Comparación de la microfiltración apical de cuatro tipos de cementos endodónticos: Endofill, mtaFillapex, Adseal y Roeko Seal / Comparison of the Apical Microleakage of Four Types Of Endodontic Cements: Endofill, mta Fillapex, Adseal and Roeko Seal / Comparação da microinfiltração apical de quatro tipos de cimentos endodônticos: Endofill, mta Fillapex, Adseal e Roeko seal

Introducción: La microfiltración apical es uno de los principales causantes de fracasos endodónticos donde hay invasión de bacterias y líquidos periapicales a la parte interna del conducto radicular y material de relleno. Materiales y Métodos: La muestra estuvo conformada por 60 dientes premolares unirradiculares que fueron seccionados en la unión amelocementaria, la instrumentación biomecánica se realizó con técnica rotatoria e irrigación con hipoclorito de sodio al 5.25% y EDTA 17%, se dividió aleatoriamente en 4 grupos (n=15) para cada tipo de cemento, la obturación se realizó con la técnica de condensación lateral, a nivel coronal se obturó con Ionómero vidrio base y resina, se colocaron en una incubadora a 37° sumergidos en NaCL 0.9% por 5 días hasta el fraguado de los cementos, para observar la microfiltración se utilizó el método filtración de tinta china y la diafanización con la técnica de Robertson. Las medidas de microfiltración apical se observaron utilizando el Estereomicroscopio. Resultados: El valor promedio fue menor para el cemento Adseal 0,33mm, seguido por los cementos Fillapex 0,87mm, Roeko seal 1,00mm y Endofill 1,30mm respectivamente. Hubo diferencias estadísticamente significativas en la microfiltración apical de los cuatro cementos endodónticos (p=0.00) Conclusiones: El cemento Adseal presentó menor microfiltración en comparación a los cementos Fillapex, Roeko seal y Endofill.

Introduction: Apical microleakage is one of the main causes of endodontic failure, either due to invasion of microorganisms or periapical fluids into the canal, and only the composition of the type of obturator cement favors its reduction. The objective of this research was to compare the apical microleakage of four types of endodontic cements Endofill, MTA Fillapex, Adseal and Roeko Seal. Materials and methods: The sample consisted of 60 single root premolar teeth that were sectioned at the cement- enamel junction, the biomechanical instrumentation was performed with a rotary technique and irrigation with sodium hypochlorite and edta, randomly divided into 4 groups (n = 15) for each type of cement, the obturation was performed with the lateral condensation technique, at the coronal level it was obturated with base glass ionomer and resin, they were placed in an incubator at 37° submerged in NaCL 0.9% for 5 days until setting. of the cements, to observe the microleakage the India ink filtration method was used and diaph-anization with the Robertson technique. Apical microleakage measurements were observed using the Stereomicroscope. Results: The average value was lower for the Adseal 0.33 mm cement, followed by the Fillapex 0.87 mm, Roeko Seal 1.00 mm and Endofill 1.30 mm cements respectively. There were sta-tistically significant differences in the apical microleakage of the four endodontic cements (p = 0.00) Conclusions: Adseal cement presented less microfiltration compared to Fillapex, Roeko Seal and Endofill cements

Introdução: a microinfiltração apical é uma das principais causas de falhas endodônticas onde há inva-são de microrganismos e líquidos periapicais ao interior do conducto e só a composição do tipo de cimento obturador favorece sua disminuição. O objetivo desta pesquisa foi comparar a microinfiltração apical de quatro tipos de cimentos endodônticos Endofill, MTA Fillapex, Adseal e Roeko Seal. Materiais e métodos: a amostra foi composta por 60 dentes pré-molares uniradiculares que foram seccionados na junção amelocementária. A instrumentação biomecânica foi realizada com técnica rotatória e irrigação com hipoclorito e edta, sendo dividida aleatoriamente em 4 grupos (n = 15) para cada tipo de cimento. A obturação foi realizada pela técnica de condensação lateral, no nível coronal foi obturado com base de ionômero de vidro e resina, foram colocados em incubadora a 37° submersos em NaCl 0,9% por 5 dias até a pega dos cimentos. Para observar a microfiltração utilizou-se o método de filtração em tinta nan-quim e diafanização pela técnica de Robertson. As medidas de microinfiltração apical foram observadas utilizando o estereomicroscópio. Resultados: o valor médio foi menor para o cimento Adseal (0,33 mm), seguido pelos cimentos Fillapex (0,87 mm), Roeko Seal (1,00 mm) e Endofill (1,30 mm), respectivamente. Houve diferenças estatisticamente significativas na microinfiltração apical dos quatro cimentos endo-dônticos (p = 0,00). Conclusões: o cimento Adseal apresentou menor microinfiltração comparado aos cimentos Fillapex, Roeko seal e Endofill.

