Artigos - Odontologia Restauradora - FOA

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Effect of ELVAX polymer subgingival implants with echistatin on extracted and reimplanted rats’ teeth
(2023-01-01) Pinheiro, Bethânia Camargo; Pinheiro, Tiago Novaes; Leite, Milena Gomes Melo; Garcia, Roberto Brandão; Bernardineli, Norberti; Faria, Flávio Duarte [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Bramante, Clovis Monteiro; Universidade de São Paulo (USP); Dental School of Amazonas State University; Universidade Estadual Paulista (UNESP)
To investigate the effect of ELVAX polymer subgingival implants incorporated with echistatin peptide on incisor reimplanted tooth in rats. Forty-two male Wistars rats were divided into two groups: echistatin-treated rats (E) and control rats (C). The animals had their right maxillary incisors extracted and treated according to the International Association of Dental Traumatology replantation protocol. The extra-alveolar dry period was 30 and 60 min, and the post-surgical experimental periods were 15, 60, and 90 days. The samples were stained with H&E and analyzed for the presence of an inflammatory response, incidence of resorptions, and dental ankylosis. Results were statistically analyzed (p < 0.05). The presence of inflammatory resorption was significantly higher in group C at 30 and 60 min extra-alveolar time, in the 15-day postoperative period as compared with the E group (p < 0.05). Dental ankylosis was significantly more prevalent in group E in 30 min extra-alveolar time and 15 days postoperative period (p < 0.05). However, in 60 min extra-alveolar time and 60 days postoperative period, dental ankylosis was more prevalent in C group (p < 0.05). The use of ELVAX subgingival implants with echistatin demonstrated therapeutic potential in preventing the experimental resorption process after replantation of maxillary incisors in rats.
Mechanism of action of Bioactive Endodontic Materials
(2023-01-01) Estrela, Carlos; Cintra, Luciano Tavares Angelo [UNESP]; Duarte, Marco Antônio Hungaro; Rossi-Fedele, Giampiero; Gavini, Giulio; Sousa-Neto, Manoel Damião; Universidade Federal de Goiás (UFG); Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); University of Adelaide
A continuous search for bioactive materials capable of supporting the replacement of damaged pulp tissue, with effective sealing potential and biocompatibility, has represented the attention of studies over the last decades. This study involves a narrative review of the literature developed by searching representative research in PUBMED/MEDLINE and searches in textbooks associated with the mechanism of action of bioactive materials (calcium hydroxide, mineral trioxide aggregate (MTA), and calcium silicate cements). The reflective analysis of the particularities of the chemical elements of these materials, considering the tissue and antibacterial mechanism of action, allows a better understanding of the characteristics and similarities in their tissue responses. Calcium hydroxide paste remains the antibacterial substance of choice as intracanal dressing for the treatment of root canal system infections. Calcium silicate cements, including MTA, show a favorable biological response with the stimulation of mineralized tissue deposition in sealed areas when in contact with connective tissue. This is due to the similarity between the chemical elements, especially ionic dissociation, the potential stimulation of enzymes in tissues, and the contribution towards an alkaline environment due to the pH of these materials. The behavior of bioactive materials, especially MTA and the new calcium silicate cements in the biological sealing activity, has been shown to be effective. Contemporary endodontics has access to bioactive materials with similar properties, which can stimulate a biological seal in lateral and furcation root perforations, root-end fillings and root fillings, pulp capping, pulpotomy, apexification, and regenerative endodontic procedures, in addition to other clinical conditions.
Inflammatory profile of apical periodontitis exacerbated by cigarette smoke inhalation: Histological and immunohistochemical analysis in rats
(2023-04-01) Vasques, Ana Maria Veiga [UNESP]; da Silva, Ana Claudia Rodrigues [UNESP]; Bueno, Carlos Roberto Emerenciano [UNESP]; Cury, Marina Tolomei Sandoval [UNESP]; Ervolino, Edilson [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Dezan Junior, Eloi [UNESP]; Universidade Estadual Paulista (UNESP)
Aim: The aim of this study was to evaluate the effects of cigarette smoke inhalation (CSI) on inflammation, pro-inflammatory mediators and haematological parameters in rats with induced apical periodontitis (AP). Methodology: Thirty-two 3-month-old male Wistar rats were divided into four experimental groups (n = 8): C—Control; S—rats with CSI; AP—rats with AP; and SAP—rats with CSI + AP. Animals in groups S and SAP inhaled cigarette smoke by remaining inside a smoking chamber for 8 min, three times daily, for 50 days. After 20 days of smoke inhalation, animals in AP and SAP groups had the pulps of the lower right first molar exposed to oral environment for 30 days to induce AP. In these subsequent 30 days, animals in group S and SAP continued with CSI. On Day 50, animals were euthanized and mandibles were histologically processed to assess inflammatory infiltrate, immunohistochemical interleukins (IL-1β, IL-6 and TNF-α), and blood samples collected for laboratory analysis. The Mann–Whitney test was performed for non-parametric data and the pairwise analyses of Student's t-test for parametric data, with a significance level of p <.050. Results: Inflammatory infiltrate was moderate in AP group and more severe in the SAP (p =.010). The interleukins IL-6, IL-1β and TNF-α were higher in SAP group (p <.001) when compared to the AP group. A greater number of red blood cells (p =.010), haemoglobin (p =.007) and neutrophils (p =.014) were observed in the SAP group in comparison with the AP group. Conclusion: Cigarette smoke inhalation induced a more severe inflammatory infiltrate, with increased levels of pro-inflammatory cytokines and changes in haematological parameters in rats with induced AP. Thus, CSI aggravated AP, exacerbating the inflammatory response.
