Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT

Teixeira, Flávia F.C.; Cardoso, Flávia G.R.; Ferreira, Nádia; Corazza, Bruna Jordão Motta; Valera, Márcia Carneiro; Nascimento, Gustavo G.; Martinho, Frederico Canato

doi:10.1016/j.joen.2022.04.010

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…This argument was supported by a study comparing periapical cytokine expression in medicated and unmedicated canal systems (Tavares et al, 2013). On the other hand, there are in vivo studies reporting a decrease of IL‐1β even in unmedicated canals (de Brito et al, 2012; Martinho et al, 2018; Tavares et al, 2012; Teixeira et al, 2022). Conflicting results might be correlated with complexity of the immune response contributed by the host‐ and microbial‐related factors and differences in study methodologies (Maia et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial

Keskin,

Aksoy,

Kalyoncuoğlu

et al. 2023

Int Endodontic J

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Aim To investigate the changes in the biomarker levels related to inflammation and tissue destruction in the periapical exudate of mandibular pre‐molar teeth with asymptomatic apical periodontitis after receiving intracanal cryotherapy, to compare cryotherapy and control groups in terms of analgesic intake, interappointment, and post‐operative pain and evaluate the correlation between biomarker levels and interappointment pain. Methodology Mandibular pre‐molar teeth of 44 patients aged 18–35 years, diagnosed with asymptomatic apical periodontitis, were root canal treated in two visits (registered as NCT04798144). Baseline periapical exudate samples were obtained, and the patients were assigned to either control or intracanal cryotherapy group according to the final irrigation with distilled water either at room temperature or 2.5°C. The canals were dressed with calcium hydroxide. In the second visit, the calcium hydroxide was removed with passive ultrasonic irrigation, and the periapical exudate was sampled again. IL‐1β, IL‐2, IL‐6, IL‐8, TNF‐α, PGE2 and MMP‐8 levels were determined with ELISA. Post‐operative pain levels were recorded for 6 days following both visits using a visual analogue scale. Data were analysed using t‐test, the Mann–Whitney U test and correlation tests. Results There was a significant correlation between the pain scores reported after first visit and IL‐1β and PGE2 levels (p < .05). IL‐1β, IL‐2 and IL‐6 levels showed no significant difference in the cryotherapy group (p > .05), while they significantly increased in the control group (p < .05). There was a decrease in IL‐8, TNF‐α, PGE2 and MMP‐8 levels, however, the difference was not significant (p > .05). Pain scores were significantly lower in the cryotherapy group for the first 3 days (p < .05), except for 24th hours (p > .05). Conclusions The positive correlation between interappointment pain and IL‐1β and PGE2 levels might indicate that these biomarker levels can be used to predict the severity of post‐operative pain. Intracanal cryotherapy was effective in reducing post‐operative pain in the short term in teeth with asymptomatic apical periodontitis. Cryotherapy prevented an increase in IL‐1β, IL‐2 and IL‐6 levels compared with the control group.

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Section: Discussionmentioning

confidence: 99%

Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial

Keskin,

Aksoy,

Kalyoncuoğlu

et al. 2023

Int Endodontic J

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“…Most notably, it was not possible to normalize crude analyte values to TPC due to low yields found in NATs, an issue similarly observed by Zehnder et al (2014) in dentinal tubular fluid. Normalizing to TFV, an alternative strategy utilized in several prior investigations (Ballal et al, 2017;Mente et al, 2016;Teixeira et al, 2022;Wahlgren et al, 2002; F I G U R E 6 Heat map and network analysis graphs. (a) Seriated heat map demonstrating positive (blue) and negative (orange) correlations between analytes and presence of asymptomatic apical periodontitis.…”