Características clínicas y radiográficas de reabsorciones radiculares externas / Clinical and radiographic characterization of external root resorption

Introducción La siguiente revisión bibliográfica se realizó con el propósito de reconocer las características clínicas y radiográficas que deben ser evaluadas para el diagnóstico de las reabsorciones radiculares externas incluyendo también sus tratamientos. Metodología Se llevó a cabo una búsqueda en las bases de datos MEDLINE/PubMed, Cochrane Library y Google Scholar bajo el término , incluyendo estudios experimentales y revisiones bibliográficas desde 2010 a 2022 en español e inglés, incluyendo finalmente 17 artículos. Resultados Los resultados obtenidos señalaron que cada tipo de reabsorción radicular externa presenta características clínicas específicas que las diferencian. Estas diferencias son: para la reabsorción externa inflamatoria la vitalidad pulpar negativa; para la reabsorción externa de reemplazo la ausencia de movilidad y percusión metálica; para la reabsorción externa cervical una coloración rosada de la corona; la reabsorción externa superficial no presenta ningún tipo de sintomatología clínica y la reabsorción de colapso apical transitorio presenta un cambio de coloración transitorio. Conclusión Las reabsorciones radiculares externas requieren un diagnóstico preciso y temprano. Se debe realizar un examen clínico con énfasis en sondaje, coloración, movilidad y pruebas de vitalidad.

Introduction The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. Methods A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. Results The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. Conclusion External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.

Microcomputed-Tomographic Analysis of the Root Canal Morphology of the Mandibular First Molars in a Malaysian Subpopulation Using Two Classification Systems / Análisis por Tomografía Microcomputada de la Morfología del Conducto Radicular de los Primeros Molares Mandibulares en una Subpoblación de Malasia Utilizando dos Sistemas de Clasificación

SUMMARY: This work investigated the morphology of the root canal system of the mandibular first molar in a Malaysian subpopulation. Using micro-computed tomography with an isotropic resolution of 22 µm, 140 mandibular first molars were scanned. MIMICS software was used for segmentation, 3-D reconstruction and analysis of the acquired images. The canal configuration was described using Vertucci [supported by the supplementary configurations proposed by Sert & Bayirli (2004)] and Ahmed et al. (2027), coding systems. The chi-square test was used to assess the association between qualitative variables. By non-considering intercanal communications, Vertucci types IV (17.1%) and I (76.4%) were the most frequently reported configurations in the mesial and distal roots, respectively. Of the reported configurations, 24.3% and 4.3% were non-classifiable by Vertucci system in the mesial and distal roots, respectively. Up to 63.6% and 9.3% of the reported configurations were non- classifiable, and type I was the most frequent when considering intercanal communications (7.1% and 76.4% in the mesial and distal roots, respectively). According to Ahmed et al., system, almost half of the sample had more than four digits (47.9%), followed by the 3-digits category (20.71%). In both systems, a significant association was found between the canal configuration and the root type (p<0.001). The mandibular first molar of this Malaysian subpopulation demonstrated a wide range of root canal morphology. When compared to the Vertucci system, the system developed by Ahmed et al., successfully classified all molars configurations despite their level of complexity. The complex canal anatomy of mandibular first molars in this subpopulation warrants special attention during root canal treatment procedures.

