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High expression of MMP-2 and MMP-9 in periapical lesions plays an important role in the degradation of the extracellular matrix. This study aimed to investigate the effect of epigallocatechin-3-gallate (EGCG)-based endodontic paste as an intracanal dressing on the expression of MMP-2 and MMP-9 in periapical lesions. Periapical lesions were experimentally induced in 35 mature beagle dog premolars randomly divided into healthy teeth, untreated periapical lesions, periapical lesions treated in a single session (control groups), and periapical lesions treated in two sessions with EGCG or calcium hydroxide-based pastes (experimental groups). After 120 days, specimens were obtained for histopathologic and immunofluorescence analyses to assess the expression of MMP-2 and MMP-9. The statistical analysis was performed using a p-value of 0.05. Endodontic treatment in two sessions using medication with EGCG and calcium hydroxide-based pastes provided similar repair of the apical and periapical tissues and neoformation of periodontal ligament fibers, cementum, and alveolar bone (p>0.05). The experimental groups treated in two sessions with both medications presented expression of MMP-2 and MMP-9 similar to that in healthy teeth (p>0.05), and significantly lower than teeth treated in a single session or untreated periapical lesions (p <0.001). Expression of MMP-2 and MMP-9 was observed in the cytoplasm of fibroblasts, osteoblasts, cementoblasts, cementocytes, and vascular endothelium. The use of EGCG-based endodontic paste reduced the expression of MMP-2 and MMP-9 and allowed repair of periapical lesions, similar to calcium hydroxide-based paste, and superior to treatment performed in a single session.
Assuntos
Catequina/análogos & derivados , Periodontite Periapical , Cães , Animais , Metaloproteinase 9 da Matriz , Hidróxido de Cálcio/farmacologia , Metaloproteinase 2 da Matriz , BandagensRESUMO
Abstract High expression of MMP-2 and MMP-9 in periapical lesions plays an important role in the degradation of the extracellular matrix. This study aimed to investigate the effect of epigallocatechin-3-gallate (EGCG)-based endodontic paste as an intracanal dressing on the expression of MMP-2 and MMP-9 in periapical lesions. Periapical lesions were experimentally induced in 35 mature beagle dog premolars randomly divided into healthy teeth, untreated periapical lesions, periapical lesions treated in a single session (control groups), and periapical lesions treated in two sessions with EGCG or calcium hydroxide-based pastes (experimental groups). After 120 days, specimens were obtained for histopathologic and immunofluorescence analyses to assess the expression of MMP-2 and MMP-9. The statistical analysis was performed using a p-value of 0.05. Endodontic treatment in two sessions using medication with EGCG and calcium hydroxide-based pastes provided similar repair of the apical and periapical tissues and neoformation of periodontal ligament fibers, cementum, and alveolar bone (p>0.05). The experimental groups treated in two sessions with both medications presented expression of MMP-2 and MMP-9 similar to that in healthy teeth (p>0.05), and significantly lower than teeth treated in a single session or untreated periapical lesions (p <0.001). Expression of MMP-2 and MMP-9 was observed in the cytoplasm of fibroblasts, osteoblasts, cementoblasts, cementocytes, and vascular endothelium. The use of EGCG-based endodontic paste reduced the expression of MMP-2 and MMP-9 and allowed repair of periapical lesions, similar to calcium hydroxide-based paste, and superior to treatment performed in a single session.