Section: In Vivo Cross-sectional Studymentioning

confidence: 99%

“…This could be due to a lack of methodological work-up data, which contrasts other intricate diagnostic procedures where basic parameters have been first optimized in vitro (Hartroth et al, 1999;Inic-Kanada et al, 2012;Zehnder et al, 2014). Additionally, existing PTF studies have limited their investigations to a small array of cytokines using conventional enzyme-linked immunosorbent assays (ELISA; Rechenberg et al, 2014;Teixeira et al, 2022;Zhi et al, 2017). It thus remains one of the only oral exudates that has not been characterized using more contemporary high-throughput methods of proteomic analysis, an approach that better reflects the complex multifaceted nature of periradicular pathophysiology.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, PTF has been retrieved clinically through root canals using paper points and its composition investigated at the proteomic and transcriptomic levels (Virdee et al, 2019). These experiments have quantified analytes (Martinho et al, 2016; Safavi & Rossomando, 1991; Shimauchi et al, 1996), correlated them with acute endodontic symptoms (Alptekin et al, 2005; Martinho et al, 2016; Pezelj‐Ribarić et al, 2007), longitudinally monitored changes throughout treatment (Alptekin et al, 2005; Grga et al, 2013; Liu et al, 2003) and utilized several markers as surrogate outcome measures in clinical trials (Corazza et al, 2021; Teixeira et al, 2022; Zhi et al, 2017). This body of evidence demonstrates PTF's ability to be harvested for local biomarker molecular analysis and proof‐of‐concept for their diagnostic, prognostic and predictive potential.…”

Section: Introductionmentioning

confidence: 99%

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Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

et al. 2023

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BackgroundPeriradicular tissue fluid (PTF) offers a source of diagnostic, prognostic and predictive biomarkers for endodontic disease.Aims(1) To optimize basic parameters for PTF paper point sampling in vitro for subsequent in vivo application. (2) To compare proteomes of PTF from teeth with normal apical tissues (NAT) and asymptomatic apical periodontitis (AAP) using high‐throughput panels.Methodology(1) To assess volume absorbance, paper points (n = 20) of multiple brands, sizes and sampling durations were inserted into PBS/1%BSA at several depths. Wetted lengths (mm) were measured against standard curves to determine volume absorbance (μL). To assess analyte recovery, paper points (n = 6) loaded with 2 μL recombinant IL‐1β (15.6 ng/mL) were eluted into 250 μL: (i) PBS; (ii) PBS/1% BSA; (iii) PBS/0.1% Tween20; (iv) PBS/0.25 M NaCl. These then underwent: (i) vortexing; (ii) vortexing/centrifugation; (iii) centrifugation; (iv) incubation/vortexing/centrifugation. Sandwich‐ELISAs determined analyte recovery (%) against positive controls.(2) Using optimized protocols, PTF was retrieved from permanent teeth with NAT or AAP after accessing root canals. Samples, normalized to total fluid volume (TFV), were analysed to determine proteomic profiles (pg/TFV) of NAT and AAP via O‐link Target‐48 panel. Correlations between AAP and diagnostic accuracy were explored using principal‐component analysis (PCA) and area under receive‐operating‐characteristic curves (AUC [95% CI]), respectively. Statistical comparisons were made using Mann–Whitney U, anova and post hoc Bonferonni tests (α < .01).Results(1) UnoDent's ‘Classic’ points facilitated maximum volume absorbance (p < .05), with no significant differences after 60 s (1.6 μL [1.30–1.73]), 1 mm depth and up to 40/0.02 (2.2 μL [1.98–2.20]). For elution, vortexing (89.3%) and PBS/1% BSA (86.9%) yielded the largest IL‐1β recovery (p < .05).(2) 41 (NAT: 13; AAP: 31) PTF samples proceeded to analysis. The panel detected 18 analytes (CCL‐2, ‐3, ‐4; CSF‐1; CXCL‐8, ‐9; HGF; IL‐1β, ‐6, ‐17A, ‐18; MMP‐1, ‐12; OLR‐1; OSM; TNFSF‐10, ‐12; VEGF‐A) in ≥75% of AAP samples at statistically higher concentrations (p < .01). CXCL‐8, IL‐1β, OLR‐1, OSM and TNFSF‐12 were strongly correlated to AAP. ‘Excellent’ diagnostic performance was observed for TNFSF‐12 (AUC: 0.94 [95% CI: 0.86–1.00]) and the PCA‐derived cluster (AUC: 0.96 [95% CI: 0.89–1.00]).ConclusionsOptimized PTF sampling parameters were identified in this study. When applied clinically, high‐throughput proteomic analyses revealed complex interconnected networks of potential biomarkers. TNFSF‐12 discriminated periradicular disease from health the greatest; however, clustering analytes further improved diagnostic accuracy. Additional independent investigations are required to validate these findings.