Biomechanical performance of three fiberglass post cementation techniques: Imaging, in vitro, and in silico analysis
(2023-01-01) Hoshino, Isis Almela Endo [UNESP]; Dos Santos, Paulo Henrique [UNESP]; Briso, Andre Luiz Fraga [UNESP]; Sundfeld, Renato Herman [UNESP]; Yamaguchi, Satoshi; Rocha, Eduardo Passos [UNESP]; Anchieta, Rodolfo Bruniera [UNESP]; Universidade Estadual Paulista (UNESP); Osaka University Graduate School of Dentistry; Centro Universitario do Norte Paulista-UNIPOS UNORP
Purpose: The structural integrity of the resin cement layer, the bond strength, and the biomechanical behavior of different fiberglass post cementation techniques were evaluated. Methods: Thirty-three bovine incisors were divided into three groups (n = 11): conventional fiberglass post (CFP), conventional fiberglass post in flared root canals (CFL), and relined fiberglass post (RFP). Six specimens from each group were submitted for high-resolution microcomputed tomography (μCT) to evaluate the integrity and presence/volume of voids at the resin cement layer. Finite element analysis (FEA) of two three-dimensional (3D) models of each group were conducted, one considered ideal (without interface defects) and another containing the conditions identified in the μCT analysis. Push-out bond strength tests were conducted for all specimens. Results: The CFL group had the greatest mean values of void (Thirds cervical: 73.67; middle: 95.67; apical: 47.33) and gap concentration (Thirds cervical: 14.67; middle: 15.83; apical: 8.33) compared with CFP and RFP. A significant difference in bond strength was observed between the cervical (1.33 MPa) and middle thirds (1.85 MPa) compared with the apical third (4.85 MPa) of the CFL. A significant difference was observed in the bond strength in the CFL (1.33 MPa) and RFP (3.29 MPa) in the cervical third, which were statistically similar to the bond strength of the CFP. The tensile stress distributions were similar in most structures, localized in the cervical region on the lingual surface. Conclusions: Structural defects in the interface layer might influence the bond strength and biomechanical behavior under the different fiberglass post cementations.
Melatonin decreases plasma TNF-α and improves nonenzymatic antioxidant defence and insulin sensitivity in rats with apical periodontitis fed a high-fat diet
(2023-02-01) dos Santos, Rodrigo Martins [UNESP]; Tsosura, Thais Verônica Saori [UNESP]; Belardi, Bianca Elvira [UNESP]; Chaves-Neto, Antonio Hernandes [UNESP]; Chiba, Fernando Yamamoto [UNESP]; Mattera, Maria Sara de Lima Coutinho [UNESP]; Tessarin, Gestter Willian Lattari; Bravo, Lara Teschi [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Matsushita, Dóris Hissako [UNESP]; Universidade Estadual Paulista (UNESP); Unorp
Aim: To analyse the effects of melatonin (ME) treatment on oxidative stress and insulin resistance (IR) in rats with apical periodontitis (AP) fed a high-fat diet (HFD). Methodology: Eighty 60-day-old rats were divided into eight groups: control (CN), AP, HFD with AP (HFDAP), control with ME (CNME), AP with ME (APME), HFD with ME (HFDME) and HFD with AP+ME (HFDAPME). The animals from the HFD groups were fed a HFD throughout the experimental period. On day 7, the animals from the AP groups were subjected to experimental AP, and after 70 days, the ME groups were treated for 30 days. Glycaemia, insulinaemia, homeostatic model assessment for IR index, tumour necrosis factor-α (TNF-α), and interleukin-6 were analysed in plasma using biochemical tests and enzyme-linked immunosorbent assay. Thiobarbituric acid-reactive substances (TBARS), carbonyl protein (CP), superoxide dismutase (SOD), catalase, glutathione peroxidase, glutathione (GSH) and total antioxidant capacity (ferric reducing antioxidant power [FRAP]) were analysed in the gastrocnemius muscle. Results: (1) Association of AP and HDF exacerbated IR, and ME treatment improved this alteration; (2) AP and HFD and their association showed increased TNF-α, and ME reversed it; (3) TBARS increased in the AP and HFDAP groups, and ME reversed only in the group with the association of disease and diet; (4) CP increased in all HFD groups and improved in the ME groups; (5) GSH activity decreased in all experimental groups, and ME increased this parameter only in the CN and AP groups; (6) FRAP did not change between the groups, but ME treatment increased its activity in the AP and HFD groups; (7) ME increased SOD in the CN and AP groups. Conclusion: Apical periodontitis and HFD promoted IR, and the association of AP with diet promoted IR exacerbation; this resistance might have been caused by an increase in TNF-α. AP promoted more intense changes in lipid oxidative damage than in protein oxidative damage. In non-enzymatic antioxidant defence, it was observed that both AP and HFD and their association promoted a decrease in GSH levels. Overall, ME treatment reversed changes such as oxidative stress and IR.
