RESUMO
The aim of this study was to evaluate the biocompatibility of the regeneration of the dentin-pulp complex in a murine model with different treatments with MTA Angelus, NeoMTA, and TheraCal PT. An in vivo controlled experimental study of 15 male Wistar rats forming three study groups, the upper and lower central incisors were selected where pulpotomies were conducted, leaving a central incisor as control at 15, 30, and 45 days. For data analysis, these were expressed as mean ± standard deviation and were examined by Kruskal-Wallis test. Three factors were analyzed as follows: "inflammatory infiltrate; disorganization of pulp tissue, and the formation of reparative dentin". No statistical significance was found between the different groups (p > 0.05). Treatment with these three biomaterials (MTA, TheraCal PT, and Neo MTA) presented an inflammatory infiltrate and slight disorganization of the odontoblast layer in the pulp tissue of a murine model, with normal coronary pulp tissue and the formation of reparative dentin in the three experimental groups. Thus, we are able to conclude that all three are biocompatible materials.
RESUMO
The prevalence of dental caries in the Mexican adult population aged 20 to 85 years is around 93.3%, and 50% in Mexican children and adolescents. Worldwide, it is the most common non-communicable disease. One of the main etiological factors for dental caries is the oral microbiome and changes in its structure and function, with an expansion of pathogenic bacteria like Streptococcus mutans. The exposed dental pulp tissue triggers an innate immune response to counteract this bacterial invasion. The relation between oral dysbiosis and innate immune responses remains unclear. We aimed to understand the relationship between innate immune response and the oral microbiota by quantifying the expression of Toll-like receptors (TLRs) and proinflammatory markers (cytokines and a chemokine) in dental pulp tissue, either exposed or not to carious dentin, and to correlate this information with the oral microbiome found in healthy teeth and those with moderate caries. RNA was purified from pulp tissue, subjected to RT-qPCR and analysed with the ΔΔCt method. Supragingival dental plaque of non-carious teeth and dentin of carious teeth were subjected to 16S targeted sequencing. Principal coordinate analysis, permutational multivariate ANOVA, and linear discriminant analysis were used to assess differences between non-carious and carious teeth. Correlations were assessed with Spearman´s test and corrected for multiple comparisons using the FDR method. The relative abundance (RA) of Lactobacillus, Actinomyces, Prevotella, and Mitsuokella was increased in carious teeth; while the RA of Haemophilus and Porphyromonas decreased. Olsenella and Parascardovia were only detected in carious teeth. Significant overexpression of interleukin 1 beta (IL1 ß), IL6, and CXCL8 was detected in pulp tissue exposed to carious dentin. IL1ß correlated positively with TLR2 and Actinomyces; yet negatively with Porphyromonas. These findings suggest that immune response of pulp tissue chronically exposed to cariogenic microbiome is triggered by proinflammatory cytokines IL1ß and IL6 and the chemokine CXCL8.
Assuntos
Cárie Dentária , Polpa Dentária , Microbiota , Adolescente , Adulto , Criança , Humanos , Actinobacteria , Actinomyces , Citocinas/imunologia , Cárie Dentária/imunologia , Cárie Dentária/microbiologia , Polpa Dentária/imunologia , Polpa Dentária/microbiologia , Dentina/metabolismo , Dentina/microbiologia , Interleucina-6/metabolismo , Microbiota/genética , Microbiota/imunologia , Streptococcus mutans/genéticaRESUMO
OBJECTIVES: This systematic review (PROSPERO CRD42021227711) evaluated the influence of diabetes mellitus (DM) on the response of the pulp tissue and in the pulp cells behaviour. MATERIALS AND METHODS: Searches in PubMed/MEDLINE, Embase, Web of Science and OpenGrey were performed until March 2022. Studies evaluating the effects of DM in the pulp tissue inflammation and in the cell behaviour were included, followed by risk of bias assessment (Methodological Index for Non-Randomized Studies and SYRCLE's RoB tools). The meta-analysis was unfeasible, and a narrative synthesis for each outcome was provided. RESULTS: Of the 615 studies, 21 were eligible, mainly with in vivo analysis (16 studies). The pulp inflammation (10 studies) was analysed mainly by haematoxylin-eosin stain; DM increased pulp inflammation/degeneration in 9 studies, especially after dental procedures. The cell viability (5 studies) was analysed mostly using MTT assay; DM and glycating agents decreased cellular viability in 3 studies. DM reduced collagen in all of three studies. There were controversial results regarding mineralization; however, increased alkaline phosphatase was reported in three of four studies. CONCLUSIONS: DM seems to increase inflammation/degeneration and mineralization in the pulp tissue while reducing cell proliferation. Further analyses in human pulp are important to provide stronger evidence.
