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BackgroundThe objective was to analyze clinical, microbiological, and immunological periodontal parameters in patients in corrective orthodontic treatment.Materials and methodsTwenty-eight patients were selected. Plaque index (PI), bleeding on probing (BOP), width of keratinized gingiva, levels of 40 bacterial species, and of 3 cytokines (IL-1β, MMP-8, and TNF-α) in gingival crevicular fluid (GCF) were evaluated at T0, before orthodontic treatment; T1, 6 months; and T2, 12 months post-treatment. Non-parametric, Friedman, Wilcoxon, ANOVA, and Spearman correlation coefficient tests were used for statistical analyses, with the significance level of 5%.ResultsNo significant difference was found for the width of keratinized gingiva, but PI presented a significant increase at T1 and T2 (p < 0.05) when compared with T0. The percentage of sites with BOP increased significantly from T0 to T1 (p < 0.05); however, at T2, the values decreased and did not differ anymore from T0 (p > 0.05). In the microbiological analysis, red complex pathogens were in significantly greater proportions in T2 compared with T0 (p < 0.05). There was no statistically significant difference in the cytokine levels between the periods but there was a positive correlation between BOP and IL-1β (r = 0.49 p = .01) and TNF-α (r = 0.39 and p = .05).ConclusionIn conclusion, corrective orthodontic treatment caused clinical periodontal alterations regarding biofilm accumulation and gingival bleeding, with alteration of periodontopathogens.

The oral cavity is one of the environments on the human body with the highest concentrations of microorganisms that coexist harmoniously and maintain homeostasis related to oral health. Several local factors can shift the microbiome to a pathogenic state of dysbiosis. Existing treatments for infections caused by changes in the oral cavity aim to control biofilm dysbiosis and restore microbial balance. Studies have used probiotics as treatments for oral diseases, due to their ability to reduce the pathogenicity of the microbiota and immunoinflammatory changes. This review investigates the role of the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in oral health, and its mechanism of action in pre-clinical and clinical studies. This probiotic strain is a lactic acid bacterium that is safe for human consumption. It mediates bacterial co-aggregation with pathogens and modulates the immune response. Studies using B. lactis HN019 in periodontitis and peri-implant mucositis have shown it to be a potential adjuvant treatment with beneficial microbiological and immunological effects. Studies evaluating its oral effects and mechanism of action show that this probiotic strain has the potential to be used in several dental applications because of its benefit to the host.

To evaluate one-session endodontic treatment with aPDT and two-session treatment with calcium hydroxide (CH)-based dressing in dog’s teeth with apical periodontitis. After experimental induction of apical periodontitis, 48 teeth were randomly assigned to the following groups: groups OS/aPDT 120d and OS/aPDT 180d (one-session treatment with aPDT) and groups TS/CH 120d and TS/CH 180d (two-session treatment with CH-based dressing—control groups). The animals were euthanized after 120 and 180 days. After histotechnical processing, microscopic and radiographic analyses were performed. Data were analyzed by Kruskal-Wallis and Fisher’s exact tests (α = 0.05). Groups TS/CHs presented repaired resorbed cemental areas, with collagen bundles and few inflammatory cells. In groups OS/aPDTs, the areas of cemental resorption were not repaired with reduced presence of cells and fibers. In the analysis of the apical closure, fluorescence microscopy and percentage of radiographic reduction of lesions, there was significant difference between groups TS/CH 120d and OS/aPDT 120d and between TS/CH180d and OS/aPDT 180d ( p  < 0.05). Groups TS/CHs had weak RANKL expression and positive immunostaining for RANK and OPG. In OS/aPDT 120d , there was positive immunostaining for RANKL. In OS/aPDT180d, the three osteoclastogenesis markers were expressed. The results using aPDT were worse than those obtained with two-session endodontic treatment using a CH-based dressing in teeth with apical periodontitis.