Influence of ethylenediaminetetraacetic acid irrigation on the regenerative endodontic procedure in an immature rat molar model
(2023-01-01) dos Reis-Prado, Alexandre Henrique; Oliveira, Sabrina de Castro; Goto, Juliana [UNESP]; Silva, Gerluza Aparecida Borges; Cintra, Luciano Tavares Angelo [UNESP]; de Mesquita, Ricardo Alves; Szawka, Raphael Escorsim; Ribeiro-Sobrinho, Antônio Paulino; Benetti, Francine; Universidade Federal de Minas Gerais (UFMG); Universidade Estadual Paulista (UNESP)
Aim: To analyse the influence of ethylenediaminetetraacetic acid (EDTA) on the repair process in immature rat molars after a regenerative endodontic procedure (REP). Methodology: The lower first molars of 12 4-week-old Wistar rats underwent pulpectomy in the mesial root and were divided into the following groups: sodium hypochlorite (NaOCl; n = 6) – the mesial canals were irrigated with 2.5% NaOCl for 5 min, and NaOCl-EDTA (n = 6) – the canals were irrigated with 2.5% NaOCl, followed by 17% EDTA for 5 min each. After evoking bleeding using a size 10 K-file, the cavities were sealed. Three molars on the untreated side were randomly used as control (control-15 d; n = 3), and three molars from the other three rats untreated were used as immediate control (n = 3). After 15 days (NaOCl, NaOCl-EDTA and control-15 d groups) or immediately (control-immediate), the animals were euthanized, and the teeth were subjected to histologic evaluation of tissue regeneration and presence of collagen fibres. Mann–Whitney U-test was used (p <.05). Results: The experimental groups had newly formed cementum-like tissue and increased root length and thickness. Half of the specimens in NaOCl-EDTA group showed apical foramen closure, whilst the NaOCl group had partial apical closure. The experimental groups showed inflammatory infiltrate extending mainly to the medium third of the root canal. These parameters were similar between experimental groups (p >.05). Newly formed connective tissue in the pulp space was significantly higher in the NaOCl-EDTA group than in NaOCl group (p <.05). Regarding the collagen fibres, the NaOCl-EDTA group had more collagen fibres in the root tip, but there was no significant difference compared to NaOCl group, and both groups showed greater amount of immature fibres in this area; in the centre of the apical third of root canal, there was equivalence between mature and immature fibres from both groups (p >.05). Conclusions: Ethylenediaminetetraacetic acid irrigation improved newly formed intracanal connective tissue after REP in immature molars of rats; however, EDTA did not influence cementum-like tissue formation, apical closure, inflammatory infiltrate and maturation of collagen fibres.
Frequency and Risk Factors of Maxillary Sinusitis of Endodontic Origin Evaluated by a Dynamic Navigation and a New Filter of Cone-Beam Computed Tomography
(2022-10-01) Estrela, Cyntia R.A.; Bueno, Mike R.; Estrela, Matheus R.A.; Estrela, Lucas R.A.; Guedes, Orlando A.; Azevedo, Bruno C.; Cintra, Luciano Tavares Angelo [UNESP]; Estrela, Carlos; Evangelical University of Goiás; Center for Radiology and Orofacial Imaging (CROIF) Diagnostic Imaging Center; Oral Maxillofacial Radiology (OMFR) Private Practice; Universidade Estadual Paulista (UNESP); Universidade Federal de Goiás (UFG)
Introduction: The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using dynamic navigation and a novel filter of cone-beam computed tomographic (CBCT) imaging. Methods: CBCT scans of 453 patients (814 teeth) were selected. Data were divided into 4 groups: (1) root canal treatment (RCT), (2) relation of the root apex to the maxillary sinus, (3) apical periodontitis (AP), and (4) maxillary sinus inflammation (no inflammation, periapical osteoperiostitis, periapical mucositis, partial obstruction, or total obstruction). Frequency distribution and cross-tabulation were used for data analysis. The association of maxillary sinus abnormalities with other variables was analyzed using the chi-square test. The significance level was set at 5%, and the association between dependent and independent variables was analyzed using robust Poisson regression models. Results: MSEO was found in 65.6% of the cases, and the highest frequency rates were in the periapical mucositis (44%) and partial obstruction (15.8%) groups. The rates of risk factors were highest in the cases of RCT (54.9%), AP (34.3%), and the root apex in contact with the maxillary sinus (53.8%). The most frequent sex and age group were female (55.8%) and 41–50 years (30.5%). Conclusions: The frequency of MSEO was high and positively associated with RCT, AP, and the root apex's position in contact with the floor of the maxillary sinus. The maxillary sinus filter of the CBCT software provides a clear image of maxillary sinus abnormalities.