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“…Devido à ausência de estudos caracterizando e quantificando os diferentes tipos celulares da resposta inflamatória e imune em dentes decíduos com necrose pulpar e lesão periapical, e considerando os potenciais efeitos sistêmicos da infecção e das reações desencadeadas em crianças (Simon et al, 2015), torna-se relevante a realização de estudos nesse sentido. Além disso, esse conhecimento pode propiciar uma melhor compreensão da patologia pulpar e periapical em dentes decíduos, comparativamente aos permanentes, favorecendo o desenvolvimento e utilização de técnicas de tratamento mais direcionadas (Braz-Silva et al, 2019;Wang et al, 2022;Teixeira et al, 2022).…”

Section: Introductionunclassified

Quantificação de células da resposta imune e inflamatória e de peptídeo antimicrobiano (beta-defensina-3), em cistos radiculares de dentes decíduos e permanentes

Bertasso¹

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A Deus, Ao Senhor, que sempre me concedeu bem mais do que eu pedi e/ou mereci, sobe hoje, em forma de oração, o meu muito obrigado. Aos meus Pais,Antônio e Fernanda, meu profundo agradecimento por tudo que fizeram por mim em toda a minha vida. O amor que recebi foi incondicional e infinito e assim também é o meu amor por vocês. Hoje só tenho gratidão a Deus por ter me abençoado com uma família tão maravilhosa, amorosa e perfeita.Mãe, obrigada por confiar em mim em todos os momentos da minha vida.Pai, obrigada por ser meu porto seguro, quando tudo parecia desabar.Para mim e para vocês (Pais) estes 4 anos de doutorado foram de muita luta, perseverança e fé, por isto este título é uma vitória nossa! Obrigada por tudo, Amo vocês.Ao meu amor, Guilherme, você chegou no meio da minha trajetória da Pós-graduação e veio para "ressignificar" minha vida. Você me deu forças para não desistir do meu sonho: Ser Doutora pela Universidade de São Paulo. Hoje este sonho se realiza e para você minha eterna gratidão. O Amor verdadeiro constrói, impulsiona e não deixa o outro olhar para atrás. Te amo. Aos meus Avós,Vó Minda e Vô Orlando, Vó Leza e Vô Luiz (in Memoriam) que, para mim, são exemplos de caráter, honestidade, família e amor. Agradeço por terem contribuído na formação do meu caráter mostrando, sempre com muito carinho, as melhores escolhas para mim. Aos meus Padrinhos,Romeu e Renata, obrigada por serem tão presentes na minha vida, sempre me impulsionando para que eu conseguisse alcançar meus objetivos.

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Effects of Calcium Hydroxide Intracanal Medications on T Helper (Th1, Th2, Th9, Th17, and Tfh) and Regulatory T (Treg) Cell Cytokines in Apical Periodontitis: A CONSORT RCT

Cited by 10 publications

References 36 publications

Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial

Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial

Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

Quantificação de células da resposta imune e inflamatória e de peptídeo antimicrobiano (beta-defensina-3), em cistos radiculares de dentes decíduos e permanentes

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