Reação do periodonto e parâmetros bioquímicos sistêmicos em resposta ao selamento de perfurações de furca de molares de ratos com Biodentine e MTA
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2018-03-28
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Universidade Estadual Paulista (Unesp)
Resumo
Biodentine é um cimento reparador à base de silicato tricálcico com indicações semelhantes ao MTA. O objetivo deste estudo foi avaliar a resposta do periodonto ao selamento de perfurações de furca em molares de ratos com Biodentine ou MTA e as possíveis alterações séricas em marcadores de atividade hepática e renal. As perfurações realizadas nos primeiros molares da maxila direita de 60 ratos foram preenchidas com Biodentine, MTA ou algodão (Sham). As maxilas contralaterais do grupo Sham foram utilizadas como grupo Controle. Após 7, 15, 30 e 60 dias, o sangue foi coletado e as maxilas foram fixadas e incluídas em parafina (n=5). A partir do soro foram mensurados ou níveis de transaminase glutâmico-oxalacética (TGO), transaminase glutâmico-pirúvica (TGP), ureia e creatinina. O sangue de 5 animais sem qualquer procedimento foi coletado para mensurar os padrões sorológicos de referência. O espaço periodontal (EP), densidade de volume de células inflamatórias (VvCI) e de fibroblastos (VvFb) e o número de osteoclastos TRAP-positivos foram obtidos. Interleucina-6 (IL-6) e osterix foram detectados por imuno-histoquímica. O conteúdo de colágeno birrefringente foi quantificado a partir de cortes corados com picrosirius. Os dados foram submetidos à ANOVA e ao teste Tukey (p≤0,05). Diferenças significantes nos níveis séricos de TGO (p≥0,1258) e TGP (p≥0,5827) não foram detectadas nos grupos Biodentine, MTA e Sham em comparação aos níveis de referência. Aos 7 dias, a concentração de ureia sérica foi significantemente maior nos grupos Biodentine e MTA em comparação aos níveis de referência (p=0,0166). Um nível mais alto de creatinina sérica no grupo Biodentine aos 60 dias foi detectado em comparação aos valores de referência (p=0,0222). Aos 7 dias, os altos valores de VvCI, células IL-6-positivas e número de osteoclastos foram acompanhados por reduzido conteúdo de colágeno no EP alargado dos grupos experimentais. Em todos os períodos, VvCI, número de osteoclastos e de células IL-6-positivas e EP foram significantemente maiores em Sham que nos grupos Biodentine e MTA (p<0,0001). Do 7º ao 60º dia, significante redução de VvCI, expressão de IL-6 e osteoclastos foi acompanhada por significante aumento de VvFb, osteoblastos e conteúdo de colágeno nos grupos Biodentine e MTA. Aos 60 dias, diferenças significantes em VvCI, espessura do LP, imunoexpressão de IL-6 e número de osteoclastos e osteoblastos não foram detectadas entre Biodentine e MTA (p≥0,3255). Aos 30 e 60 dias, o número de osteoblastos osterix-positivos foi significantemente mais alto nos grupos Biodentine e MTA que no grupo controle (p<0,0001) enquanto diferenças significantes no número de osteoclastos não foram observadas (p≥0,8933). A análise bioquímica sugere que Biodentine e MTA não induzem mudanças hepáticas no decorrer do tempo. No entanto, é possível que mudanças renais sejam promovidas por Biodentine. Apesar da reação inflamatória e reabsorção óssea iniciais, o selamento de perfurações de furca com Biodentine e MTA promovem condições para o reparo periodontal.
