Estudo in vivo da ação do tratamento endodôntico sobre endotoxinas bacterianas em canais radiculares com polpa necrosada e avaliação dos efeitos citotóxicos do conteúdo do canal radicular
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Data
2010-11-08
Autores
Carvalho, Alessandra Sverberi [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Em canais radiculares com polpa necrosada, a infecção é causada por diferentes bactérias, principalmente Gram-negativas anaeróbias facultativas e estritas, que, conseqüentemente, liberam diferentes endotoxinas durante sua duplicação ou morte celular. Os objetivos deste estudo foram: a) avaliar in vivo as quantidades de endotoxinas em canais radiculares com polpa necrosada, antes da realização do tratamento endodôntico; b) avaliar a efetividade do preparo biomecânico utilizando diferentes associações de agentes irrigantes [hipoclorito de sódio (NaOCl) 2,5%; NaOCl 2,5% + hidróxido de cálcio 0,14% e NaOCl 2,5% + polimixina B] sobre endotoxinas em canais radiculares; c) avaliar a ação da medicação intracanal (clorexidina gel 2% + hidróxido de cálcio) sobre endotoxinas; d) avaliar, durante todo o tratamento endodôntico, a produção de citocinas por macrófagos estimulados pelas amostras coletadas dos canais radiculares. Foram selecionados 33 dentes com necrose pulpar e lesão periapical visível radiograficamente e, imediatamente após o isolamento absoluto e acesso ao canal radicular foi realizada a primeira coleta. Os terços cervical e médio dos canais foram preparados com instrumentação oscilatória utilizando-se como solução irrigadora o hipoclorito de sódio 2,5% e para o preparo manual do terço apical os canais foram divididos em 3 grupos (n=11): G1) NaOCl 2,5%; G2) NaOCl 2,5% + água de cal (0,14%); G3) NaOCl 2,5% + polimixina B. Após o preparo biomecânico foi realizada a segunda coleta e, após a aplicação do EDTA, a terceira coleta. A quarta coleta foi realizada após 14 dias de medicação intracanal com pasta de clorexidina gel 2% + hidróxido de cálcio. Para todas as coletas foi realizada a quantificação de endotoxinas pelo teste cinético cromogênico do lisado de amebócitos de Limulus (LAL) e avaliação dos efeitos citotóxicos pela...
In radicular canals with necrotic pulp, infection is caused by several bacterium, mainly by the facultative anaerobic and strict Gram-negative, which, afterwards, release various endotoxins throughout its duplication or cellular death. This analysis aims at: a) evaluate in vivo the endotoxin amount in radicular canals with necrotic pulp, prior to endodontic treatment; b) evaluate the effects of biomechanical preparation using various associations of irrigating agents (sodium hypochlorite 2.5% + polymyxin B; sodium hypochlorite 2.5% + calcium hydroxide (0.14%) and sodium hypochlorite 2.5% on endotoxins in radicular canals; c)evaluate the intracanal gauge (2% chlorhexidine gel + calcium hydroxide) on endotoxins; d)evaluate, throughout the entire endodontic treatment, the macrophages cytokine output stimulated by the collected samples in radicular canals. 33 teeth, from various patients with necrotic pulp and periapical lesion visible on x-ray, were selected. The first sampling was performed immediately after the complete isolation and access into radicular canal. The cervical e medium thirds of the canals were prepared by using sodium hypochlorite 2.5% irrigating solution, and for the manual preparation of the apical third, the canals were divided into 3 groups (n=11): G1) sodium hypochlorite 2.5%; G2) sodium hypochlorite 2.5% + limewater (0.14%); G3) sodium hypochlorite 2.5% + polymyxin B. The second sampling was performed after the biomechanical preparation, and the third was performed 3 minutes after the EDTA was applied. The fourth sampling was performed after 14 days on intracanal medication of chlorhexidine gel 2% paste + calcium hydroxide. To all the samplings, endotoxin quantification was performed, using the Limulus amebocyte lysate (LAL) chromogenic kinetic test, and evaluating citotoxic effects due to the production of cytokines (IL-1, TNF-) in macrophage cultures... (Complete abstract click electronic access below)
In radicular canals with necrotic pulp, infection is caused by several bacterium, mainly by the facultative anaerobic and strict Gram-negative, which, afterwards, release various endotoxins throughout its duplication or cellular death. This analysis aims at: a) evaluate in vivo the endotoxin amount in radicular canals with necrotic pulp, prior to endodontic treatment; b) evaluate the effects of biomechanical preparation using various associations of irrigating agents (sodium hypochlorite 2.5% + polymyxin B; sodium hypochlorite 2.5% + calcium hydroxide (0.14%) and sodium hypochlorite 2.5% on endotoxins in radicular canals; c)evaluate the intracanal gauge (2% chlorhexidine gel + calcium hydroxide) on endotoxins; d)evaluate, throughout the entire endodontic treatment, the macrophages cytokine output stimulated by the collected samples in radicular canals. 33 teeth, from various patients with necrotic pulp and periapical lesion visible on x-ray, were selected. The first sampling was performed immediately after the complete isolation and access into radicular canal. The cervical e medium thirds of the canals were prepared by using sodium hypochlorite 2.5% irrigating solution, and for the manual preparation of the apical third, the canals were divided into 3 groups (n=11): G1) sodium hypochlorite 2.5%; G2) sodium hypochlorite 2.5% + limewater (0.14%); G3) sodium hypochlorite 2.5% + polymyxin B. The second sampling was performed after the biomechanical preparation, and the third was performed 3 minutes after the EDTA was applied. The fourth sampling was performed after 14 days on intracanal medication of chlorhexidine gel 2% paste + calcium hydroxide. To all the samplings, endotoxin quantification was performed, using the Limulus amebocyte lysate (LAL) chromogenic kinetic test, and evaluating citotoxic effects due to the production of cytokines (IL-1, TNF-) in macrophage cultures... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Hipoclorito de sódio, Citocinas, Hidroxido de calcio, Necrose da polpa dentária, Calcium hydroxide
Como citar
CARVALHO, Alessandra Sverberi. Estudo in vivo da ação do tratamento endodôntico sobre endotoxinas bacterianas em canais radiculares com polpa necrosada e avaliação dos efeitos citotóxicos do conteúdo do canal radicular. 2010. 150 f. Tese (doutorado) – Universidade Estadual Paulista, Faculdade de Odontologia de São José dos Campos, 2010.