RESUMO
Mesenchymal stromal cells (MSCs) have been used in immunosuppressive therapy due to their therapeutic effects, with the HLA-G molecule seeming to play a fundamental role. This work evaluated alternative MSC sources to bone marrow (BM), namely, umbilical cord tissue (UC), adipose tissue (AD) and dental pulp tissue (DP), and the influence of interferon-γ (IFN-γ) and hypoxia on the cultivation of these cells for use in immunosuppression therapies. Expression of costimulatory markers CD40, CD80 and CD86 and immunosuppressive molecules CD152 and HLA-G was analyzed. Lymphocyte inhibition assays were also performed. Sequencing of the HLA-G gene from exons 1 to 5 was performed using next-generation sequencing to determine the presence of alleles. UC-derived MSCs (UCMSCs) expressed higher CD152 and HLA-G1 under standard cultivation. UCMSCs and DP-derived MSCs (DPSCs) secreted similar levels of HLA-G5. All MSC sources inhibited the proliferation of peripheral blood mononuclear cells (PBMCs); growth under regular versus hypoxic conditions resulted in similar levels of inhibition. When IFN-γ was added, PBMC growth was inhibited to a lesser extent by UCMSCs. The HLA-G*01:04:01:01 allele appears to generate a more efficient MSC response in inhibiting lymphocyte proliferation. However, the strength of this conclusion was limited by the small sample size. UCMSCs are an excellent alternative to BM in immunosuppressive therapy: they express high concentrations of inhibitory molecules and can be cultivated without stimuli, which minimizes cost.
Assuntos
Antígenos HLA-G , Células-Tronco Mesenquimais , Proliferação de Células , Células Cultivadas , Antígenos HLA-G/genética , Antígenos HLA-G/metabolismo , Terapia de Imunossupressão , Interferon gama/metabolismo , Interferon gama/farmacologia , Leucócitos Mononucleares/metabolismo , Células-Tronco Mesenquimais/metabolismo , Cordão Umbilical/metabolismoRESUMO
AIM: To validate a new method for the evaluation of pulp tissue debridement in the root canals of extracted teeth using an impregnation protocol involving potassium triiodide, a radiocontrast solution known as Lugol's, combined with micro-computed tomographic (micro-CT) imaging. METHODOLOGY: The impact of NaOCl on the radiopacity of Lugol's solution was assessed using a two-fold dilution series of Lugol in distilled water and 5.25% NaOCl, which were then pipetted into transparent dishes and radiographed. To verify the influence of Lugol on the proteolytic effect of NaOCl, a dissolution test was performed using fresh bovine meat. Ten slices did not undergo any tissue processing, whilst twenty slices were fixed in formaldehyde for 24 h. After that, 10 of them were immersed in Lugol for another 24 h. Then, all specimens were placed in NaOCl and the time required for a complete tissue dissolution was recorded. For the last experiments (histological validation and micro-CT assessment), 8 extracted mandibular premolars with formerly vital pulps were immersed in buffered formalin, scanned in a micro-CT device, accessed, immersed in Lugol for 7 days and scanned again. Then, the root canals of 5 teeth were prepared and scanned, and the volume of remaining pulp tissue identified and quantified, whilst 3 teeth were histologically processed. The same specimens were subjected to histological assessment, and the images of the histologic sections were registered with the corresponding micro-CT images to verify whether the pulp tissue in the histological sections matched its counterpart in the Lugol-impregnated tissues identified in the micro-CT slices. RESULTS: There was no discernible effect on radiopacity when NaOCl was mixed with Lugol's solution. Tissue processing did not affect the time required for the complete dissolution of fresh bovine meat. Histological evaluation revealed a correlation between micro-CT and histological images confirming the identification of Lugol-impregnated pulp tissue in micro-CT images. CONCLUSIONS: The radiocontrast Lugol's solution was unaffected by NaOCl and did not interfere with its soft tissue dissolution capability. The impregnation protocol using Lugol's solution allowed the visualization of pulp tissue on the micro-CT images and the identification of pulp remnants after chemical-mechanical canal procedures.
Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Animais , Bovinos , Desbridamento , Polpa Dentária , Cavidade Pulpar/diagnóstico por imagem , Microtomografia por Raio-XRESUMO
OBJECTIVE: This study provides an in vivo evaluation of the inflammatory response, levels of cell proliferation and apoptosis, and the presence of necrosis after dental bleaching with two concentrations of hydrogen peroxide (H2O2). DESIGN: Wistar rats were divided into Control (placebo gel), BLUE (20% H2O2, 1×50min), and MAXX (35% H2O2, 3×15min) groups. At 2 and 30days, the rats were killed (n=10). The jaws were processed for histology analysis and PCNA and Caspase-3-cleaved immunohistochemistry, and data were submitted to the Mann-Whitney or ANOVA test (P<0.05). RESULTS: At 2days, the MAXX group showed necrosis and the BLUE group revealed moderate inflammation on the occlusal third of the crown (P<0.05). At 30days, tertiary dentin had formed and there was an absence of inflammation. The level of cell proliferation was higher in the middle third of the BLUE group (P<0.05), and cervical of MAXX at 2days (P<0.05), decreasing at 30days. The apoptosis was present at 2days, particularly in the cervical third of the crown in the bleached groups (P<0.05), with a decrease only at 30days in the BLUE group (P<0.05). CONCLUSIONS: The concentration of H2O2 influences effects on the pulp tissue, where a higher concentration of H2O2 can cause necrosis in the pulp and a prolonged effect within the apoptotic process; lower concentrations of H2O2 provide moderate inflammation, cell proliferation and apoptosis with a reduction of these processes over time.
Assuntos
Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Necrose da Polpa Dentária/induzido quimicamente , Polpa Dentária/citologia , Polpa Dentária/efeitos dos fármacos , Peróxido de Hidrogênio/toxicidade , Clareadores Dentários/toxicidade , Animais , Imuno-Histoquímica , Masculino , Ratos , Ratos WistarRESUMO
This study evaluated the influence of the addition of cetrimide and polypropylene glycol to sodium hypochlorite (NaOCl) on its capacity to dissolve pulp tissue. Bovine pulp fragments with standardized weight and volume were immersed for 5, 15 and 30 min in 2 mL of NaOCl and Hypoclean (NaOCl added with cetrimide and polypropylene glycol) solutions at 5.25%, 2.5%, 1%, 0.5% and 0.25% and afterwards re-weighted. Distilled water was used as a control. The percentage of tissue loss was considered for statistical analysis (univariate ANOVA, SPSS, v. 17.0) at 5% significance level. There was no tissue dissolution in the control group. NaOCl added with surfactants (Hypoclean) dissolved more pulp tissue (p<0.05) than NaOCl alone. Tissue dissolution was directly dependent on the concentration of solutions (p<0.05), and also on the time range (p<0.05). The combination of NaOCl at high and low concentrations with the surfactants cetrimide and polypropylene glycol increased significantly its capacity to dissolve pulp tissue.
Este estudo avaliou a influência da adição de cetramida e polipropilenoglicol ao hipoclorito de sódio (Hypoclean) na capacidade de dissolução pulpar do hipoclorito de sódio (NaOCl). Fragmentos de tecido pulpar bovino, com peso e volume padronizados foram imersos por períodos de 5, 15 e 30 min em 2 mL de NaOCl ou Hypoclean nas concentrações 5,25%, 2,5%, 1%, 0,5% e 0,25%. Após a imersão nas soluções testadas, os fragmentos foram novamente pesados. Como controle, foi utilizada água destilada. O percentual de perda tecidual foi considerado para análise estatística (ANOVA univariada, SPSS, v. 17.0). Não houve dissolução tecidual no grupo controle. A solução de NaOCl combinada a surfactantes (Hypoclean) dissolveu um maior percentual de tecido pulpar (p<0,05) que o NaOCl sem associações. A dissolução tecidual foi diretamente dependente da concentração das soluções (p<0,05), assim como do tempo de exposição às soluções (p<0,05). A adição dos surfactantes cetramida e polipropilenoglicol ao NaOCl em concentrações altas e baixas aumentou significativamente sua capacidade de dissolução do tecido pulpar.