En este trabajo se investigó la morfología del sistema de conductos radiculares del primer molar mandibular en una subpoblación de Malasia. Utilizando tomografía microcomputada con una resolución isotrópica de 22 µm, se escanearon 140 primeros molares mandibulares. Se utilizó el software MIMICS para segmentar (enmascarar), reconstruir en 3D, visualizar y analizar las imágenes adquiridas. La configuración del canal se describió utilizando Vertucci respaldado por las configuraciones complementarias propuestas por Sert & Bayirli (2004)] y Ahmed et al. (2017, 2020), sistemas de codificación. Se utilizó la prueba de chi-cuadrado para evaluar la asociación entre variables cualitativas. Sin considerar las comunicaciones intercanales, los tipos Vertucci IV (17,1%) y I (76,4%) fueron las configuraciones reportadas con mayor frecuencia en las raíces mesiales y distales, respectivamente. De las configuraciones reportadas, el 24,3 % y el 4,3 % fueron no clasificables por el sistema de Vertucci en las raíces mesial y distal, respectivamente. Hasta el 63,6 % y el 9,3 % de las configuraciones reportadas fueron no clasificables, siendo la tipo I la más frecuente al considerar las comunicaciones intercanales (7,1 % y 76,4 % en las raíces mesiales y distales, respectivamente). Según Ahmed et al. (2017, 2020) en el sistema, casi la mitad de la muestra tenía más de cuatro dígitos (47,9 %), seguido por la categoría de 3 dígitos (20,71 %). En ambos sistemas se encontró una asociación significativa entre la configuración del canal y el tipo de raíz (p<0,001). El primer molar mandibular de esta subpoblación de Malasia demostró una amplia gama morfológica del conducto radicular. En comparación con el sistema Vertucci, el sistema desarrollado por Ahmed et al. (2017, 2020) clasificaron con éxito todas las configuraciones de los molares a pesar de su nivel de complejidad. La compleja anatomía del canal de los primeros molares mandibulares en esta subpoblación merece una atención especial durante los procedimientos de tratamiento de conducto.

Prevalencia de conductos en C de segundos molares mandibulares evaluados en tomografía de haz cónico / Prevalence of C-ducts of Mandibular Second Molars Evaluated on Cone Beam Tomography

Introducción: El conocimiento adecuado de la configuración de conductos radiculares es fundamental en endodoncia; la evaluación tomográfica permite una correcta evaluación de su disposición radicular. Objetivo: Determinar la prevalencia de conductos en C de segundos molares mandibulares, evaluados en tomografía de haz cónico. Métodos: Se realizó un estudio descriptivo y de corte transversal; la muestra estuvo conformada por 200 segundos molares mandibulares permanentes de una población peruana, observadas en tomografías cone beam, donde se registró la presencia del conducto en C, su configuración según la clasificación de Fan y el sexo del paciente. Resultados: La prevalencia de la configuración radicular en forma de C en segundos molares inferiores fue del 65,5 por ciento; según la Clasificación de Fan se observó mayor prevalencia en el tercio cervical del conducto radicular el tipo C1 con 85,7 por ciento; en el tercio medio el tipo C2 con 42,9 por ciento; a nivel apical fue el tipo C3C con 72,1 por ciento; según el sexo, el 65,2 por ciento de los conductos en C correspondió al femenino. Conclusión: La prevalencia de los conductos en C de los segundos molares mandibulares evaluados en tomografías de haz cónico fue de 65,5 por ciento con mayor predominio en el sexo femenino. La evaluación tomográfica permite una mejor identificación y configuración interna de los conductos radiculares(AU)

Introduction: Adequate knowledge of the configuration of root canals is fundamental in endodontics; tomographic evaluation allows a correct assessment of their radicular arrangement. Objective: To determine the prevalence of C-shaped canals in mandibular second molars, evaluated by cone beam tomography. Methods: A descriptive and cross-sectional study was carried out; the sample consisted of 200 permanent mandibular second molars from a Peruvian population, observed in cone beam tomography, where the presence of the C-shaped canal, its configuration according to Fan's classification and the patient's gender were recorded. Results: The prevalence of the C-shaped root canal configuration in lower second molars was 65.5 percent; according to the Fan classification, the highest prevalence was observed in the cervical third of the root canal, type C1 with 85.7 percent; in the middle third, type C2 with 42.9 percent; at the apical level it was type C3C with 72.1 percent; according to gender, 65.2 percent of the C-shaped canals corresponded to females. Conclusion: The prevalence of C-shaped canals in mandibular second molars evaluated in cone beam tomography was 65.5% with a higher predominance in the female gender. The tomographic evaluation allows a better identification and internal configuration of the root canals(AU)

