Proinflammatory Activity of Primarily Infected Endodontic Content against Macrophages after Different Phases of the Root Canal Therapy

Autor(es)

Marinho, Ariane C. S. ^[1] ; Martinho, Frederic C. ^[1] ; Leite, Fabio R. M. ^[2] ; Nascimento, Gustavo G. ^[3] ; Gomes, Brenda P. F. A. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, UNICAMP, Endodont Div, Dept Restorat Dent, Sao Paulo - Brazil

^[2] Fed Univ Pelotas UFPel, Pelotas Sch Dent, Dept Semiol & Clin, Periodont Div, Pelotas - Brazil

^[3] Fed Univ Pelotas UFPel, Pelotas Sch Dent, Grad Program Dent, Pelotas - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF ENDODONTICS; v. 41, n. 6, p. 817-823, JUN 2015.
• Citações Web of Science: 5

Resumo

Introduction: This study investigated the presence of target bacterial species and the levels of endotoxins in teeth with apical periodontitis. Levels of inflammatory mediators (interleukin {[}IL]-1 beta and tumor necrosis factor {[}TNF]-alpha) were determined after macrophage stimulation with endodontic content after different phases of endodontic therapy using different irrigants. Methods: Thirty primarily infected root canals were randomly assigned into 3 groups according to the irrigant used for root canal preparation (n = 10 per group): GI: 2.5% sodium hypochlorite, GII: 2% chlorhexidine gel, and GIII (control group): saline solution. Root canal samples were taken by using paper points before (s1) and after root canal instrumentation (s2), subsequently to 17% EDTA (s3), after 30 days of intracanal medication (Ca{[}OH](2) + saline solution) (s4), and before root canal obturation (s5). Polymerase chain reaction (16S recombinant DNA) and limulus amebocyte lysate assay were used for bacterial and endotoxin detection, respectively. Macrophages were stimulated with the root canal contents for IL-1 beta/TNF-alpha measurement using enzyme-linked immunosorbent assay. Results: Porphyromonas gingivalis (17/30), Porphyromonas endodontalis (15/30), and Prevotella nigrescens (11/30) were the most prevalent bacterial species. At s1, endotoxins were detected in 100% of the root canals (median = 32.43 EU/mL). In parallel, substantial amounts of IL-1 beta and TNF-alpha were produced by endodontic content-stimulated macrophages. At s2, a significant reduction in endotoxin levels was observed in all groups, with GI presenting the greatest reduction (P < .05). After a root canal rinse with EDTA (s3), intracanal medication (s4), and before root canal obturation (s5), endotoxin levels reduced without differences between groups (P < .05). IL-1 beta and TNF-alpha release decreased proportionally to the levels of residual endotoxin (P < .05). Conclusions: Regardless of the use of sodium hypochlorite or CHX, the greatest endotoxin reduction occurs after chemomechanical preparation. Increasing steps of root canal therapy associated with intracanal medication enhances endotoxin reduction, leading to a progressively lower activation of proinflammatory cells such as macrophages (AU)

• Processo FAPESP: 10/19136-1 - Estudo microbiológico e de endotoxinas em canais radiculares com necrose pulpar e lesão periapical e avaliação do seu potencial antigênico contra macrófagos na produção de IL1-beta e TNF-alfa durante a terapia endodôntica
• Beneficiário: Brenda Paula Figueiredo de Almeida Gomes
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/02402-9 - Investigação do conteúdo microbiológico e de endotoxinas e sua atividade antigênica em canais radiculares de dentes com pulpite irreversível e necrose pulpar na produção de citocinas pró-inflamatórias
• Beneficiário: Ariane Cássia Salustiano Marinho
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 10/17877-4 - Análise microbiológica, de endoxinas e de citocinas pró-inflamatórias em infecções endodônticas primárias com presença de lesões periapicais
• Beneficiário: Brenda Paula Figueiredo de Almeida Gomes
• Modalidade de apoio: Auxílio à Pesquisa - Regular