Resumo A alta expressão de MMP-2 e MMP-9 em lesões periapicais desempenha um papel importante na degradação da matriz extracelular. Este estudo teve como objetivo investigar o efeito de uma pasta à base de epigalocatequina-3-galato (EGCG) como curativo intracanal na expressão de MMP-2 e MMP-9 em lesões periapicais. Lesões periapicais foram induzidas experimentalmente em 35 pré-molares de cães da raça beagle, maduros, divididos aleatoriamente em dentes saudáveis, lesões periapicais não tratadas, lesões periapicais tratadas em uma única sessão e lesões periapicais tratadas em duas sessões com a pasta de EGCG ou pasta à base de hidróxido de cálcio. O operador monitorou os animais e realizou a eutanásia após 120 dias para análises histopatológicas e de imunofluorescência para avaliar a expressão de MMP-2 e MMP-9. A análise estatística foi realizada utilizando p=0,05. O tratamento endodôntico em duas sessões com pasta à base de EGCG e pasta à base de hidróxido de cálcio proporcionou níveis semelhantes de reparação dos tecidos apicais e periapicais e neoformação de fibras do ligamento periodontal, cemento e osso alveolar. Em ambos os grupos, a expressão de MMP-2 e MMP-9 foi mínima, sendo observada no citoplasma de fibroblastos, osteoblastos, cementoblastos, cementócitos e endotélio vascular. Em ambos os grupos tratados em duas sessões, a expressão de MMP-2 e MMP-9 foi semelhante à dos dentes hígidos e significativamente menor do que nas lesões periapicais tratadas em sessão única ou não tratadas (p < 0,001). O uso da pasta à base de EGCG reduziu a expressão de MMP-2 e MMP-9 e permitiu o reparo de lesões periapicais, semelhante à pasta à base de hidróxido de cálcio, e foi superior ao tratamento realizado em sessão única.
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Objetivo: Realizar uma revisão sistemática para avaliar os principais agentes e métodos de descontaminação das escovas dentais contra vírus, bactérias e fungos encontrados na literatura. Métodos: Foi realizada uma busca nas bases de dados LILACS® (Literatura científica e técnica da América Latina e Caribe/BVS Biblioteca Virtual em Saúde), MEDLINE® (Medical Literature Analysis and Retrieval System Online / PubMed)®, EMBASE® (Elsevier), em agosto de 2020. Como critério de inclusão, foram selecionados artigos publicados entre os anos de 2010 e 2020, nos idiomas português, inglês e espanhol, estudos de ensaios clínicos controlados randomizados, ensaios clínicos não randomizados e estudos in vitro, que avaliaram diferentes agentes e métodos de descontaminação das escovas dentais. Resultados: Foram recuperados um total de 2523 artigos, sendo qualificados para o estudo um total de 6 artigos "in vivo" e 4 "in vitro". O agente de descontaminação mais estudado e eficaz foi a clorexidina 0,12% (em forma de imersão ou spray), seguida pelo hipoclorito de sódio 1% e 2,5% (imersão), vinagre branco 50% (imersão), solução de cloreto de cetilpiridínio (imersão ou spray), micro-ondas e máquina de lavar-louças. Conclusão: Considerando as evidências de qualidade encontradas, a clorexidina 0,12% constitui o agente mais estudado e eficaz, seguido pelo hipoclorito de sódio 1 % e cloreto de cetilpiridínio, utilizados em forma de spray ou imersão, constituem soluções eficazes, de fácil acesso, que podem ser utilizadas pela população para descontaminação das escovas dentais.
Aim: To carry out a systematic review of articles found in the literature in order to evaluate the main agents and methods for decontaminating toothbrushes against viruses, bacteria, and fungi. Methods: A search was performed in LILACS® (Scientific and Technical Literature of Latin America and the Caribbean/VHL Virtual Health Library), MEDLINE® (Medical Literature Analysis and Retrieval System Online /PubMed)®, and EMBASE® databases (Elsevier), in August 2020. As inclusion criteria, articles published between 2010 and 2020, in Portuguese, English, and Spanish, studies of randomized controlled clinical trials, non-randomized clinical trials, and in vitro studies were selected, which evaluated different agents and methods for decontaminating toothbrushes. Results: A total of 2,523 articles were retrieved, with a total of 6 in vivo and 4 in vitro articles deemed to be eligible for the study. The most studied and effective decontamination agent was 0.12% chlorhexidine (in immersion or spray form), followed by 1% and 2.5% sodium hypochlorite (immersion), 50% white vinegar (immersion), solution of cetylpyridinium chloride (dip or spray), microwave, and dishwasher. Conclusion: Considering the quality evidence found, 0.12% chlorhexidine is the most studied and effective agent, followed by 1% sodium hypochlorite and cetylpyridinium chloride, used in spray or immersion form; these are effective, easily accessible solutions that can be used by the population to decontaminate toothbrushes.