Effect of sodium hypochlorite and calcium hypochlorite on the apical sealing ability of endodontic sealers

Aim: This study aimed to compare the influence of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2 ] on the apical sealing capacity of AH Plus (Dentsply Maillefer) and Bio-C Sealer (Angelus) endodontic sealers. Methods: Sixty permanent human lower incisors were randomly allocated (http://www.randomized.org), according to the irrigant used, into three groups (n=20): 0.9% sodium chloride (NaCl/Control); 2.5% NaOCl; and 2.5% Ca(OCl)2 . The root canal was prepared with rotary files under 10 mL of the solution corresponding to the experimental group. Each group was subdivided into two (n=10) according to the sealer used for filling: AH Plus (Dentsply Maillefer) or Bio-C Sealer (Angelus). Then, all samples were immersed in black India ink for one week. After the storage period, the roots were then grooved longitudinally and split, and the ink penetration was measured from the apical part to the coronal part of the root canal into which the ink penetrated using a stereomicroscope. Data were analyzed by one-way ANOVA and Tukey's post-hoc tests. Results: There was no statistical difference in ink penetration between the different endodontic sealers tested for the same irrigating solution (p > 0.05). However, when the Bio-C Sealer (Angelus) was used, the group treated with 2.5% Ca(OCl)2 was associated with lower values of apical leakage, compared to 2.5% NaOCl (p < 0.05). For the AH Plus sealer (Dentsply Maillefer), there was no difference between the irrigants (p > 0.05). Conclusions: Associating Ca(OCl)2 irrigant with Bio-C Sealer (Angelus) seems to be a good option to reduce apical leakage

Influence of root canal sealer composition on postoperative pain after endodontic treatment of permanent teeth: a systematic review and meta-analyses / Influência da composição do cimento endodôntico na dor pós-operatória de dentes permanentes tratados endodonticamente: uma revisão sistemática e meta-análise

Postoperative pain is a frequent complication after root canal treatment. Its management is an important aspect of endodontic practice. Some treatment-related parameters were associated with the development of postoperative pain, including the sealer composition and extrusion. Objective: This systematic review aimed to answer the clinical question: Do root canal sealers composition influence postoperative pain after endodontic treatment of permanent teeth? Material and Methods: Electronic searches were conducted in PubMed, Scopus, Web of Science, Cochrane, LILACS, and grey literature databases until September 2021. The studies were qualitatively assessed using the RoB2 tool (Cochrane) and the certainty of evidence (GRADE). Sensitivity and pooled estimates were calculated using a random-effects model. Twelve articles were included. Results: The risk of bias was high in one study, low in nine, and two had some concerns. Qualitative analyses showed no influence of sealer extrusion on postoperative pain. Meta-analyses showed no significant difference in postoperative pain with moderate to very low levels of certainty between AH Plus and calcium silicate-based sealers, in a 95% confidence interval. Analysis between AH Plus, Zinc Oxide and Eugenol (ZOE), and calcium hydroxide (Ca(OH)2)-based sealers were not performed due to heterogeneity and lack of data. Conclusion: Literature showed contrasting results in postoperative pain between AH Plus and ZOE-based sealers, with low to moderate certainty of evidence. Regarding Ca(OH)2-based sealers, a single study with a low level of certainty concluded that AH Plus presented less postoperative pain than Apexit Plus. Therefore, further studies are needed to assess the influence of these sealers on postoperative pain. Evidence showed no difference in postoperative pain between AH Plus and calcium silicate-based sealers. Sealer extrusion is a variable that requires further studies (AU)

