
Animais , Endodontia , Pulpotomia , Cimento de Óxido de Zinco e Eugenol , Hidróxido de CálcioRESUMO
A Endodontia é uma ciência que engloba a etiologia, diagnóstico, prevenção e tratamento da periodontite apical e suas repercussões no organismo. Recu rsos tecnológ icos no diagnóstico, exploração e novas estratégias associadas principalmente à limpeza e desinfecção do sistema de canais radiculares, modelagem e obturação do espaço endodôntico, de acordo com bases biológicas,permitirão a obtenção de melhores padrões de sucesso pós-tratamento.
Endodontics is a science that embodies etiology, diagnosis, prevention, and treatment of apical periodontitis and its repercussion in the organismo Technological resources in diagnosis and root canal negotiation, and new strategies , associated to mainly cleaning and eliminating the infection of the root canal system, shaping, and filling the endodontic space, according to biological bases, will allow us to reach higher standards of post-treatment success.
Assuntos
Cavidade Pulpar , Endodontia/métodos , Periodontite Periapical/patologia , Preparo de Canal RadicularRESUMO
This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.
Assuntos
Materiais Restauradores do Canal Radicular/farmacologia , Tela Subcutânea/efeitos dos fármacos , Animais , Materiais Biocompatíveis/farmacologia , Biópsia , Hidróxido de Cálcio/farmacologia , Colágeno , Tecido Conjuntivo/efeitos dos fármacos , Tecido Conjuntivo/patologia , Fibroblastos/patologia , Células Gigantes de Corpo Estranho/patologia , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Macrófagos/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Neutrófilos/patologia , Polietileno , Distribuição Aleatória , Salicilatos/farmacologia , Tela Subcutânea/patologia , Fatores de Tempo , Dente Decíduo , Óxido de Zinco/farmacologia , Cimento de Óxido de Zinco e Eugenol/farmacologiaRESUMO
AIM: To investigate the root canal microbiota of primary teeth with apical periodontitis and the in vivo antimicrobial effects of a calcium hydroxide/chlorhexidine paste used as root canal dressing. DESIGN: Baseline samples were collected from 30 root canals of primary teeth with apical periodontitis. Then, the root canals were filled with a calcium hydroxide paste containing 1% chlorhexidine for 14 days and the second bacteriologic samples were taken prior to root canal filling. Samples were submitted to microbiologic culture procedure to detect root canal bacteria and processed for checkerboard DNA-DNA hybridization. RESULTS: Baseline microbial culture revealed high prevalence and cfu number of anaerobic, black-pigmented bacteroides, Streptococcus, and aerobic microorganisms. Following root canal dressing, the overall number of cfu was dramatically diminished compared to initial contamination (P <0.05), although prevalence did not change (P > 0.05). Of 35 probes used for checkerboard DNA-DNA hybridization, 31 (88.57%) were present at baseline, and following root canal dressing, the number of positive probes reduced to 13 (37.14%). Similarly, the number of bacterial cells diminished folowing application of calcium hydroxide/chlorhexidine root canal dressing (P = 0.006). CONCLUSION: Apical periodontitis is caused by a polymicrobial infection, and a calcium hydroxide/chlorhexidine paste is effective in reducing the number of bacteria inside root canals when applied as a root canal dressing.
Assuntos
Bactérias Anaeróbias/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Necrose da Polpa Dentária/microbiologia , Bactérias Gram-Negativas/efeitos dos fármacos , Periodontite Periapical/microbiologia , Irrigantes do Canal Radicular/farmacologia , Dente Decíduo/microbiologia , Análise de Variância , Bactérias Aeróbias/efeitos dos fármacos , Bacteroides/efeitos dos fármacos , Hidróxido de Cálcio/farmacologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Clorexidina/farmacologia , Contagem de Colônia Microbiana , DNA Bacteriano/análise , Necrose da Polpa Dentária/terapia , Feminino , Humanos , Masculino , Hibridização de Ácido Nucleico , Periodontite Periapical/terapia , Preparo de Canal Radicular/métodos , Estatísticas não Paramétricas , Streptococcus/efeitos dos fármacosRESUMO
This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.
