Pro-inflammatory and anti-inflammatory cytokine expression in post-treatment apical periodontitis

Abstract Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions' data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. Conclusions: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.

Esthetic and endosurgical management of Turner's hypoplasia; a sequlae of trauma to developing tooth germ.

Turner's hypoplasia usually manifests as a portion of missing or diminished enamel, generally affecting one or more permanent teeth in the oral cavity. A case report of 8 year old girl who met with trauma at 2 years of age leading to primary incisors being knocked out, reported after 6 years with complaint of pain and discharge in her anterior malformed teeth is discussed in this article. The permanent incisors erupted with dilacerated crown, root malformations and missing enamel. Further, patient developed sinus, lateral root pathology, tooth mobility and malocclusion in relation to affected teeth which were managed by esthetic, functional, endodontic and surgical procedure. Root canal treatment along with palatal contouring and esthetic restoration by light cure composite was performed on the tooth with crown dilaceration and sinus, where as surgical management was considered for the tooth with root malformation.

Reimplante intencional: informe de un caso / Intentional replantation: report of a case

Se describe el caso de un reimplante intencional de un segundo molar inferior que presenta serias dificultades para el retratamiento endodóntico por vía convencional. Luego de un período de observación de cuatro años, el molar se encuentra confortable y asintomático, sin movilidad y sin pérdida de inserción. En el control radiográfico se observó que la pieza dentaria se encuentra rodeada por un trabeculado óseo normal y un espacio periodontal y cortical alveolar regulares y sin interrupciones. Se discuten los factores que condicionan los resultados a distancia

Preservaçäo do espaço biológico em técnica cirurgica parendodôntica: relato de casos / Preservation of the biological space in a parendodontic surgery technique: cases report

Os autores apresentam casos clínicos de cirurgia periapical, onde o enfoque principal é o tipo de incisäo a ser executada. Trata-se de obter o total respeito ao binômio epitélio juncional - crista óssea alveolar, de maneira que assim procedendo, condiçöes säo dadas para manter a integridade do espaço biológico, além de garantir um resultado estético previsível