A dor pós-operatória é uma complicação frequente após o tratamento endodôntico. O seu manejo é um importante aspecto na prática endodôntica. Algumas variáveis relacionados ao tratamento foram associados com o desenvolvimento da dor pós-operatória, incluindo a composição e extrusão dos cimentos endodônticos. Objetivo: Esta revisão sistemática objetivou responder a seguinte pergunta clínica: A composição dos cimentos endodônticos podem influenciar a dor pós-operatória de dentes permanentes tratados endodonticamente?Material e Métodos: Buscas eletrônicas foram realizadas nas bases de dados no PubMed, Scopus, Web of Science, Cochrane, LILACS, e literatura cinzenta até setembro de 2021. Os estudos foram avaliados qualitativamente usando a ferramenta RoB2 (Cochrane) e a certeza de evidência (GRADE). A sensibilidade e as estimativas agrupadas foram calculadas usando um modelo de efeitos aleatórios. Doze artigos foram incluídos. Resultados: O risco de viés foi alto em um estudo, baixo em nove e dois tiveram algumas preocupações. A análise qualitativa mostrou que não há influência da extrusão do cimento na dor pós-operatória. A meta-análise mostrou que não houve diferença estatisticamente significante na dor pós-operatória entre o AH Plus e os cimentos a base de silicato de cálcio com moderada a muito baixa certeza de evdência. Análises entre os cimentos AH Plus, óxido de zinco e eugenol (OZE) e hidróxido de cálcio não foram realizados devido a heterogeneidade e falta de dados. Conclusão:A literatura sugere resultados contrastantes com relação a dor pós-operatória e entre os cimentos AH Plus e OZE, com baixa a moderada certeza de evidência. Já os cimentos a base de hidróxido de cálcio, um único estudo com baixa certeza de evidência concluiu que o AH Plus apresentou menos dor pós tratamento endodôntico do que o Apexit Plus. Portanto,mais estudos são necessários para avaliar a influência desses tipos de cimentos na dor pós-operatória. Com relação ao cimento AH Plus e os cimentos a base de silicato de cálcio não houve diferença estatística entre eles e a dor. A extrusão dos cimentos é uma variável que requer mais estudos (AU)

Using manual versus mechanized glide path instruments and ProTaper Gold versus ProTaper Next systems in curved canals: micro-CT study

Abstract The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.

Natural canal deviation and dentin thickness of mesial root canals of mandibular first molars assessed by microcomputed tomography

Abstract The aim of this study was to assess the centralization and dentin thickness of mesial root canals of the first mandibular molars by microcomputed tomography (micro-CT). Material and methods: Ninety-nine mandibular molars of Vertucci's type IV canals were scanned by micro-CT. The mesiodistal deviation and centroid were assessed, in both mesiobuccal (MB) and mesiolingual (ML) canals, for the apical 4mm and the full canal length. Results: The dentin thickness was similar for both MB and ML canals. The narrowest thickness was in the distal wall of an MB canal (0.07mm), while the widest was found in the mesial wall of an MB canal (2.46mm). In centroid analysis, both the MB and ML canals exhibited deviations when compared to the root centroid, along the full canal length and the apical 4mm. For the MB canal, the mean deviation was 0.83mm (0.02 mm-2.30 mm) for the full canal and 0.18mm (0.01 mm-1.01 mm) for apical 4mm. Similarly, for the ML canal, the mean deviation measured 0.83 mm (0.05mm-3.99mm) for the full canal and 0.21 mm (0.01mm-1.01mm) for the apical 4 mm. Overall, deviations were observed towards the mesial of the roots, with 69% for MB and 57% for ML canals for the full canal, and 51% for MB canals within the 4 mm. The exception was the ML canal, which exhibited a higher deviation towards distal in the apical 4mm, accounting for 52% of cases. The dentin thickness was consistent between the mesial canals of mandibular molars. However, there is no centrality of mesial canals in their roots, with frequent deviation to mesial.