Neste estudo avaliou-se a resposta do tecido conjuntivo subcutâneo de camundongos BALB/c a materiais obturadores de canal radicular de dentes decíduos: óxido de zinco/eugenol (OZE), pasta Calen® espessada com óxido de zinco (Calen/OZ) e cimento Sealapex®. Os camundongos (n=102) receberam implantes de tubos de polietileno??? e foram divididos em grupos: I, II, III - Calen/OZ (7, 21 e 63 dias, respectivamente); IV, V, VI - Sealapex (7, 21 e 63 dias, respectivamente); VII, VIII, IX - OZE (7, 21 e 63 dias, respectivamente); X, XI - tubo vazio (7 e 21 dias, respectivamente). Os tecidos foram submetidos ao processamento e análise histopatológica descritiva e por meio de escores do fibrosamento, espessura tecidual e infiltrado inflamatório. Para a análise quantitativa mensurou-se a área e a espessura do tecido granulomatoso reacional (TGR). Os resultados foram analisados pelos testes de Kruskal-Wallis, ANOVA e pós-teste de Tukey (?=0,05). Não houve diferença significante (p>0,05) entre os materiais, com relação ao fibrosamento e à espessura do TGR. Contudo, Calen/OZ apresentou infiltrado inflamatório de menor intensidade (p<0,05). A área do TGR foi menor (p<0,05) para Calen/OZ e Sealapex. Pôde-se concluir que Calen/OZ foi o material que apresentou a melhor compatibilidade tecidual, seguido pelos cimentos Sealapex e OZE.
Assuntos
Animais , Masculino , Camundongos , Materiais Restauradores do Canal Radicular/farmacologia , Tela Subcutânea/efeitos dos fármacos , Biópsia , Materiais Biocompatíveis/farmacologia , Colágeno , Hidróxido de Cálcio/farmacologia , Tecido Conjuntivo/efeitos dos fármacos , Tecido Conjuntivo/patologia , Fibroblastos/patologia , Células Gigantes de Corpo Estranho/patologia , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Camundongos Endogâmicos BALB C , Macrófagos/patologia , Neutrófilos/patologia , Polietileno , Distribuição Aleatória , Salicilatos/farmacologia , Tela Subcutânea/patologia , Fatores de Tempo , Dente Decíduo , Cimento de Óxido de Zinco e Eugenol/farmacologia , Óxido de Zinco/farmacologiaRESUMO
The purpose of this study was to evaluate the accuracy of electronic apex locators Digital Signal Processing (DSP) and ProPex, for root canal length determination in primary teeth. Fifteen primary molars (a total of 34 root canals) were divided into two groups: Group I - without physiological resorption (n = 16); and Group II - with physiological resorption (n = 18). The length of each canal was measured by introducing a file until its tip was visible and then it was retracted 1 mm. For electronic measurement, the devices were set to 1 mm short of the apical resorption. The data were analysed statistically using the intraclass correlation coefficient (ICC). Results showed that the ICC was high for both electronic apex locators in all situations - with (ICC: DSP = 0.82 and Propex = 0.89) or without resorption (ICC: DSP = 0.92 and Propex = 0.90). Both apex locators were extremely accurate in determining the working length in primary teeth, both with or without physiological resorption.
Assuntos
Cavidade Pulpar/anatomia & histologia , Odontometria/instrumentação , Processamento de Sinais Assistido por Computador , Raiz Dentária/anatomia & histologia , Dente Decíduo/anatomia & histologia , Humanos , Dente Molar/anatomia & histologia , Odontometria/métodos , Reabsorção da RaizRESUMO
This study aimed to assess the response of apical and periapical tissues of dogs' teeth after root canal filling with different materials. Forty roots from dogs' premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort and camphorated paramonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.