Biodentine is a calcium silicate-based cement with similar indications of MTA. The aim of this study was to evaluate the periodontium response in the sealing of furcation perforations in rat molars with Biodentine and MTA, and its potential systemic effects in serum levels of hepatic and renal functions. The pulp chamber floor of right upper first molars of 60 rats were perforated and filled with Biodentine, MTA or sterile cotton pellet (Sham); the left first molars were used as control. After 7, 15, 30 and 60 days, the blood was collected and serum glutamic-oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), creatinine and urea levels were measured. The blood of 5 rats without any treatment was collected to measure serum reference levels. The maxillary fragments were fixed and processed for paraffin-embedding. The periodontal space (PS), volume density of inflammatory cells (VvIC) and of fibroblasts (VvFb), and number of TRAP-positive osteoclasts were obtained. Interleukin-6 (IL-6), a pro-inflammatory cytokine, and osterix, an osteoblast marker, were detected by immunohistochemistry. The birefringent collagen content was quantified from picrosirius-stained sections. Data were submitted to ANOVA and Tukey test (p≤0.05). Significant differences in GOT (p≥0.1258) and GPT (p≥0.5827) serum levels were not observed in the Biodentine, MTA and Sham groups in comparison with reference levels. At 7 days, the concentration of serum urea increased significantly in the Biodentine and MTA groups compared with reference levels (p=0.0166). A higher concentration of serum creatinine in Biodentine group than reference level (p=0.0222) was detected at 60 days. At 7 days, the high values in VvIC, IL-6-immunolabelled cells and number of osteoclasts were accompanied by reduced collagen content in the enlarged PS of experimental groups. In all periods, VvIC, number of osteoclasts and IL-6, and PS were significantly higher in Sham than Biodentine and MTA groups (p<0.0001). From 7 to 60 days, significant reduction in VvIC, IL-6 immunoexpression and osteoclasts was accompanied by significant increase in VvFb, osteoblasts and collagen content in Biodentine and MTA groups. At 60 days, significant differences in VvIC, width of PS, IL-6 immunoexpression, in the number of osteoclasts and osteoblasts were not found between Biodentine and MTA (p≥0.3255). At 30 and 60 days, the number of osterix-immunolabelled osteoblasts was significantly higher in Biodentine and MTA than control group (p<0.0001) while significant differences in the number of osteoclasts were not observed (p≥0.8933). The biochemical analyses suggest that Biodentine and MTA did not induce changes in the liver over time. However, it is possible that kidney changes may be promoted by Biodentine. Despite the initial inflammatory reaction and bone resorption, the sealing of furcation perforations with Biodentine or MTA provide conditions to the periodontium repair.
Biodentine is a calcium silicate-based cement with similar indications of MTA. The aim of this study was to evaluate the periodontium response in the sealing of furcation perforations in rat molars with Biodentine and MTA, and its potential systemic effects in serum levels of hepatic and renal functions. The pulp chamber floor of right upper first molars of 60 rats were perforated and filled with Biodentine, MTA or sterile cotton pellet (Sham); the left first molars were used as control. After 7, 15, 30 and 60 days, the blood was collected and serum glutamic-oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), creatinine and urea levels were measured. The blood of 5 rats without any treatment was collected to measure serum reference levels. The maxillary fragments were fixed and processed for paraffin-embedding. The periodontal space (PS), volume density of inflammatory cells (VvIC) and of fibroblasts (VvFb), and number of TRAP-positive osteoclasts were obtained. Interleukin-6 (IL-6), a pro-inflammatory cytokine, and osterix, an osteoblast marker, were detected by immunohistochemistry. The birefringent collagen content was quantified from picrosirius-stained sections. Data were submitted to ANOVA and Tukey test (p≤0.05). Significant differences in GOT (p≥0.1258) and GPT (p≥0.5827) serum levels were not observed in the Biodentine, MTA and Sham groups in comparison with reference levels. At 7 days, the concentration of serum urea increased significantly in the Biodentine and MTA groups compared with reference levels (p=0.0166). A higher concentration of serum creatinine in Biodentine group than reference level (p=0.0222) was detected at 60 days. At 7 days, the high values in VvIC, IL-6-immunolabelled cells and number of osteoclasts were accompanied by reduced collagen content in the enlarged PS of experimental groups. In all periods, VvIC, number of osteoclasts and IL-6, and PS were significantly higher in Sham than Biodentine and MTA groups (p<0.0001). From 7 to 60 days, significant reduction in VvIC, IL-6 immunoexpression and osteoclasts was accompanied by significant increase in VvFb, osteoblasts and collagen content in Biodentine and MTA groups. At 60 days, significant differences in VvIC, width of PS, IL-6 immunoexpression, in the number of osteoclasts and osteoblasts were not found between Biodentine and MTA (p≥0.3255). At 30 and 60 days, the number of osterix-immunolabelled osteoblasts was significantly higher in Biodentine and MTA than control group (p<0.0001) while significant differences in the number of osteoclasts were not observed (p≥0.8933). The biochemical analyses suggest that Biodentine and MTA did not induce changes in the liver over time. However, it is possible that kidney changes may be promoted by Biodentine. Despite the initial inflammatory reaction and bone resorption, the sealing of furcation perforations with Biodentine or MTA provide conditions to the periodontium repair.
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Endodontia, Doença iatrogênica, Teste de materiais, Periodonto, Análise química do sangue, Endodontics, Iatrogenic desease, Materials testing, Periodontium, Blood chemical analysis