Objectives To evaluate the in vitro effects of radiotherapy (RT) on the morphological surface of the enamel and dentin and to determine the best adhesive system and most appropriate time to restore teeth in head and neck cancer patients. Methods Sixty third molars were cut into 120 enamel fragments and 120 dentin fragments and divided into four groups ( n  = 30): G1 (control): nonirradiated, only restorative procedure; G2: restorative procedure immediately before RT; G3: restorative procedure immediately after RT; and G4: restorative procedure 6 months after RT. Each group was divided into two subgroups: Adper™ Single Bond 2 (SB) and Clearfill SE Bond (CL) based on the material used. After RT and restorative procedures, the specimens were subjected to confocal microscopy and shear bond strength test. Data were analyzed using a two-way ANOVA followed by Tukey’s test at a significance level of 5%. Results Morphological changes were observed in both substrates after a cumulative dose of 40 Gy, and after 60 Gy, the changes were more evident in both substrates. CL had the highest strength values in both substrates ( p  < 0.05), and G2 had the lowest strength values for the enamel and dentin ( p  < 0.05). Conclusions Based on the in vitro study results, we can conclude that RT substantially changes the morphological surface of enamel and dentin and impairs the bond strength. The Clearfill system yielded better results than Adper Single Bond 2, and restoring teeth before RT resulted in the worst results in both substrates.

Objectives To evaluate denosumab, a human monoclonal antibody that mimics the effects of osteoprotegerin in bone metabolism, as a topical treatment of root surface to be used prior to delayed tooth replantation. Materials and methods Thirty-six rats’ right incisors were used. Teeth were extracted and divided into: delayed replantation without root surface treatment (control); delayed replantation with root surface treatment with denosumab 60 mg/mL and 30 mg/mL, respectively, for 10 min both experimentals groups. After that, the root canals were filled with calcium hydroxide and replanted. After 15 and 60 days, the animals were euthanized, and the samples were collected and processed for microscopic analysis. Histological sections were performed, and stained with HE to describe the dental characteristics, measure ankylosis, replacement resorption, and dental resorption by conventional microscopy. Also, was performed Brown & Brenn staining and immunohistochemistry for RANKL, OPG, and periostin. Results Denosumab 60 mg/mL reducted ankylosis ( p  < 0.0001), replacement resorption ( p  < 0.0001), and tooth resorption, 60 days after replantation, compared to untreated replanted teeth ( p  < 0.005). Lower bacterial contamination in root surface in the denosumab treatment groups was found, regardless of the concentration used ( p  < 0.001). Also, denosumab treatment inhibited the expression of RANKL without modulating OPG. Periostin was observed in periodontal ligament of replanted tooth, although this labelling was absent in the ankylosis areas, in both experimental periods. Conclusion Treatment of the root surface with denosumab at 60 mg/mL of rat teeth before delayed replantation reduced dental root resorption compared with the untreated teeth after 60 days. Clinical relevance Survival of a replanted tooth has been a challenge in clinical practice. The use of a medication, such as denosumab, to limit dental root resorption represents an important therapeutical approach.

Background To investigate if 5-LO selective inhibitor (MK-886) could be used for systemic treatment of experimentally induced apical periodontitis in a mouse model. Methods Twenty-four C57BL/6 mice were used. After coronal opening, a solution containing Escherichia coli LPS (1.0 µg/µL) was inoculated into the root canals of the lower and upper right first molars (n = 72 teeth). After 30 days apical periodontitis was established, and the animals were treated with MK-886 (5 mg/kg), a 5-LO inhibitor, for 7 and 14 days. The tissues were removed for histopathological and histometric analyses, evaluation of osteoclast number and gene expression for receptor activator of nuclear factor kappa-B ( Tnfrsf11a ), receptor activator of nuclear factor kappa-B ligand ( Tnfsf11 ), osteoprotegerin ( Tnfrsf11b) , tartrate-resistant acid phosphatase ( Acp5 ), matrix metalloproteinase-9 ( Mmp9 ), cathepsin K ( Ctsk ) and calcitonin receptor ( Calcr ) . Statistical data analysis was performed using Kruskal Wallis followed by Dunn’s tests (α = 0.05). Results Administration of MK-886 for 7 days exerted no effect on apical periodontitis progression compared to LPS inoculation without treatment ( p  = 0.3549), while treatment for 14 days exacerbated bone loss ( p  < 0.0001). Administration of MK-886 enhanced osteoclastogenesis signaling and osteoclast formation within 7 days ( p  = 0.0005), but exerted no effect at 14 days ( p  > 0.9999). After 7 days of treatment, MK-886 induced mRNA expression for Acp5 ( p  = 0.0001), Calcr ( p  = 0.0003), Mmp9 ( p  = 0.0005) and Ctsk ( p  = 0.0008), however no effect in those gene expression was observed after 14 days ( p  > 0.05). Conclusion Systemic treatment with MK-886 exacerbated LPS-induced apical periodontitis in a mouse model.

Objectives The objective of this study was to evaluate the effect of non-steroidal anti-inflammatory drugs (NSAIDs) in controlling pulpal and periapical inflammation in vivo as a potential coadjutant systemic therapy for pulpitis. Materials and methods A suspension containing E. coli lipopolysaccharide (LPS; 1.0 μg/μL) was inoculated into the pulp chamber of the first molars of C57BL/6 mice ( n = 72), and the animals were treated daily with indomethacin or celecoxib throughout the experimental periods. After 7, 14, 21, and 28 days, the tissues were removed for histopathological, histoenzymology, histometric, and immunohistochemical evaluation. Results Inoculation of LPS into the pulp chamber induced the synthesis of the enzyme cyclooxygenase-2 (COX-2) in dental pulp and periapical region. Indomethacin and celecoxib treatment changed the profile of inflammatory cells recruited to dental pulp and to the periapex, which was characterized by a higher mononuclear cell infiltrate, compared to LPS inoculation alone which recruited a higher amount of polymorphonuclear neutrophils. Administration of indomethacin for 28 days resulted in the development of apical periodontitis and increased osteoclast recruitment, unlike celecoxib. Conclusions NSAIDs indomethacin and celecoxib changed the recruitment of inflammatory cells to a mononuclear profile upon inoculation of LPS into the pup chamber, but indomethacin enhanced periapical bone loss whereas celecoxib did not. Clinical relevance Celecoxib, a selective COX-2 inhibitor, can change the profile of inflammatory cells recruited to the dental pulp challenged with LPS and might a be potential systemic coadjutant for treatment of pulpitis.

Objectives The aim of this study was to investigate the inflammatory infiltrate, osteoclast formation, and expression of MMP-9 during the healing phase following root canal treatment in teeth with apical periodontitis. Materials and methods Apical periodontitis was induced in dogs teeth, and root canal treatment was performed in a single visit or using calcium hydroxide as intracanal medication. One hundred and eighty days following treatment the presence of inflammation was examined, and the tissues were stained to detect osteoclasts by means of a tartrate resistant alkaline phosphatase (TRAP) assay. Synthesis of MMP-9 was detected using Western blotting and immunohistochemistry. Results Teeth with apical periodontitis that had root canal therapy performed in a single visit presented a higher synthesis of MMP-9 compared with root canal treatment using calcium hydroxide. Treatment with calcium hydroxide resulted in a reduced amount of inflammatory cells and MMP-9 positive cells. Osteoclast formation, the number of MMP-9 positive osteoclasts and cementocytes, was reduced following root canal treatment, regardless of the root canal treatment protocol used. Conclusion Root canal treatment reduced the amount of inflammatory cells and osteoclasts in periapical area. The use of calcium hydroxide as intracanal medication resulted in a lower synthesis of MMP-9, though the number of osteoclasts and MMP-9 positive osteoclasts were similar between the groups. Clinical relevance Periapical bone repair following root canal treatment is impacted by therapy performed either in single visit or using calcium hydroxide dressing measured by inflammatory cell recruitment, osteoclast formation, and MMP-9 synthesis.

Background Leukotriene B 4 (LTB 4 ) is a potent lipid mediator that stimulate the immune response. Because dental pulp inflammation and dentin repair are intrinsically related responses, the aim of this research was to investigate the potential of LTB 4 in inducing differentiation of dental pulp stem cells. Methods Microspheres (MS) loaded with LTB 4 were prepared using an oil emulsion solvent extraction evaporation process and sterility, characterization, efficiency of LTB 4 encapsulation and in vitro LTB 4 release assay were investigated. Mouse dental pulp stem cells (OD-21) were stimulated with soluble LTB 4 or MS loaded with LTB 4 (0.01 and 0.1 μM). Cytotoxicity and cell viability was determined by lactate dehydrogenase and methylthiazol tetrazolium assays. Gene expression were measured by quantitative reverse transcription polymerase chain reaction after 3, 6, 24, 48 and 72 h. Mineralized nodule formation was assessed after 28 days of OD-21 cell stimulation with LTB 4  in mineralized media or not. Groups were compared using one-way ANOVA test followed by Dunnett’s post-test (α = 0.05). Results Treatment with LTB 4 or MS loaded with LTB 4 (0.01 and 0.1 µm-μM) were not cytotoxic to OD-21 cells. Treatment with LTB 4 modulated the expression of the Ibsp (integrin binding sialoprotein) and Runx2 (runt-related transcription factor 2) genes differently depending on the experimental period analyzed. Interestingly LTB 4 loaded in microspheres (0.1 μM) allowed long term dental pulp cell differentiation and biomineralization. Conclusion LTB 4 , soluble or loaded in MS, were not cytotoxic and modulated the expression of the Ibsp and Runx2 genes in cultured OD-21 cells. When LTB 4 was incorporated into MS, odontoblast differentiation and mineralization was induced in long term culture.

Objectives The aim of this study was to compare the efficacy of apical negative pressure irrigation (ANP) and passive ultrasonic irrigation (PUI) with apical positive pressure irrigation (PP—conventional irrigation) in the periapical repair of dogs’ teeth with apical periodontitis. Methods Forty-nine mesial and distal root canals of premolars of three dogs with experimentally induced periapical lesions were subjected to a single-session root canal treatment. The teeth were randomly assigned to three groups: ANP, PUI, and PP (control). After 180 days, the animals were euthanized, and the anatomic pieces were removed and subjected to histotechnical processing for morphological and morphometric histological analyses of hematoxylin and eosin (HE)-stained sections under conventional and fluorescence microscopy. Periapical lesion size before and 180 days after root canal treatment was measured by periapical radiographic examination. Tartrate-resistant acid phosphatase (TRAP) histoenzymology was performed for osteoclast counting and Brown and Brenn staining to assess bacteria. Data were analyzed statistically by the Kruskal-Wallis test ( α  = 5 %). Result There were no statistically significant differences among the groups regarding periapical lesion size in the radiographic evaluation ( p  = 0.91). In the comparison of histopathological parameters, group ANP presented more homogeneous results. There was a statistically significant difference ( p  = 0.02) between groups ANP and PP, with better results for group ANP in which milder infiltrate inflammatory was observed. No statistically significant difference ( p  > 0.05) was found among the groups with respect to periodontal ligament space, presence of mineralized tissue resorption, size of the periapical lesions, and number of osteoclasts. Conclusion Although the three irrigation systems elicited similar periapical tissue response with respect to almost all evaluated parameters, ANP presented the mildest inflammatory infiltrate, suggesting an advantage over PP in the indication for clinical use. Clinical relevance Irrigation of the root canal systems is an extremely important step in root canal treatment. Therefore, it is of relevance to evaluate the efficacy of these systems by in vivo experimental models to provide scientific background for the clinical practice.