Resumo O objetivo deste trabalho foi avaliar a centralização e a espessura da dentina dos canais radiculares mesiais de primeiros molares inferiores por meio de microtomografia computadorizada (micro-CT). Material e métodos: Noventa e nove molares inferiores com canais tipo IV de Vertucci foram escaneados por micro-TC. O desvio mesiodistal e o centroide foram avaliados para os canais mesiovestibular (MB) e mesiolingual (ML), nos 4mm apicais e em todo o comprimento do canal. Resultados: A espessura da dentina foi semelhante para os canais MB e ML. A espessura mais estreita foi encontrada na parede distal de um canal MB (0,07mm), enquanto a mais larga foi encontrada na parede mesial de um canal MB (2,46mm). Na análise centroide, tanto o canal MB quanto o ML exibiram desvios quando comparados ao centroide da raiz, ao longo de todo o comprimento do canal e nos 4 mm apicais. Para o canal MB, o desvio médio foi de 0,83mm (0,02mm-2,30mm) para canal inteiro e 0,18mm (0,01mm-1,01mm) para o apical de 4mm. Da mesma forma, para o canal ML, o desvio médio mediu 0,83 mm (0,05 mm-3,99 mm) para o canal inteiro e 0,21 mm (0,01 mm-1,01 mm) para os 4 mm apicais. No geral, foram observados desvios em direção mesial das raízes, sendo 69% para canais MB e 57% para canais ML para canal inteiro, e 51% para canais MB dentro dos 4 mm. A exceção foi o canal ML, que apresentou maior desvio para distal nos 4mm apicais, representando 52% dos casos. A espessura da dentina foi consistente entre os canais mesiais dos molares inferiores. Entretanto, não há centralidade dos canais mesiais em suas raízes, com frequente desvio para mesial.

Influence of genetic polymorphisms on oral health-related quality of life after root canal treatment

Abstract To evaluate the impact of genetic polymorphisms in interleukins (IL1A rs17561, rs1304037; IL10 rs1800871; IL1RN rs9005), nitric oxide (NOS2 rs2779249, rs2897518) and suppressor of cytokine signaling (SOCS1 rs243327, rs33977706) on oral health-related quality of life (OHRQoL) of patients under-going root canal treatment (RCT). Methods: The sample consisted of 108 participants, presenting single-rooted teeth with asymptomatic periapical periodontitis. The impact of the OHRQoL was recorded using the Oral Health Impact Profile (OHIP-14) before, seven, and 30 days after RCT. Saliva samples were collected as a source of genomic DNA. Genetic polymorphisms were genotyped by Real-Time PCR using the Taqman method. Univariate and Multivariate analyses were used (p<0.05). Results: A significant difference was observed for the polymorphism rs2297518 in the NOS2 gene in functional limitation in the codominant (p=0.037) and recessive (p=0.001) models; in the physical pain (p<0.001 in both models); in psychological discomfort (p<0.001 in both models); in physical disability (p<0.001 in both models) and in psychological disability (p<0.001 in both models). Polymorphisms in the SOCS1 gene, in the recessive model, rs33977706 (p=0.045) and rs243327 (p=0.019), influenced the OHRQoL in the psychological discomfort domain. Conclusions: Polymorphisms in NOS2 and SOCS1 genes influenced the OHRQoL of patients undergoing RCT.

Resumo Avaliar o impacto de polimorfismos genéticos em interleucinas (IL1A rs17561, rs1304037; IL10 rs1800871; IL1RN rs9005), óxido nítrico (NOS2 rs2779249, rs2897518) e supressor da sinalização de citocinas (SOCS1 rs243327, rs33977706) na qualidade de vida relacionada à saúde bucal (QVRSB) de pacientes submetidos a tratamento endodôntico (TE). Métodos: A amostra foi composta por 108 participantes, que apresentavam dentes unirradiculares com lesão periapical assintomática. O impacto da QVRSB foi registrado usando o Oral Health Impact Profile (OHIP-14) antes, sete e 30 dias após o TE. Amostras de saliva foram coletadas como fonte de DNA genômico. Os polimorfismos genéticos foram genotipados por PCR em tempo real usando o método Taqman. Análises univariadas e multivariadas foram utilizadas (p<0,05). Resultados: Observou-se diferença significativa para o polimorfismo rs2297518 no gene NOS2 na limitação funcional nos modelos codominante (p=0,037) e recessivo (p=0,001); na dor física (p<0,001 em ambos os modelos); no desconforto psicológico (p<0,001 em ambos os modelos); na deficiência física (p<0,001 em ambos os modelos) e na deficiência psicológica (p<0,001 em ambos os modelos). Polimorfismos no gene SOCS1, no modelo recessivo, rs33977706 (p=0,045) e rs243327 (p=0,019), influenciaram a QVRSB no domínio desconforto psicológico. Conclusões: Polimorfismos nos genes NOS2 e SOCS1 influenciaram a QVRSB de pacientes submetidos a TE.