Assuntos
Escovação Dentária , Descontaminação , Desinfecção , MétodosRESUMO
Abstract Objective: To compare the accuracy of periapical radiography (PR) and cone-beam computed tomography (CBCT) for the detection of external apical root resorption (EARR) due to root canal contamination. Material and Methods: Dog's teeth with experimentally induced root resorption due to root canal contamination underwent or not root canal treatment (n=62). True positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) in PR and CBCT diagnoses were determined using histopathologic findings as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (TP + TN) in the diagnosis of EARR were calculated. Data were compared using chi-squared test (α=0.05). Results: EARR was detected in 35% of roots by PR, in 47% by CBCT, and in 50% of the roots by microscopy (p=0.03 PR versus microscopy; p=0.67 CBCT versus microscopy). Overall, CBCT produced more accurate diagnoses than PR (p=0.008). PR and CBCT allowed the identification of large resorption in 100% of the cases and showed the same accuracy. However, for small resorptions, PR showed an accuracy of 0.83, whereas CBCT showed an accuracy of 0.96 (p=0.003). Conclusion: Cone-beam computed tomography showed higher accuracy in detecting external apical root resorption of endodontic origin.
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Animais , Cães , Periodontite Periapical/diagnóstico por imagem , Reabsorção da Raiz/diagnóstico por imagem , Radiografia Dentária/instrumentação , Tomografia Computadorizada de Feixe Cônico/instrumentação , Precisão da Medição Dimensional , Distribuição de Qui-Quadrado , Cavidade PulparRESUMO
Abstract The aim of this study was to evaluate the expression of MMP2 and MMP9 during apical periodontitis (AP) progression in TLR2 (TLR2 KO) and in MyD88 (MyD88 KO) knockout mice compared to wild type (WT) mice. AP was induced in mandibular first molars of TLR2 KO (n= 18), MyD88 KO (n= 18), and WT mice (n= 18). After 7, 21, and 42 days, the animals were euthanized and the jaws were dissected and subjected to histotechnical processing. Subsequent sections were stained by immunohistochemistry and evaluated for detection of MMP2 and MMP9. Statistical analysis of the semi-quantitative analysis of immunohistochemistry was performed using chi-square test (α = 0.05). In the initial periods of AP progression, an increased expression of MMP9 in the TLR2 KO and MyD88 KO mice was observed. In the final periods of AP progression, a reduction of MMP2 expression and an increase of MMP9 expression in the TLR2 KO mice were observed. MMP2 and MMP9 production was modulated for TLR2 and MyD88 during apical periodontitis progression.
Resumo O objetivo deste estudo foi avaliar a expressão de MMP2 e MMP9 durante a progressão da periodontite apical (AP) em camundongos knockout para TLR2 (TLR2 KO) e MyD88 (MyD88 KO) comparados aos camundongos wild type (WT). A AP foi induzida nos primeiros molares inferiores dos camundongos TLR2 KO (n = 18), MyD88 KO (n = 18) e WT (n = 18). Após 7, 21 e 42 dias, os animais foram eutanaziados e as mandíbulas foram dissecadas e submetidas a processamento histotécnico. As lâminas foram coradas por imuno-histoquímica e analisadas para a detecção de MMP2 e MMP9. A análise estatística semi-quantitativa da imuno-histoquímica foi realizada pelo teste qui-quadrado (α = 0,05). Nos períodos iniciais de progressão AP, foi observada uma expressão aumentada de MMP9 nos camundongos TLR2 KO e MyD88 KO. Nos períodos finais de progressão AP, observou-se uma redução da expressão de MMP2 e um aumento da expressão de MMP9 nos camundongos TLR2 KO. A produção de MMP2 e MMP9 foi modulada por TLR2 e MyD88 durante a progressão da periodontite apical.
