Influência da laserterapia de baixa intensidade no processo inflamatório e na imunomarcação da interleucina­23 e do fator indutor de hipóxia 1-alfa no tecido pulpar de dentes clareados / Influence of low-level laser therapy on the inflammatory process and immunolabeling of interleukin-23 and hypoxia-inducing factor 1-alpha in the pulp tissue of bleached teeth

Introdução: O uso do laser infravermelho (LIV) através da fotobiomodulação, tem demonstrado efeitos benéficos aos tecidos. Objetivos: Avaliar a influência do LIV sobre o processo inflamatório, por meio da imunomarcação da interleucina próinflamatória IL-23, e sobre a angiogênese, por meio da imunomarcação do fator induzível por hipóxia-1 alfa (HIF-1α), no tecido pulpar de dentes clareados. Materiais e métodos: Quarenta ratos Wistar foram distribuídos aleatoriamente em 4 grupos de 20 hemi-maxilas cada: Grupo Controle ­ recebeu o tratamento com o gel placebo; Grupo Cla - recebeu 30 minutos do gel clareador H2O2 a 35%; Grupo LIV ­ recebeu uma aplicação de LIV (808 nm, 30 segundos, 3J); Grupo Cla-LIV ­ imediatamente após a aplicação do H2O2 a 35%, recebeu uma aplicação de LIV, como descrito no grupo LIV. Após 2 e 30 dias (n = 10), os animais foram eutanasiados e as maxilas removidas e processadas para avaliação histológica (H.E.) e imunoistoquímica. Forma de análise: Os cortes teciduais seriados e com espessura de 5 µm corados em H.E. foram avaliados por escores atribuídos à inflamação, e a análise imunoistoquímica foi realizada através de escores atribuídos à imunomarcação. Os dados foram submetidos aos testes de Wilcoxon e Mann Whitney (p < 0,05). Resultados: Aos 2 dias, houve inflamação severa e necrose nos terços oclusal e médio do tecido pulpar no grupo Cla, diferente do grupo Cla-LIV com inflamação leve à moderada (p < 0,05). No terço cervical, houve inflamação moderada a severa no grupo Cla, e leve no grupo Cla-LIV (p < 0,05). Aos 30 dias, houve ausência de inflamação e os grupos clareados apresentaram deposição de dentina terciária. Em relação à IL-23, aos 2 dias foi observada imunomarcação severa no grupo Cla e moderada no grupo Cla-LIV (p < 0,05); aos 30 dias, houve redução na imunomarcação de IL-23 nos grupos clareados, onde o grupo Cla apresentou imunomarcação moderada, e o grupo Cla-LIV leve imunomarcação, sem diferença significante (p > 0,05). HIF-1α foi mais presente aos 2 dias no grupo Cla, sem diferença significativa com Cla-LIV (p > 0,05). Foi observada diferença entre os grupos clareados e seus respectivos controles, que não apresentaram imunomarcação (p < 0,05); aos 30 dias, o grupo Cla apresentou redução na imunomarcação para HIF-1α, enquanto o grupo Cla-LIV apresentou aumento da imunomarcação, mas a diferença permaneceu apenas entre os grupos clareados e seus controles (p > 0,05). Conclusão: O laser infravermelho minimizou o infiltrado inflamatório e a imunomarcação de IL-23 no tecido pulpar após a clareação dentária, mas não influenciou a imunomarcação de HIF-1α(AU)

Introduction: The use of infrared laser (IRL) through photobiomodulation has shown beneficial effects on tissues. Objectives: To evaluate the influence of LLL on the inflammatory process, by immunolabeling IL-23 pro-inflammatory interleukin, and on angiogenesis, by immunolabeling hif-1 alpha inducible factor (HIF-1α) in the pulp tissue of bleached teeth (HIF-1α). Materials and methods: Forty Wistar rats were randomly divided into 4 groups of 20 hemimaxilla each: control group - received treatment with placebo gel; Ble group - received 30 minutes of 35% H2O2 bleaching gel; IRL group - received one application of IRL (808 nm, 30 seconds, 3 J); Ble-IRL group - immediately after application of 35% H2O2, received an application of IRL, as described in the IRL group.. After 2 and 30 days (n = 10), the rats were euthanized and the jaws removed and processed for histological evaluation (H.E.) and immunohistochemistry. Form of analysis: Serial tissue sections with thickness of 5 µm stained in H.E. were evaluated by scores attributed to inflammation, and immunohistochemical analysis was performed by scores attributed to immunolabeling. The data were submitted to the Wilcoxon and Mann Whitney tests (P < 0.05). Results: At 2 days, there was a severe inflammation and the presence of necrosis in the occlusal and middle thirds of the pulp tissue in the Ble group, different compared to the Ble-IRL group with moderate to mild inflammation (P < 0.05). In the cervical third, there was moderate to severe inflammation in the Ble group, and mild in the Ble-IRL group (P < 0.05). At 30 days, there was absence of inflammation and bleached groups had an extensive deposition of tertiary dentin. Regarding IL-23, at 2 days was observed severe immunolabeling in the Ble group and moderate in the Ble-IRL group (P < 0.05); at 30 days, there was a reduction in IL-23 immunolabeling in the bleached groups, where Ble group had moderate immunolabeling, and Ble-IRL group had mild immunolabeling, without significant difference (P > 0.05). HIF-1α was more evident at 2 days in the Ble group, without significant difference with Ble-IRL (P > 0.05). The difference was observed between the bleached groups and their respective controls, which had no immunolabeling (P < 0.05); at 30 days, the Ble group had a reduction in HIF-1α immunolabeling, while the Ble-IRL group had an increase in immunolabeling from moderate to severe; however, the difference remained only between the bleached groups and their controls (P > 0.05). Conclusion: Infrared laser minimized the inflammatory infiltrate and IL-23 immunolabeling in the pulp tissue after dental bleaching, but did not influenced HIF-1α immunolabeling(AU)