Influence of Hydrogen Peroxide on Mineralization in Dental Pulp Cells: A Systematic Review
(2021-01-01) Reis-Prado, Alexandre Henrique dos; Grossi, Isadora Rodrigues; Chaves, Hebertt Gonzaga dos Santos; André, Carolina Bosso; Morgan, Luís Fernando dos Santos Alves; Briso, André Luiz Fraga [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Benetti, Francine; Universidade Federal de Minas Gerais (UFMG); Universidade Estadual Paulista (UNESP)
Background: Dental bleaching agents show the ability to permeate through dental hard tissues, which may lead to pulp tissue changes. This systematic review (PROSPERO register: CRD42020213767) is aimed at understanding the effects of bleaching agents on the process of mineralization of the pulp tissue. Methods: Only in vitro studies evaluating the influence of hydrogen peroxide (HP) on mineralization in dental pulp cells were included. Studies without a non-bleached control group or cells after co-treatment with a bleaching agent other than HP and/or carbamide peroxide were excluded. The primary outcomes evaluated were alkaline phosphatase (ALP) activity and mineralized nodule deposition. The mineralization markers analysis in dental pulp cells and the cell viability were considered secondary outcomes. Two independent authors conducted a systematic search (PubMed/MEDLINE, Scopus, Embase, Cochrane Library, and OpenGrey until January 2021) with no language restrictions and performed data extraction. The quality assessment was appraised according to a modified Joanna Briggs Institute critical appraisal checklist. Results: The search resulted in 473 studies, and 11 were considered eligible. Overall, a reduction in the process of mineralization was observed among pulp cells after bleaching. A reduction in the ALP activity was reported in the mostly bleached groups using different protocols and analysis periods of nine studies. Regarding mineralized nodule deposition, 6 studies reported a significant reduction from 7 to 21 days among bleached groups. Of those three studies that investigated other mineralization markers, two found a reduction in the expression of dentin matrix acidic phosphoprotein (DMP)-1, dentin sialophosphoprotein (DSPP), and matrix extracellular phosphoglycoprotein (MEPE) among some bleaching gel concentrations. In contrast, one study showed a greater expression of osteopontin (OPN) and osteocalcin (OCN) in 100 μmol/L HP after 5 or 10 min of exposure, and another study showed significant induction of DSPP in concentrations of up to 0.5 mmol/L HP. Conclusion: Especially, high concentrations of bleaching gel reduce the potential of mineralization in pulp cells in in vitro studies; however, different HP concentrations, bleaching protocols, and analysis periods can influence this outcome.
Oral Condition of Adolescents who Participated in an Oral Health Program During the First Decade of Life
(2023-01-01) Amaral, Jaqueline Canova Paludetto [UNESP]; Gawlinski, Bárbara Curi [UNESP]; Duque, Cristiane [UNESP]; Cunha, Robson Frederico [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: To evaluate the oral health of adolescents who participated in an oral health preventive program during the first decade of life. Material and Methods: For the evaluation of dental caries and gingival condition, DMFT and Community Periodontal Index were used, both recommended by the World Health Organization. To verify the occurrence of dental fluorosis, the Dean index was used. Results: Data collection was obtained from 252 patients aged 12 to 16 years. The average DMFT index was 1.14; in relation to the gingival condition, the index of healthy gingival tissue prevailed and the average of this value was 84%, with code 0 being more registered in tooth 11, code 1, more frequently in teeth 16/17 and 36/37 and for last, code 2, in tooth 31 most frequently. Dean's index showed a percentage of 89% of patients without clinical signs of dental fluorosis. Conclusion: Adolescents participating in an oral health preventive program in the first decade of life exhibited very satisfactory results regarding the prevention of caries disease, healthy periodontal condition and reduced prevalence of dental fluorosis.