Assuntos
Cavidade Pulpar/efeitos dos fármacos , Materiais Restauradores do Canal Radicular/uso terapêutico , Dente Decíduo/efeitos dos fármacos , Animais , Dente Pré-Molar/cirurgia , Reabsorção Óssea/etiologia , Hidróxido de Cálcio/uso terapêutico , Cânfora/uso terapêutico , Clorofenóis/uso terapêutico , Tecido Conjuntivo/efeitos dos fármacos , Cemento Dentário/efeitos dos fármacos , Desinfetantes de Equipamento Odontológico/uso terapêutico , Cavidade Pulpar/patologia , Dentina/efeitos dos fármacos , Cães , Combinação de Medicamentos , Edema/etiologia , Hidrocarbonetos Iodados/uso terapêutico , Leucócitos Mononucleares/patologia , Teste de Materiais , Tecido Periapical/efeitos dos fármacos , Tecido Periapical/patologia , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Polietilenoglicóis/uso terapêutico , Prednisolona/análogos & derivados , Prednisolona/uso terapêutico , Rifamicinas/uso terapêutico , Preparo de Canal Radicular/métodos , Reabsorção da Raiz/etiologia , Fatores de Tempo , Ápice Dentário/efeitos dos fármacos , Ápice Dentário/patologia , Dente Decíduo/patologia , Óxido de Zinco/uso terapêutico , Cimento de Óxido de Zinco e Eugenol/uso terapêuticoRESUMO
INTRODUCTION: This study investigated the inhibition of the antimicrobial activity of sodium hypochlorite (NaOCl) by bovine serum albumin (BSA). The killing of Enterococcus faecalis, Candida albicans, Staphylococcus epidermidis, and Escherichia coli by NaOCl in concentrations from 2% to 0.03% was measured in the presence of BSA in concentrations between 6.7% and 0.1%. METHODS: NaOCl, BSA, and microorganism suspensions were mixed, and, after 30 seconds, 6 minutes, and 30 minutes, samples were taken and NaOCl was inactivated by 5% sodium thiosulphate. The microbes were incubated in tryptic soy broth broth for up to 7 days for the detection of growth. RESULTS: All microorganisms were killed within 30 seconds by 0.03% NaOCl when BSA was not present. High concentrations of BSA significantly reduced the antimicrobial activity of NaOCl against the four species. CONCLUSIONS: The inhibition of sodium hypochlorite by BSA was directly dependent on their quantitative relationships. The result partly explains the poorer performance in vivo of NaOCl as compared to in vitro experiments.
Assuntos
Desinfetantes/farmacologia , Interações Medicamentosas , Testes de Sensibilidade Microbiana/métodos , Soroalbumina Bovina/farmacologia , Hipoclorito de Sódio/farmacologia , Animais , Anti-Infecciosos Locais/farmacologia , Bactérias/efeitos dos fármacos , Bovinos , Relação Dose-Resposta a Droga , Irrigantes do Canal Radicular/farmacologiaRESUMO
This study aimed to assess the response of apical and periapical tissues of dogs' teeth after root canal filling with different materials. Forty roots from dogs' premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen®) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort® and camphorated paramonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.
O objetivo deste estudo foi avaliar a resposta dos tecidos apicais e periapicais de dentes de cães, após obturação dos canais radiculares com diferentes materiais indicados para dentes decíduos. Foram utilizados pré-molares de cães, totalizando 40 raízes que, após pulpectomia e preparo biomecânico, foram divididas em 4 grupos, nos quais os canais radiculares foram obturados com os seguintes materiais: Grupo I - pasta comercial composta de hidróxido de cálcio e polietileno glicol 400 (Calen®) espessada com óxido de zinco; Grupo II - pasta composta de iodofórmio, Rifocort® e paramonoclorofenol canforado; Grupo III - cimento de óxido de zinco e eugenol; e Grupo IV - solução salina. Decorridos 30 dias, as peças foram submetidas ao processamento histológico. De acordo com os resultados da análise histopatológica observou-se que nos Grupos I e IV as regiões apical e periapical apresentaram aspecto de normalidade, com grande número de fibras e células e ausência de reabsorção dos tecidos mineralizados. No Grupo II observou-se infiltrado inflamatório e edema leves, com discreta fibrogênese e reabsorção óssea. O Grupo III apresentou alteração na região periapical e ligamento periodontal ampliado, com presença de células inflamatórias e edema. Os resultados obtidos permitiram concluir que a pasta Calen espessada com óxido de zinco apresentou a melhor resposta tecidual, sendo a mais indicada para a obturação de canais radiculares de dentes decíduos com vitalidade pulpar.