Assuntos
Animais , Bovinos , Compostos de Cetrimônio/química , Polpa Dentária/química , Polímeros/química , Propilenoglicóis/química , Hipoclorito de Sódio/química , SolubilidadeRESUMO
INTRODUCTION: Sodium hypochlorite (NaOCl) solutions with added wetting agents are advertised to dissolve necrotic tissue in root canals faster than their counterparts without a lowered surface tension. This was tested in the current study, and the null hypothesis formulated was that there was no difference between a commercially available NaOCl solution with a lowered surface tension (Chlor-XTRA; Vista Dental Products, Racine, WI) and a counterpart containing the same amount of available chlorine without added wetting agents regarding the soft tissue that remains in oval-shaped canals after mechanical preparation and irrigation. METHODS: Formerly vital extracted teeth (N = 44, 22 pairs) with similar anatomy were radiographically paired and chemomechanically prepared. In 1 tooth from each pair, a 5.25% NaOCl solution with reduced surface tension was used; in the other, a pure, technical-grade NaOCl solution of 5.25% was used. The percentage of remaining pulp tissue (PRPT) was histologically assessed in root cross-sections. The non-Gaussian raw data were subjected to Kruskal-Wallis and Mann-Whitney U tests to verify the respective effect of the cross-section level and solution on the PRPT. The relationship between the cross-section level and the PRPT was estimated by the Spearman correlation test. The alpha-type error was set at 5%. RESULTS: The cross-section level significantly influenced the PRPT (P < .05), whereas the PRPT was not influenced by the solution used (P > .05). A significant inverse correlation was found between the cross-section level and the PRPT (P < .05, r = -0.330). The lower the distance to the apex, the higher the PRPT regardless of the solution used. CONCLUSIONS: Contrary to the advertised statement, the dental solution with a reduced surface tension did not dissolve vital pulp tissue in oval root canals any better than a conventional NaOCl solution of similar strength. Closer to the apex, pulp tissue dissolution is less efficient irrespective of the solution.
Assuntos
Polpa Dentária/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Agentes Molhantes/farmacologia , Adulto , Anatomia Transversal , Polpa Dentária/anatomia & histologia , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/efeitos dos fármacos , Humanos , Concentração de Íons de Hidrogênio , Teste de Materiais , Irrigantes do Canal Radicular/química , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/química , Solubilidade , Tensão Superficial , Fatores de Tempo , Ápice Dentário/anatomia & histologia , Ápice Dentário/efeitos dos fármacos , Raiz Dentária/anatomia & histologia , Raiz Dentária/efeitos dos fármacos , Molhabilidade , Agentes Molhantes/químicaRESUMO
PURPOSE: The aim of the present study was to evaluate the tissue dissolving capacity of various concentrations of sodium hypochlorite either alone or in combination with 17 percent EDTA. METHODS: Eighty bovine pulp fragments were prepared, and their weight was determined using a precision balance. Each pulp fragment was immersed for 2 hours in a solution/mixture that was based on the following groups: G1 - saline solution; G2 - 0.5 percent NaOCl; G3 - 1.0 percent NaOCl; G4 - 2.5 percent NaOCl; G5 - 17 percent EDTA; G6 - 0.5 percent NaOCl+17 percent EDTA; G7 - 1.0 percent NaOCl+17 percent EDTA; and G8 - 2.5 percent NaOCl+17 percent EDTA. The final weight was measured, and the weight loss was calculated. A statistical analysis was performed using either the Student's t-test for paired samples or an ANOVA and Tukey tests (P<0.05 was considered to be significant). RESULTS: We measured a significant difference between the sample weight before and after treatment for each of the tested groups (P<0.05). The 2.5 percent sodium hypochlorite solution (G4) completely dissolved the pulp tissue within the test period. NaOCl+EDTA was less effective than sodium hypochlorite alone at dissolving the pulp tissue (P<0.05), and EDTA alone (G5) did not markedly dissolve the pulp tissue. CONCLUSION: Using EDTA together with NaOCl reduced the tissue dissolving properties compared with NaOCl alone, regardless of the concentration of NaOCl that was used.
OBJETIVO: O objetivo do presente estudo foi avaliar a capacidade de dissolução tecidual de várias concentrações de hipoclorito de sódio, isoladamente ou em combinação com o EDTA 17 por cento. METODOLOGIA: Oitenta fragmentos de polpa bovina foram preparados e seus pesos foram determinados através de uma balança de precisão. Cada fragmento pulpar foi imerso por 2 horas em cada uma das soluções/misturas e formaram os seguintes grupos: G1- Solução salina; G2- NaOCl 0,5 por cento; G3- NaOCl 1 por cento; G4- NaOCl 2,5 por cento; G5- EDTA 17 por cento; G6- NaOCl 0,5 por cento + EDTA 17 por cento; G7- NaOCl 1,0 por cento + EDTA 17 por cento; G8- NaOCl 2,5 por cento + EDTA 17 por cento. O peso final foi medido e a perda de peso calculada. A análise estatística foi realizada através do teste t de Student para amostras pareadas, ou ANOVA e teste de Tukey. RESULTADOS: Verificaram-se diferenças entre os pesos das amostras antes e depois do tratamento para cada um dos grupos testados (P< 0,05). A solução de hipoclorito de sódio 2,5 por cento (G4) dissolveu completamente o tecido pulpar dentro do período teste. O hipoclorito de sódio + EDTA foi menos efetivo na dissolução do tecido pulpar do que o hipoclorito de sódio sozinho (P < 0,05), e o EDTA (G5) não dissolveu o tecido pulpar. CONCLUSÃO: O uso do EDTA misturado com o hipoclorito de sódio reduziu a propriedade de dissolução tecidual comparado ao hipoclorito de sódio sozinho, a despeito das concentrações de hipoclorito de sódio.