Does hypersensitive teeth show pulp inflammation? / Dentes hipersensíveis apresentam inflamação pulpar?

ABSTRACT Objective: This study investigated the presence of inflammatory response in the dental pulp of rats showing hypersensitive dentin, induced by erosive episodes. Methods: Sixteen Wistar rats were fed with commercial sucrose-free pellet diet for 12 hours; whereas the food was removed during the remainder of the day, and the animals received mineral water or a lemon-based sucrose-free soft drink, according to the group to which they belonged. Eight animals consumed the soft drink to induce hypersensitivity, while the other 8 animals received mineral water (control). After six weeks, the animals were euthanized, the mandible was removed and subjected to a median incision in the sagittal plane, to obtain right and left hemimandibles. The slides stained with hematoxylin-eosin were analyzed using light microscopy. Results: Histological evaluation of the control and experimental groups revealed no inflammatory process in the pulp tissue, and the presence of inflammatory cells, such as lymphocytes, plasma cells, eosinophils and macrophages, was not observed. In addition, there was no edema or dilated and congested blood vessels. The Mann-Whitney test showed no significant difference (p = 1.000) between the experimental and the control groups. Conclusion: In the animal model used, dentin hypersensitivity does not trigger dental pulp inflammatory response.

RESUMO Objetivo: Este estudo investigou a presença de resposta inflamatória na polpa dentária de ratos apresentando hipersensibilidade dentinária induzida por episódios erosivos. Métodos: Dezesseis ratos Wistar foram alimentados com ração peletizada isenta de sacarose por 12 horas; enquanto a dieta estava ausente no restante do período diário, os animais receberam água mineral ou um refrigerante dietético à base de limão, de acordo com o grupo ao qual pertenciam. Oito animais consumiram o refrigerante para a indução do quadro de hipersensibilidade, enquanto os demais receberam água mineral (controle). Após seis semanas, realizou-se a eutanásia dos animais, os quais tiveram suas mandíbulas removidas e seccionadas medialmente no plano sagital, a fim de serem obtidas hemimandíbulas direita e esquerda. Lâminas coradas com hematoxilina-eosina foram analisadas sob microscopia óptica. Resultados: A avaliação histológica dos grupos controle e experimental revelou ausência de processo inflamatório no tecido pulpar e também não foi observada a presença de células inflamatórias como linfócitos, plasmócitos, eosinófilos ou macrófagos. Em adição, não houve edema ou vasos sanguíneos dilatados e congestos. O teste de Mann-Whitney demonstrou inexistência de diferença significativa (p = 1,000) entre os grupos experimental e controle. Conclusão: No modelo animal adotado, a hipersensibilidade dentinária não desencadeou resposta inflamatória na polpa dentária.

Lesiones pulpares y periapicales en la consulta de Urgencia Estomatológica. Clínica "Felipe Soto". 2010-2011 / Periapical and pulp lesions in the stomatological emergency consultation at Felipe Soto dental clinic. 2010-2011

Introducción: la mayoría de las urgencias estomatológicas se debe a enfermedades pulpares y periapicales. En nuestro país son pocos los estudios realizados en relación con la prevalencia de estas lesiones en la población, lo que motivó la realización de este trabajo. Objetivo: determinar el comportamiento de las lesiones pulpares y periapicales en pacientes de 19 a 59 años. Material y Método: se realizó un estudio descriptivo y transversal a pacientes comprendidos entre 19 y 59 años de edad quienes asistieron a la consulta de Urgencia Estomatológica de la clínica "Felipe Soto", del municipio Boyeros, de febrero del 2010 a junio del 2011. El universo fue de 250 pacientes a los que se realizó un examen clínico-estomatológico, de los cuales solo 154 presentaron este tipo de lesiones; se analizaron variables como edad, sexo, grupo dentario y causa de la enfermedad. Resultados: el grupo dentario más afectado fue el de los molares, la caries dental fue la principal causa relacionada con la aparición de dichas patologías. Conclusiones: el sexo femenino fue el predominante y el grupo de edad más afectado fue el de 19-34 años, el grupo dentario más afectado por lesiones pulpares y periapicales fue el de los molares, seguido de las bicúspides y las principales causas relacionadas con la aparición de estas enfermedades fueron la caries dental y las obturaciones defectuosas.

