Radiographic and Immunohistochemical Evaluation of Root Canal Treatment Using Different Irrigation Systems

Abstract

The aim of this study was to evaluate the radiographic periapical repair and the synthesis of inflammatory mediators after endodontic treatment in a single session, using different irrigation protocols, in teeth with apical periodontitis. Experimental apical periodontitis were induced in dog’s teeth randomly assigned into 4 groups: G1 - Irrigation by Negative Apical Pressure (n= 20); G2 - Passive Ultrasonic Irrigation (n= 20), G3 - Positive Pressure Irrigation (n= 20); G4 - apical periodontitis without treatment (n= 20). After 180 days, the animals were euthanized, the tissues removed and submitted to histotechnical processing for immunohistochemical analysis of osteopontin (OPN), tumor necrosis factor-a (TNF-a) and interleukin 1-a (IL-1a). Radiographic analysis was performed using the Periapical Index (PAI), obtained prior to and 180 days following endodontic treatment. Data were analyzed using Wilcoxon signed-rank test, Fisher’s Exact test or Kruskal-Wallis test and Dunn’s post-test (a = 5%). Radiographically, after endodontic treatment, apical periodontitis persisted in 35% of G1 specimens, 40% of G2 and 40% of G3 (p>0.05), although a PAI reduction was observed (p<0.05). By immunohistochemical evaluation, endodontic treatment resulted in lower synthesis of TNF-a and OPN in periapical region, compared to apical periodontitis without treatment (p<0.05). Production of IL-1 was not modulated by endodontic treatment (p>0.05). Periapical healing was observed in approximately 60% of the cases after endodontic treatment performed in a single session with lower synthesis of TNF-a and OPN in the periapical region, regardless of the irrigation protocol used.

Detection of the internal anatomy of lower anterior teeth using cone‐beam computed tomography

“…Several methods are used to analyse the internal anatomy of the root canals. Among them are the conventional periapical radiography (5,27), digital radiography (28,29), contrast enhancement radiography (28), demineralisation and staining of canals (28,30,31), microscopy, computed micro-tomography (27,29) and cone-beam computed tomography (CBCT) (13,(26)(27)(28)(29).…”

“…Knowledge of root canal system morphology is essential for the correct diagnosis, choice of therapy and treatment prognosis (1–3). The literature describes several methods for studying internal and external teeth anatomy, as resin replicas in polyester moulds (4), radiographic techniques (5), diaphanisation (6), cross‐sectional samples (7), evaluation using stereoscopic magnifying glass (8) and scanning electron microscopy (9). However, these methods are destructive and have quality limitations since they provide two‐dimensional images obtained from three‐dimensional structures (10).…”

Negative Pressure Irrigation Presents Mineralizing Potential in Dogs’ Immature Teeth with Periapical Lesion

“…It is highlighted that the present findings must be exercised with caution and not transferred directly to clinical conditions because of obvious limitations of immunohistochemical analysis and studies in animals. Regarding the semi-quantitative analysis, the score system was used as in several previous published studies (15,30,31). Also, most of evaluated molecules (ALP and OPN) are extracellular proteins, making it difficult to perform a counting of immunolabelled cells.…”