Assuntos
Animais , Camundongos , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Fator 88 de Diferenciação Mieloide/fisiologia , Periodontite Periapical/enzimologia , Receptor 2 Toll-Like/fisiologia , Progressão da Doença , Imuno-Histoquímica , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fator 88 de Diferenciação Mieloide/genética , Periodontite Periapical/metabolismo , Periodontite Periapical/patologiaRESUMO
The aim of this study was to evaluate the expression of MMP2 and MMP9 during apical periodontitis (AP) progression in TLR2 (TLR2 KO) and in MyD88 (MyD88 KO) knockout mice compared to wild type (WT) mice. AP was induced in mandibular first molars of TLR2 KO (n= 18), MyD88 KO (n= 18), and WT mice (n= 18). After 7, 21, and 42 days, the animals were euthanized and the jaws were dissected and subjected to histotechnical processing. Subsequent sections were stained by immunohistochemistry and evaluated for detection of MMP2 and MMP9. Statistical analysis of the semi-quantitative analysis of immunohistochemistry was performed using chi-square test (α = 0.05). In the initial periods of AP progression, an increased expression of MMP9 in the TLR2 KO and MyD88 KO mice was observed. In the final periods of AP progression, a reduction of MMP2 expression and an increase of MMP9 expression in the TLR2 KO mice were observed. MMP2 and MMP9 production was modulated for TLR2 and MyD88 during apical periodontitis progression.
Assuntos
Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Fator 88 de Diferenciação Mieloide/fisiologia , Periodontite Periapical/enzimologia , Receptor 2 Toll-Like/fisiologia , Animais , Progressão da Doença , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fator 88 de Diferenciação Mieloide/genética , Periodontite Periapical/metabolismo , Periodontite Periapical/patologiaRESUMO
Introduction and objective:The purpose of the study was to evaluate different pH cycling protocols on the induction of artificial carious lesions in bovine dentin, since the most appropriate protocol to be applied is still not fully established. Material and methods: Fragments of bovine dentin (4 x 4 x 2 mm) were embedded in resin, polished and 7 mm² of each fragment was isolated with wax. The specimens were divided into three groups (A, B, C) according to the time of immersion in the demineralizing solution (1.5 ml). Group A - 15 minutes; Group B - 30 minutes; Group C - 60 minutes and subsequently immersed for 22 hours in a remineralizing solution (1.5 ml). Microhardness measurements were conducted initially, daily and after each pH cycling for 4 days. The Split-plot design (ANOVA) was applied. Results: There was a significant interaction between time and cariogenic challenge (p<0.0001). Bonferroni comparisons were executed to identify the differences over the cariogenic challenge, showing that increasing the immersion time in demineralizing solution for each pH cycling assessed, the cariogenic challenge aggressiveness increased (A
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Introduction: Localized Aggressive Periodontitis (LAP) is characterized by a disease with rapid progression and loss of bone support specifically in the region of the permanent first molars and incisors teeth, and may lead to loss of dental elements. Objective: The aim of this study was to conduct a brief literature review on LAP, and present the clinical, radiographic, microbiological and immunological aspects of this rare form of periodontal disease. Literature review: Epidemiological studies in different populations showed a higher incidence in non-white population, and non-industrialized countries, there is also a predilection for female gender, manifested between puberty and 25 to 30 years of age. Conclusion: LAP is a disease with low prevalence, mainly caused by Aa, and radiographically manifested by extensive destruction of periodontal tissue supporting of permanent first molars and incisors. In contrast, clinically, the affected teeth not presented significant amount of dental biofilm or gingival inf lammation. The early diagnosis is important to establish an effective treatment, including antibiotic therapy, and favor prognosis.