Influence of thickness and degree of opacity of lithium disilicate on the degree of conversion and bond strength of resin cements
(2023-07-01) Queiroz, Mariana Elias [UNESP]; Maluly-Proni, Ana Teresa [UNESP]; Tsutsumi, Mariana Sati Cantalejo [UNESP]; Dallazen, Eduardo [UNESP]; de Castro-Hoshino, Lidiane Vizioli; de Souza, Monique; Baesso, Mauro Luciano; dos Santos, Paulo Henrique [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Estadual de Maringá (UEM); Faculty of Dentistry – UofT
The aim of this study was to evaluate the influence of various opacities and thicknesses of lithium disilicate on the degree of conversion (DC) of two resin cements and on their bond strength (BS) to the ceramic. Two hundred and forty ceramic samples of lithium disilicate with high translucency (HT), low translucency (LT), and medium opacity (MO) were obtained from IPS e. max CAD in five different thicknesses. Light-cured and dual-cured resin cements were used for DC (n = 9) and BS (n = 8). Cement samples were light-cured under ceramic samples and analyzed using a Raman confocal spectrometer to determine the DC. For BS, resin cement cylinders were fabricated using ceramic samples which were thsen subjected to a microshear bond strength test. The mean values were provided for statistical analysis. The increase in thickness resulted in a decrease in DC for both cements under all experimental conditions, but only affected the BS of the light-cured cement for the MO ceramic. Comparing the opacities, the most translucent ceramics with particular thicknesses exhibited higher DC values than the less translucent ceramics. The LT and MO ceramics with certain thicknesses exhibited the highest BS values than the HT. The dual-cured cement generally showed highest values in both analyses than the light-cured cement. A thicker and more opaque ceramic material can reduce the DC of the cement. The BS decreases with the increasing thickness of the more-opaque ceramics.
Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta-analysis
(2023-01-01) Ramírez-Carmona, Wilmer [UNESP]; Fernandes, Gabriela Leal Peres [UNESP]; Díaz-Fabregat, Beatriz [UNESP]; Oliveira, Evelyn Carmo [UNESP]; do Prado, Rosana Leal; Pessan, Juliano Pelim [UNESP]; Monteiro, Douglas Roberto [UNESP]; Universidade Estadual Paulista (UNESP); University of Western São Paulo (UNOESTE)
This review assessed the effectiveness of fluconazole as antifungal prophylaxis on the incidence of oral fungal diseases in patients undergoing cancer treatment. The secondary outcomes evaluated were the adverse effects, discontinuation of cancer therapy due to oral fungal infection, mortality by a fungal infection, and the mean duration of antifungal prophylaxis. Twelve databases and records were searched. The RoB 2 and ROBINS I tools were used to assess the risk of bias. The relative risk (RR), risk difference, and standard mean difference (SMD) were applied with 95% confidence intervals (CI). The certainty of the evidence was determined by GRADE. Twenty-four studies were included in this systematic review. In randomized controlled trials pooling, fluconazole was a protective factor for the primary outcome (RR = 0.30; CI: 0.16, 0.55; p < 0.01, vs placebo). Compared to other antifungals, fluconazole was only more effective than the subgroup of amphotericin B and nystatin (alone or in combination) (RR = 0.19; CI: 0.09, 0.43; p < 0.01). Fluconazole was also a protective factor in non-randomized trials pooling (RR = 0.19; CI: 0.05, 0.78; p = 0.02, vs untreated). The results showed no significant differences for the secondary outcomes. The certainty of the evidence was low and very low. In conclusion, prophylactic antifungals are necessary during cancer treatment, and fluconazole was shown to be more effective in reducing oral fungal diseases only compared with the subgroup assessing amphotericin B and nystatin, administered alone or in combination.
CHRONIC SODIUM FLUORIDE INTAKE PROMOTES CHANGES IN INSULIN SIGNALING AND INFLAMMATORY PATHWAYS IN THE SKELETAL MUSCLE OF RATS
(2021-01-01) Chiba, Fernando Yamamoto [UNESP]; Tsosura, Thaís Verônica Saori [UNESP]; Mattera, Maria Sara de Lima Coutinho [UNESP]; Pereira, Renato Felipe [UNESP]; Dos Santos, Rodrigo Martins [UNESP]; de Oliveira, Renan Akira Fujii [UNESP]; Garbin, Cléa Adas Saliba [UNESP]; Belardi, Bianca Elvira [UNESP]; de Oliveira, Sandra Helena Penha [UNESP]; Matsushita, Doris Hissako [UNESP]; Universidade Estadual Paulista (UNESP)
This study aimed to investigate the final step of insulin signaling and the relationship between the inflammatory pathway and insulin signal attenuation in the gastrocnemius muscle (GM) of rats chronically treated with NaF. Thirty-two seven-week-old male Wistar rats were randomly distributed into 2 groups: a control group, which was treated with drinking water without fluoride; and a fluoride group, which received drinking water with NaF and F present in their food pellets (total fluoride intake= 4.0 mg/ kg body weight/day). After six weeks, the following were measured in the GM: content of protein kinase B (Akt), inhibitor of kappa B kinase (IκΚα/β), tumor necrosis factorα (TNF-α), c-Jun N-terminal kinase (JNK), and glucose transporter type 4 (GLUT4) by western blotting; phosphorylation status of Akt threonine, Akt serine, IκΚα/β, and JNK by western blotting; and expression of GLUT4 mRNA by real-time PCR. The fluoride-treated rats showed a decrease (p<0.05) in the insulin-stimulated Akt serine phosphorylation status, GLUT4 gene expression and its protein content in the plasma membrane fraction and translocation index; and increased (p<0.05) IκΚα/β phosphorylation status and TNF-α protein content in GM. No significant differences in the Akt threonine and JNK phosphorylation status, and protein contents of Akt, IκΚα/β, and JNK were observed between the fluoride-treated and control rats. Chronic NaF intake led to alterations in the final step of insulin signaling, and increased the IκΚα/β phosphorylation status and TNF-α content in GM of rats. Insulin resistance induced by excessive fluoride intake might be related to the activation of inflammatory signaling pathways.