Introduction: most of emergency in the Cuban stomatological clinics are due to dental pulp diseases. In our country, there are only a few studies performed on this topic in relation to the prevalence of these injuries in the population. That's why we were motivated to work on this matter. Objective: to determine pulp and periapical lesions conduct in patients from 19 to 59 years old. Material and Methods: a descriptive and cross-sectional study was done in patients between 19 and 59 years old who attended to stomatological emergency services at "Felipe Soto" clinic from Boyeros Municipality, from February 2010 to June 2011. A stomatological clinical exam was done to a population of 250 patients and the sample was of 154 patients who presented dental pulp injuries, some variables were analyzed such as age, sex, dental group and causes of the disease. Results: the more affected teeth groups were the molars. As identified causes, the dental caries were the main related to the appearance of these pathologies. Conclusions: female sex predominant and the most affected age group was the one between 19 and 34 years old. The most affected dental group due to pulp and periapical lesions was that of molars fallowed by bicuspids and the main causes related to the appearing of these sicknesses were dental caries and faulty obturations.

CCL3 and CXCL12 production in vitro by dental pulp fibroblasts from permanent and deciduous teeth stimulated by Porphyromonas gingivalis LPS

ABSTRACT Objective: The aim of this study was to compare the production of the chemokines CCL3 and CXCL12 by cultured dental pulp fibroblasts from permanent (PDPF) and deciduous (DDPF) teeth under stimulation by Porphyromonas gingivalis LPS (PgLPS). Material and Methods: Primary culture of fibroblasts from permanent (n=3) and deciduous (n=2) teeth were established using an explant technique. After the fourth passage, fibroblasts were stimulated by increasing concentrations of PgLPS (0 – 10 µg/mL) at 1, 6 and 24 h. The cells were tested for viability through MTT assay, and production of the chemokines CCL3 and CXCL12 was determined through ELISA. Comparisons among samples were performed using One-way ANOVA for MTT assay and Two-way ANOVA for ELISA results. Results: Cell viability was not affected by the antigen after 24 h of stimulation. PgLPS induced the production of CCL3 by dental pulp fibroblasts at similar levels for both permanent and deciduous pulp fibroblasts. Production of CXCL12, however, was significantly higher for PDPF than DDPF at 1 and 6 h. PgLPS, in turn, downregulated the production of CXCL12 by PDPF but not by DDPF. Conclusion: These data suggest that dental pulp fibroblasts from permanent and deciduous teeth may present a differential behavior under PgLPS stimulation. .

Immunohistochemical assessment of lymphangiogenesis in inflamed human dental pulp

The present study aimed to investigate the effect of inflammation on lymphangiogenesis in human dental pulp using monoclonal mouse anti-human D2-40 antibody. Thirty samples of healthy dental pulps and twenty-seven pulps with irreversible pulpitis were included in this study. All cases were immunohistochemically stained for D2-40. Positively stained lymphatic vessels were counted by a light microscopy in an area of 1 mm2. The mean number and standard deviation of lymphatic vessels positive for D2-40 in the group with inflammation (8.04 ± 2.8) was significantly higher (p< 0.0001) than the mean number in the group without inflammation (3.93 ± 1.11). The study established an increased number of lymphatic vessels in the inflamed human dental pulp, which suggests that inflammation contributes lymphangiogenesis. The new lymphatic vessels can accelerate the removal of interstitial fluid and thus limit the effects of increased tissue pressure on the connective tissue. This may have importance in the process of regeneration of dental pulp and conservative procedures such as pulpotomy.

Pulp response of beagle dog to direct pulp capping materials: Histological study / 대한치과보존학회지

The purpose of this study was to evaluate the pulp tissue reaction to direct pulp capping of mechanically exposed beagle dogs'pulp with several capping materials. A total of 36 teeth of 2 healthy beagle dongs were used. The mechanically exposed pulps were capped with one of the followings: (1) Mineral Trioxide Aggregate (MTA: ProRoot(R) MTA, Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photo-polymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA) at 7, 30, and 90 days before sacrificing. The cavities were restored with Z350 flowable composite resin (3M ESPE, St. Paul. MN, USA). After the beagle dogs were sacrificed, the extracted teeth were fixed, decalcified, prepared for histological examination and stained with HE stain. The pulpal tissue responses to direct pulp capping materials were assessed. In MTA, calcium hydroxide, and photo-polymerized calcium hydroxide groups, initial mild inflammatory cell infiltration, newly formed odontoblast-like cell layer and hard tissue bridge formation were observed. Compared with dentin adhesive system, these materials were biocompatible and good for pulp tissue regeneration. In dentin adhesive system group, severe inflammatory cell infiltration, pulp tissue degeneration and pulp tissue necrosis were observed. It seemed evident that application of dentin adhesive system in direct pulp capping of beagle dog teeth cannot lead to acceptable repair of the pulp tissue with dentine bridge formation.