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Periapical lesions are diseases resulting from contamination and necrosis of dental pulp and the progression of this infection toward the periapical tissues. Technological advances in microbiological culture and identification have shown that anaerobic microorganisms, especially Gram-negative, are predominate in root canals of teeth with pulp necrosis and chronic periapical lesions. Gram-negative bacteria not only have different factors of virulence and generate products and sub-products that are toxic to apical and periapical tissues, but also contain endotoxin in the outer membrane of their cell wall. This information is important because endotoxin is released during multiplication or bacterial death, causing a series of biological effects that lead to an inflammatory reaction and resorption of mineralized tissues. Thus, the aim of this work is to carry out a review of the literature on the role of bacterial endotoxin in the etiology of periapical lesions, its mechanism of action, and to elucidate molecular mechanisms involved in endotoxin's recognition by the immune system and cell activation.
As lesões periapicais são patologias resultantes da contaminação e necrose da polpa dental e progressão da infecção em direção aos tecidos periapicais. Os avanços tecnológicos na cultura e identificação microbiana demonstraram que, em canais radiculares de dentes portadores de necrose pulpar e lesão periapical crônica, predominam os microrganismos anaeróbios, particularmente os Gram-negativos. As bactérias Gram-negativas, além de possuírem diferentes fatores de virulência e gerarem produtos e subprodutos tóxicos aos tecidos apicais e periapicais, contêm a endotoxina em sua parede celular. Esse conhecimento é importante, uma vez que a endotoxina é liberada durante a multiplicação ou morte bacteriana, exercendo uma série de efeitos biológicos relevantes, que conduzem a uma reação inflamatória e à reabsorção dos tecidos mineralizados. Sendo assim, o objetivo deste trabalho foi efetuar uma revisão da literatura relativa ao papel da endotoxina bacteriana na etiologia das lesões periapicais, seu mecanismo de ação, bem como elucidar mecanismos moleculares envolvidos no seu reconhecimento pelo sistema imunológico e na ativação celular.
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Abstract: The objective of this in vitro study was to evaluate the antimicrobial effect of toothpastes containing natural extracts, chlorhexidine or triclosan. The effectiveness of toothpastes containing natural extracts (Parodontax(r)), 0.12% chlorhexidine (Cariax(r)), 0.3% triclosan (Sanogil(r)) or fluoride (Sorriso(r), control) was evaluated against yeasts, Gram-positive and Gram-negative bacteria using the disk diffusion method. Water was used as a control. Disks impregnated with the toothpastes were placed in Petri dishes containing culture media inoculated with 23 indicative microorganisms by the pour plate method. After incubation, the inhibition growth halos were measured and statistical analyses (α=0.05) were performed. The results indicated that all formulations, except for conventional toothpaste (Sorriso(r)), showed antimicrobial activity against Gram-positive bacteria and yeasts. The toothpaste containing natural extracts (Parodontax(r)) was the only product able to inhibit the growth of Pseudomonas aeruginosa. The toothpastes containing chlorhexidine, triclosan or natural extracts presented antimicrobial activity against Gram-positive bacteria and yeasts.
Resumo: O objetivo deste estudo in vitro foi avaliar o efeito antimicrobiano de dentifrícios contendo extratos naturais, clorexidina ou triclosan. A efetividade dos dentifrícios contendo extratos naturais (Parodontax(r)), 0,12% de clorexidina (Cariax(r)), 0,3% de triclosan (Sanogil(r)) ou flúor (Sorriso(r), controle) foi avaliada contra leveduras, bactérias Gram-positivas e Gram-negativas utilizando o método de difusão em disco. A água foi utilizada como um controle. Discos impregnados com os dentifrícios foram colocados em placas de Petri contendo meio de cultura inoculados com 23 microrganismos indicadores pelo método "pour plate". Após a incubação, os halos de inibição do crescimento foram medidos e as análises estatísticas (=0,05) foram realizadas. Os resultados indicaram que todas as formulações, com exceção do dentifrício convencional (Sorriso(r)), apresentaram atividade antimicrobiana contra bactérias Gram-positivas e leveduras. O dentifrício contendo extratos naturais (Parodontax(r)) foi o único produto capaz de inibir o crescimento de Pseudomonas aeruginosa. Os dentifrícios contendo clorexidina, triclosan ou extratos naturais apresentaram atividade antimicrobiana contra bactérias Gram-positivas e leveduras.