Synergistic antimicrobial potential of EGCG and fosfomycin against biofilms associated with endodontic infections
(2023-01-01) Duque, Cristiane [UNESP]; Souza, Amanda Caselato Andolfatto [UNESP]; Aida, Kelly Limi [UNESP]; Pereira, Jesse Augusto [UNESP]; Caiaffa, Karina Sampaio [UNESP]; Dos Santos, Vanessa Rodrigues [UNESP]; Cosme-Silva, Leopoldo; Prakki, Anuradha; Universidade Estadual Paulista (UNESP); Universidade Federal de Alagoas; Dental Research Institute
Objective: This study aimed to evaluate the cytotoxicity and synergistic effect of epigallocatechin gallate (EGCG) and fosfomycin (FOSFO) on biofilms of oral bacteria associated with endodontic infections. Methodology: This study determined minimum inhibitory and bactericidal concentration (MIC/ MBC) and fractionated inhibitory concentration (FIC) of EGCG and FOSFO against Enterococcus faecalis, Actinomyces israelii, Streptococcus mutans, and Fusobacterium nucleatum. Monospecies and multispecies biofilms with those bacteria formed in polystyrene microplates and in radicular dentin blocks of bovine teeth were treated with the compounds and control chlorhexidine (CHX) and evaluated by bacterial counts and microscopy analysis. Toxicity effect of the compounds was determined on fibroblasts culture by methyl tetrazolium assays. Results: The combination of EGCG + FOSFO demonstrated synergism against all bacterial species, with an FIC index ranging from 0.35 to 0.5. At the MIC/FIC concentrations, EGCG, FOSFO, and EGCG+FOSFO were not toxic to fibroblasts. EGCG+FOSFO significantly reduced monospecies biofilms of E. faecalis and A. israelli, whereas S. mutans and F. nucleatum biofilms were eliminated by all compounds. Scanning electron microscopy of multispecies biofilms treated with EGCG, EGCG+FOSFO, and CHX at 100x MIC showed evident biofilm disorganization and substantial reduction of extracellular matrix. Confocal microscopy observed a significant reduction of multispecies biofilms formed in dentin tubules with 84.85%, 78.49%, and 50.6% of dead cells for EGCG+FOSFO, EGCG, and CHX at 100x MIC, respectively. Conclusion: EGCG and fosfomycin showed a synergistic effect against biofilms of oral pathogens related to root canal infections without causing cytotoxicity.
Cytotoxicity and Biomineralization Potential of Flavonoids Incorporated into PNVCL Hydrogels
(2023-03-01) Braga, Gabriela Pacheco de Almeida [UNESP]; Caiaffa, Karina Sampaio [UNESP]; Rabelo, Rafaela Laruzo [UNESP]; Santos, Vanessa Rodrigues dos [UNESP]; Souza, Amanda Caselato Andolfatto [UNESP]; Ribeiro, Lucas da Silva; Camargo, Emerson Rodrigues de; Prakki, Anuradha; Duque, Cristiane [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de São Carlos (UFSCar); University of Toronto
This study aimed to evaluate the effects of flavonoids incorporated into poly(N-vinylcaprolactam) (PNVCL) hydrogel on cell viability and mineralization markers of odontoblast-like cells. MDPC-23 cells were exposed to ampelopsin (AMP), isoquercitrin (ISO), rutin (RUT) and control calcium hydroxide (CH) for evaluation of cell viability, total protein (TP) production, alkaline phosphatase (ALP) activity and mineralized nodule deposition by colorimetric assays. Based on an initial screening, AMP and CH were loaded into PNVCL hydrogels and had their cytotoxicity and effect on mineralization markers determined. Cell viability was above 70% when MDPC-23 cells were treated with AMP, ISO and RUT. AMP showed the highest ALP activity and mineralized nodule deposition. Extracts of PNVCL+AMP and PNVCL+CH in culture medium (at the dilutions of 1/16 and 1/32) did not affect cell viability and stimulated ALP activity and mineralized nodules’ deposition, which were statistically higher than the control in osteogenic medium. In conclusion, AMP and AMP-loaded PNVCL hydrogels were cytocompatible and able to induce bio-mineralization markers in odontoblast-cells.