Assuntos
Animais , Bovinos , Hipoclorito de Sódio/administração & dosagem , Hipoclorito de Sódio/farmacologia , Polpa Dentária , Ácido Edético/administração & dosagem , Ácido Edético/farmacologiaRESUMO
As metaloproteinases da matriz (MMPs) foram relacionadas a diversas doenças inflamatórias como artrite e também ao câncer. O presente trabalho tem por objetivo estabelecer o papel da MMP-2, MMP-9 e MMP-8 no processo de inflamação pulpar. Foram adotadas as seguintes hipóteses nulas: (1) o padrão de expressão das MMP-2, MMP-9 e MMP-8 não sofre alteração nos diferentes estágios da polpa humana: normal, reversível, transição, irreversível ou necrose; (2) não há diferença de expressão das MMP-2, -9 e MMP-8, considerando-se um mesmo estágio de inflamação tecidual pulpar. Os métodos utilizados foram: (I) Obtenção dos espécimes, que foram divididos em grupos de acordo com critérios adotados de semiologia subjetiva e objetiva. Obtiveram-se os seguintes grupos: GI (Controle) dentes hígidos (n=7); GII (Pulpite Reversível n=4); GIII (Pulpite Transição n=4); GIV (Pulpite Irreversível/Necrose n=8). Logo após exodontia, os dentes obtidos foram cortados ligeiramente abaixo da junção amelodentinária e fixados em formol a 10% por 48h. Foram lavados em água corrente (24h) para então serem processados histologicamente. Foram obtidas secções de 4m, aderidas em lâminas silanizadas e submetidas à imunomarcação (Técnica da Peroxidase), utilizando os anticorpos anti MMP-2, MMP-9 e MMP-8 humanos. A presença de imunomarcação foi realizada através da análise semi-quantitativa por escores, sendo que a quantificação de marcação por corte seguiu o seguinte escore: 0= ausente; 1= leve; 2= moderada; 3= intensa. Realizou-se teste estatístico não paramétrico Kruskal-Wallis, p<0,05. As comparações intergrupos revelaram, para CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0,01) e GII>GIV (p<0,05); (2)MMP-9 GI=GII=GIV, GII=GIII e GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. Na região central da polpa, obteve-se: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0,001) e GII>GIV (p<0,01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI (p<0,001) e GIV>GII (p<0,01); (3)MMP-8 GI=GII, GIII=GIV, GIII>GI (p<0,05),...
The matrix metalloproteinases (MMPs) have been related to various inflammatory diseases, such as arthritis, as well as to cancer. The aim of the present study was to establish the role of MMP-2, MMP-9 and MMP-8 in the process of dental pulp inflammation. The following null hypotheses were adopted: (1) the pattern of MMP-2, MMP-9 and MMP-8 expression does not undergo alteration in the following different stages of human pulp: normal, reversible, transition, irreversible or necrosis; (2) there is no difference in the expression of MMP-2, -9 and MMP-8, when considering the same stage of pulp tissue inflammation. The methods used were: (I) Obtainment of specimens, which were divided into groups according to the subjective and objective criteria of semiology adopted. The following groups were obtained: GI (Control) healthy teeth (n=7); GII (Reversible Pulpitis n=4); GIII (Transition Pulpitis n=4); GIV (Irreversible Pulpitis/Necrosis n=8). Soon after extraction the teeth obtained were cut slightly below the amelodentinal junction and fixed in 10% formol for 48h. They were washed under running water (24h) and were histologically processed afterwards. Sections of 4m were obtained, adhered to silanized slides, and submitted to immunomarking (Peroxidase Technique), using human anti MMP-2, MMP-9 and MMP- 8 antibodies. The presence of immunomarking was determined through semi-quantitative analysis by scores, and marking by cut was quantified using the following score: 0= absent; 1= slight; 2= moderate; 3= intense. The Kruskal-Wallis non-parametric statistical test was performed, p<0.05. Intergroup comparisons revealed the following: for CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0.01) and GII>GIV (p<0.05); (2)MMP-9 GI=GII=GIV, GII=GIII and GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. In the central region of the pulp, the following results were obtained: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0.001) and GII>GIV (p<0.01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI...