Aveiro E, Chiarelli-Neto VM, de-Jesus-Soares A, Zaia AA, Ferraz CCR, Almeida JFA, Marciano MA, Feres M, Gomes BPFA. Efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite in the reduction of microbial content and virulence factors in teeth with primary endodontic infection.

Aim: To comparatively analyse the levels of culturable bacteria, endotoxins (LPS), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and substance P in teeth with symptomatic irreversible pulpitis (SIP) and vital normal pulp (VNP) tissues.Methodology: Thirty-two patients were included (20 teeth with SIP and 12 teeth with VNP tissues) in this cross-sectional study. Samples were collected from the full length of the root canals (microbial analysis) and periapical tissues (2 mm beyond the apex for immunological analysis), using sterile absorbent paper points. The levels of culturable bacteria (culture method), endotoxins (LAL Pyrogent 5000), TNF-α, IL-1β and substance P (ELISA) were assessed. The Mann-Whitney test was used for comparisons between the levels of CFU/mL, LPS, TNF-α, IL-1β and substance P in the SIP and VNP groups. The statistical analysis was performed with the significance level set at 5%. Results:Culturable bacteria were recovered from all teeth with SIP. On the other hand, no positive cultures were observed in the VNP tissues group (p > .05). The levels of LPS were approximately four times higher in teeth with SIP than in teeth with VNP tissues (p < .05). Higher levels of TNF-α and substance P were detected in teeth with SIP (p < .05). On the other hand, no difference in the levels of IL-1β was detected between the two groups (p > .05). Conclusion:Teeth with symptomatic irreversible pulpitis present higher levels of culturable bacteria, endotoxins, TNF-α and substance P than those with vital normal pulp tissues. On the other hand, the levels of IL-1β were similar in teeth from both groups suggesting reduced implications of this inflammatory mediator in the early stages of infection.

No abstract

A deficiência da restauração coronária influencia diretamente o sucesso do tratamento endodôntico. A microinfiltração coronária ocorre nos casos de perda do material restaurador provisório, fratura ou infiltração pela restauração coronária definitiva e cáries recorrentes, permitindo a contaminação do sistema de canais radiculares que pode atingir os tecidos periapicais. O caminho percorrido pela infiltração coronária atingindo os canais radiculares ainda não foi estudado. Objetivo: Avaliar in vitro, a contaminação nos terços radiculares, após a infiltração pela porção coronária, de dentes tratados endodonticamente. Foram selecionados 62 dentes, os quais foram montados em um aparato para simular a contaminação, que foi realizada com saliva humana de único voluntário. As coletas foram feitas por terços radiculares e os espécimes divididos em 5 grupos experimentais, variando o tempo de contato com a saliva. Foram coletadas amostras de guta-percha dos canais radiculares conforme os terços radiculares e as mesmas foram plaqueadas em FAA (Fastidious Anaerobe Agar) e meio de cultura seletivo M-Enterococcus, sendo analisadas quanto a contagem de unidade formadora de colônia (UFC).Os dados foram tabulados utilizando uma tabela de contingência e analisados estatisticamente através do teste de Kruskal-Willis, com nível de significância de 5%(p<0.05). Concluímos que os dentes foram progressivamente contaminados de acordo com o tempo, sendo o terço coronário o mais contaminado.

The objective of this study was to investigate the presence of culturable bacteria, endotoxins (LPS) and lipoteichoic acid (LTA) levels in teeth with normal vital pulp (NVP) with intact crowns (IC) and those with coronal restoration (CR) limited to the enamel level. A total of 20 teeth indicated for endodontic treatment due to prosthetic reasons were selected. Samples were collected from the root canals. The levels of cultivable bacteria, LPS and LTA were assessed. Statistical analyses were performed at significance level set at 5%. None of the teeth presented microbial growth. In the IC group, the LPS levels were limited to the lowest concentration of LPS. On the contrary, higher LPS and LTA levels were detected in teeth with CR. It was concluded that teeth with NVP and IC were negative for bacteria, LPS and LTA; while teeth with CR were positive for bacterial virulence factors.