In vitro study on how photodynamic therapy and calcium hydroxide medication influence adhesive interface properties of glass-fiber posts to intraradicular dentin
(2023-05-01) Strazzi-Sahyon, Henrico Badaoui [UNESP]; Banci, Henrique Augusto [UNESP]; Melo, Fernanda Santos de [UNESP]; Soares, Lucas Silva; Spin-Neto, Rubens; Duarte, Marco Antonio Hungaro; Cintra, Luciano Tavares Angelo [UNESP]; dos Santos, Paulo Henrique [UNESP]; Sivieri-Araujo, Gustavo [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Centro Paula Souza Araçatuba; Aarhus University; Faculty of Dentistry
Purpose: This in vitro study evaluated the influence of antimicrobial photodynamic therapy (aPDT), using methylene blue (MB) as photosensitizer (PS) and calcium hydroxide (CH) as intracanal medication on adhesive bond strength, sealing, and integrity of the luting interface of glass-fiber posts to different thirds of endodontically treated root canal dentin. Material and methods: 102 incisors were sorted into 6 groups: a negative control irrigated with deionized water; a positive control irrigated with deionized water and filled with CH; CH + MB 50 mg/L without laser radiation; CH + MB 100 mg/L without laser radiation; CH + MB 50 mg/L radiated by red laser; and CH + MB 100 mg/L radiated by red laser. Push-out bond strength (n = 8), adhesive interface sealing (n = 3), and volume and quantification of voids (n = 6) were assessed using a universal testing machine, confocal laser scanning microscope, and computerized microtomography, respectively. Scanning electron micrographs were obtained from representative samples to qualify the fracture patterns. Push-out bond strength and adhesive interface integrity data were subjected to 2-way ANOVA for repeated measures followed by Tukey's test (α = 0.05). Adhesive interface sealing was evaluated by the inter-examiner Kappa test and submitted to Kruskal-Wallis and Dunns tests (α = 0.05). Results: Assessing the apical region, the positive control and MB100WA + Ca(OH)2 groups showed lower adhesive bond strength compared to the MB100A + Ca(OH)2 group (P < 0.05). The cervical third showed higher bond strength than the apical third for the positive control, MB50WA + Ca(OH)2, MB100WA + Ca(OH)2, and MB50A + Ca(OH)2 groups (P < 0.05). A prevalence of mixed failure was observed in all experimental groups. There were no statistically significant differences in adhesive interface sealing for any of the parameters assessed (P > 0.05). MB100WA + Ca(OH)2 and MB100A + Ca(OH)2 groups promoted a higher volume and quantification of voids compared to the negative control group evaluating the cervical third (P < 0.05). In general, there were no differences in the quantification of voids comparing the intraradicular thirds (P > 0.05), differently to the volume of voids in which, in general, the cervical third promoted higher values compared to the middle and apical thirds (P < 0.05). Conclusion: aPDT with methylene blue PS at 50 mg/L associated with calcium hydroxide as intracanal medication demonstrated satisfactory bond strength, sealing, and integrity of the adhesive interface at any intraradicular depth.
Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis
(2023-04-01) Chalub, Lucas Orbolato [UNESP]; Nunes, Gabriel Pereira [UNESP]; Strazzi-Sahyon, Henrico Badaoui [UNESP]; Ferrisse, Túlio Morandin [UNESP]; dos Santos, Paulo Henrique [UNESP]; Gomes-Filho, João Eduardo [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Sivieri-Araujo, Gustavo [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI). Methods: A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence. Results: A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23] p < 0.0001, I2 = 80%; and OR 3.86 [1.98; 7.53] p< 0.0001, I2 = 28.7%. Conclusion: Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI. Clinical Relevance: UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.
