Investigation of Bacterial Contents From Persistent Endodontic Infection and Evaluation of Their Inflammatory Potential

Abstract This clinical study investigated and quantified cultivable bacteria and their levels of endotoxins in persistent endodontic infection, determining their antigenicity against macrophages and fibroblast cells by IL-1β and TNF-α secretion and evaluating their relationship with clinical and radiographic features. Samples from the root canals were obtained after root filling removal. Culture techniques were used to determine the bacterial count and the endotoxins were determined by LAL-assay. PCR analysis (16S rDNA) was used for bacterial detection. Raw 264.5 macrophages and V79 fibroblast were stimulated with endodontic contents. ELISA assay measured the amounts of IL-1ß/TNF-?#61537; secretion. Bacteria and endotoxin medians were 1.24x105 CFU/mL and 9.62 EU/mL, respectively. Porphyromonas endodontalis was the most frequently detected species. Higher levels of endotoxins were found in teeth with pain on palpation (23.56 EU/mL) rather than in its absence (8.21 EU/mL). Larger areas of bone destruction were related to higher levels of endotoxins and IL-1β and TNF-α secretion. The study findings revealed the presence of Gram-negative bacteria species in persistent endodontic infection, with their endotoxins related to both severity of bone destruction and development of symptomatology. Moreover, larger areas of bone destruction were related to higher levels of IL-1β and TNF-α secreted by macrophages and fibroblast cells.

Resumo Este estudo clínico investigou e quantificou bactérias cultiváveis e seus níveis de endotoxinas na infecção endodôntica persistente, determinando a sua antigenicidade contra macrófagos e células de fibroblastos através de IL-1β e TNF-α; e avaliando sua relação com características clínicas e radiográficas. As amostras dos canais radiculares foram obtidas após a desobturação. Técnicas de cultura foram utilizadas para determinar a contagem de bactérias e a quantificação de endotoxinas foram determinadas por ensaio de LAL. Análise por PCR (16S rDNA) foi utilizada para a detecção bacteriana. Células 264,5 macrófagos e fibroblastos V79 foram estimuladas com conteúdo endodôntico. IL-1β e TNF-α produzidas pelas células avaliadas foram medidas por ensaio de ELISA. As medianas de bactérias e endotoxinas foram 1,24x105 UFC/mL e 9,62 EU/mL, respectivamente. Porphyromonas endodontalis foi a espécie mais frequentemente detectada. Níveis mais elevados de endotoxinas foram encontrados em dentes com dor à palpação (23,56 EU/mL) quando comparado a sua ausência (8,21 EU/mL). Maiores áreas de destruição óssea foram relacionados com níveis mais elevados de endotoxinas e IL-1β e TNF-α. O estudo revelou presença de espécies de bactérias Gram-negativas em infecção endodôntica persistente, com níveis elevados de endotoxinas relacionados a maior destruição óssea periapical e presença de sintomatologia. Além disso, grandes áreas de destruição óssea foram relacionados com níveis mais elevados de IL-1β e TNF-α secretadas por macrófagos e fibroblastos.

In vitro antimicrobial activity of AH Plus, EndoREZ and Epiphany against microorganisms.

Objective : The aim of the present study was to evaluate the antimicrobial activity of endodontic sealers against microorganisms. Materials and Methods : The agar diffusion method was used. A double base layer of Mueller Hinton agar was done. The microorganisms used were: Candida albicans, Enterococcus faecalis, Escherichia coli and Staphylococcus aureus. The wells were obtained by removing a standardized portion of the agar. After the distribution of the sealers, Petri plates were incubated for 24 h. Inhibition halos formed around the wells were measured. Results : Epiphany did not show any antimicrobial activity on the tested microorganisms (without inhibition halo). The AH Plus showed the greatest inhibition halo on C. albicans followed by EndoREZ on S. aureus. EndoREZ also showed greater inhibition halo in comparison to AH Plus on E. faecalis and E. coli. Conclusion : It could be concluded that AH Plus and EndoREZ showed antimicrobial activity against all the tested microorganisms. No antimicrobial activity was observed for Epiphany.

Evaluation of dentin cleansing by a detergent derived from castor oil (Ricinus communis) used as root canal irrigant: a scanning electron miscroscopy study

Introduction and objective: To evaluate, by scanning electronmicroscopy (SEM), the cleaning of root canal walls after biomechanicalpreparation and irrigation with castor oil (Endoquil®) and 0.5% sodiumhypochlorite (NaOCl). Material and methods: Fifteen maxillaryincisors were subjected to standardized root canal instrumentationwith different irrigants (n = 5): G1 ? Endoquil; G2 ? 0.5% NaOCl;G3 ? saline solution (control). After instrumentation, the teeth wereprepared for SEM analysis (X 2000 original magnification) to evaluatethe cleaning of cervical, middle and apical thirds. The area analyzedwas quantified according to the percentage of open and closed tubulesand data were statistically analyzed by ANOVA and Kruskal Wallis tests.Results: Statistical analysis showed that Endoquil was similar to 0.5%NaOCl at the apical third. However, there was statistically significantdifference at the cervical and middle thirds, between these two groups.Conclusion: It was concluded that Endoquil presented better resultsat the middle third while 0.5% NaOCl presented better results at thecervical third; at the apical third, both irrigants were similar.

Effect of photochemical activation of hydrogen peroxide bleaching gel with and without TiO 2 and different wavelengths

Aim: To evaluate the effect of photochemical activation of hydrogen peroxide (H2O2) bleaching gel with different wavelengths. Methods: In the study, 80 bovine incisors were used, which were stained in 25% soluble coffee and divided in 4 groups. The initial color was measured with the Easy Shade spectrophotometer by CIE Lab. An experimental 35% H2O2 bleaching gel was used,either with or without the presence of titanium dioxide (TiO2) pigment, associated with two light sources: G1 - Transparent Gel (TG) and no activation; G2 - Gel with TiO2 and activation with blue LED (l=470nm)laser (Easy Bleach) appliance; G3 - Gel with TiO2 and activation with ultraviolet(l=345nm - UV); G4 - TG and activation with UV. Three applications of the gels were made for 10min, and in each, 3 activations of 3 min, with interval of 30 s between them. The coloration was evaluated again and the variation in color perception (DE) was calculated. The data were submitted to one-way ANOVA and Tukey’s test at 5% significance level. Results: There were significant differences between G1 and G4. The greatest “E value was observed in G4 (13.37).There was no statistically significant difference (p>0.05) between the groups 2, 3 and 4.Conclusions: The presence of TiO2 particules in the bleaching gel did not interfere at the bleaching results.

Sindrome de Dandy-Walker: conceptos neuroquirúrgicos

Se presenta un caso con Síndrome de Dandy0Walker. La tomografia axial computarizada del cráneo y cerebro así como el neurosonograma, demostraron claramente la hidrocefalia, la presencia de un quiste de la fosa posterior contínuo con el 4§ ventrículo y la agenesia del cuerpo calloso. Se concluye que el diagnóstico es radiológico. Nuestro método preferencial de tratamento quirúrgico es la derivación de la fosa posterior que ofrece ciertas ventajas técnicas, donde no es necesario combinar la derivación supratentorial

Morbilidad y mortalidad por accidentes de transito en la poblacion menor de 20 años 1980-1986

Se revisan los acidentes automovilíticos ocurridos en la República de Panamá en los años comprendidos entre 1980 y 1986. Se analizan los menores de 20 años involucrados en los mismos, los grupos etarios, las lesiones y el tipo de accidente. Se concluye que el número creciente de accidentes de tránsito constituye un problema de Salud Pública que debe ser abordado a la mayor brevedad