Contemporary use of plant extracts in dentistry: Scientific evidence for phytotherapy and ethnopharmacology
(2020-05-07) Emerenciano Bueno, Carlos Roberto [UNESP]; Universidade Estadual Paulista (UNESP)
Since ancient times, mankind has used plants as a valuable source of natural products for maintaining human health and to treat or prevent diseases. The common knowledge around plants' healing properties, known as folk medicine, has been transmitted over the centuries for generations throughout human communities. The use of natural products and herbal medicines have been documented in the past. The antibacterial activity of plant extracts has been reported since the late 1800s and some of these traditional medicines are still used, especially in the last decade, with more intensive studies for natural therapies. Active compounds produced during vegetal metabolism are responsible for the antimicrobial and biological properties interacting with specific chemical receptors in the human body and, due to these components, plants extracts are popular as anti-inflammatory, anti-bacterial or anti-fungal drugs. However, in the absence of scientific studies, the use of aleatory plant extracts may lead to harmful adverse effects. Previously considered empirical, current data on the antimicrobial activity and biocompatibility of numerous plants have been scientifically confirmed. Phytosciences, as ethnopharmacology or phytotherapy, are emerging multidisciplinary areas with almost unlimited sources and several aspects to be discussed. Recently, there has been a growing trend to seek natural drugs as part of dental treatment. In dentistry, the association of plant extracts with restorative dentistry, endodontics or periodontics materials have been used to reduce inflammation, as antimicrobial enhancer agent, antiseptics, antifungals, antioxidants, analgesics or even as mouth rinse to prevent or reduce dental plaque. Thus, this book will address the use of plant extracts in different fields of dentistry, highlighting its use in cariology, restorative dentistry, endodontics and periodontics, besides other uses of herbal plants in dentistry, as in dental trauma, osteointegration or hemostatic, among others. As will be shown and stated, the vast variety of different plants described in literature with medicinal properties makes it impracticable to discuss all extracts found in scientific literature. Therefore, this book will contribute with some of these extracts and different methodologies to assess, as an introduction to new research and new researchers. Also, different in vivo and in vitro tests used to evaluate biological response, such as biocompatibility and antimicrobial activity in dental treatment will be discussed.
Biocompatibility of plant extracts
(2020-05-07) Cury, Marina Tolomei Sandoval [UNESP]; Nunes, Gabriel Pereira [UNESP]; Vasques, Ana Maria Veiga [UNESP]; de Almeida, Juliano Milanezi [UNESP]; Matheus, Henrique Rinaldi [UNESP]; dos Reis-Prado, Alexandre Henrique; Dezan Junior, Eloi [UNESP]; Emerenciano Bueno, Carlos Roberto [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de Minas Gerais (UFMG)
Inflammation is an inner response of a host to an external agent, encompassing complex mediators and events. The use of antiinflammatory substances is applicable for the treatment of some conditions. The anti-inflammatory property of phytotherapics turns them into therapeutic option to conventional medicine and stimulates studies for use in humans. Herbals are widely used in popular medicine in many countries. However, the effectiveness of many of them remains poorly accessed. So, experimental researches aiming to investigate their pharmaceutical properties are essential to determine these paths and compatibility. This chapter will embrace experiments assessing the biocompatibility of extracts through cell culture, edema induction, subcutaneous tests and associations made with different extracts aiming to enhance the effectiveness of some compounds already used in daily practice. In addition, several promising plant extracts with scientifically proved results will be described.
Empirical use of plant extracts: Herbal care in medicine and dentistry
(2020-05-07) Emerenciano Bueno, Carlos Roberto [UNESP]; Universidade Estadual Paulista (UNESP)
The use of herbs, herbs extracts and medicinal plants incorporated in traditional medicine has a long and ancient history going back centuries in medicine and dental practice around the world to prevent, control or recover health against several diseases. Plants are considered mankind's first medicine, which were used mainly as antiseptics, analgesics, antiinflammatory or with antimicrobial purpose. According to the World Health Organization, near 80% of the populations of developing countries still use medicinal plants as a therapeutic resource. Over the years, many plants scientifically demonstrated biological and antimicrobial properties due to the interactions with specific chemical receptors within the body, becoming promising therapeutic agents. Thus, this chapter introduces historic findings of the use of plant extracts in archaic medicine and dentistry, initially used as medicaments for body and, consequently, oral disease. An initial historic overview will link, along this book, the millennial empirical use of plants and its extracts to actual researches and findings concerning the use of plants extracts in dentistry.
Phytotherapy in cariology and restorative dentistry
(2020-05-07) de Souza Batista, Victor Eduardo [UNESP]; Catelan, Anderson; Vechiato-Filho, Aljomar José; Martins, Christine Men; Vasques, Ana Maria Veiga [UNESP]; Cury, Marina Tolomei Sandoval [UNESP]; Emerenciano Bueno, Carlos Roberto [UNESP]; University of Western São Paulo - UNOESTE; Institute of Cancer of São Paulo São Paulo (ICESP); University of Western Sao Paulo (UNOESTE); Universidade Estadual Paulista (UNESP)
The use of plant extract for health treatment has been reported over the years. The treatment of diseases that affect the oral cavity is not different, specifically for dental caries treatment. The American Academy of Cariology (AAC) defines the cariology as the science and art of understanding the etiology, mechanisms of the disease known as dental caries including initiation, reversal, progression, diagnosis, prognosis, risk management, prevention, non-surgical and surgical therapies, and oral health-focused outcomes. The use of herbal therapy is proposed in different stages of the mechanism of the dental caries disease, mainly in the diagnosis, prevention and treatment outcomes. This chapter will show the application of herbal therapy in the diagnosis and prevention as well as its application of herbal therapy regarding the treatment of the dental caries disease by restorative dentistry.

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