Comparative in vitro analysis of the antifungal activity of different calcium silicate-based endodontic sealers

Aim: This study aimed to perform an in vitro comparative analysis of the antifungal activity of different calcium silicate-based endodontic sealers against three fungal species. Methods: The antifungal properties of three calcium silicate-based sealers were tested: Bio-C Sealer, Cambiar a Sealer Plus BC, and MTA-Fillapex. Two commonly used sealers were used as controls: AH Plus and Endomethasone. An agar diffusion test was performed to analyze the antifungal activity of the sealers against Candida albicans, Candida glabrata, Candida tropicalis, and a mixed microbial culture medium. The results were analyzed using ANOVA (p <0.05). Results: Endomethasone exhibited the highest inhibition against all strains examined, maintaining a consistent level of inhibition throughout 7 days. MTA-Fillapex demonstrated the best performance among the calcium silicate-based sealers for the three fungal species (p < 0.05), maintaining stable values over the 7 days, surpassing that of Endomethasone. Nevertheless, MTA-Fillapex only exhibited antimicrobial effect against the mixed culture for the first 24 hours, and no antimicrobial activity was observed at 48 hours, being surpassed by all tested sealers (p < 0.05). Conclusion: Of all silicate-based sealers tested, only MTA-Fillapex exhibited promising antifungal activity. Nevertheless, care must be taken when extrapolating these results, as MTA-Fillapex exhibited poor antimicrobial activity when tested in mixed microbial cultures

The regulatory role of the RUS family in plant growth and development / 生物工程学报

The chloroplast genome encodes many key proteins involved in photosynthesis and other metabolic processes, and metabolites synthesized in chloroplasts are essential for normal plant growth and development. Root-UVB (ultraviolet radiation B)-sensitive (RUS) family proteins composed of highly conserved DUF647 domain belong to chloroplast proteins. They play an important role in the regulation of various life activities such as plant morphogenesis, material transport and energy metabolism. This article summarizes the recent advances of the RUS family proteins in the growth and development of plants such as embryonic development, photomorphological construction, VB6 homeostasis, auxin transport and anther development, with the aim to facilitate further study of its molecular regulation mechanism in plant growth and development.

Cone-beam computed tomography study of root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in high-angle Class Ⅱ open bite patients / 口腔疾病防治

Objective@#This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite, aiming to provide a reference for clinical treatment.@*. Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. CBCT images of eighty-one untreated patients (40 anterior open bite patients and 41 normal overbite patients) with high-angle skeletal Class Ⅱ malocclusion were selected before treatment. Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology, and the differences between the two groups were analyzed.@*Results@#There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group, significant differences were found in the root length of maxillary central incisor （11.12 ± 1.37） mm、mandibular central incisor（10.15 ± 1.09）mm, mandibular lateral incisor（11.27 ± 1.15）mm and mandibular canine（12.81 ± 1.48）mm between the open bite group and the normal overbite group（P<0.05）. On the other hand, the two groups were significantly different in crown-root morphology of the maxillary central incisor (1.10° ± 3.62° vs. 4.53° ± 2.30°, P<0.01) but not in the mandibular central incisor.@*Conclusion@#The root length of the maxillary central incisor, mandibular central incisor, mandibular lateral incisor, mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients, and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root. The crown-root angle is smaller, which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱ open bite patients.

Clinical effectiveness of valve-sparing aortic root replacement in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot / 中国胸心血管外科临床杂志

@#Objective     To evaluate the clinical effectiveness of valve-sparing aortic root replacement (VSARR) in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot (TOF). Methods     A retrospective analysis was conducted on clinical data of TOF patients with aortic root dilation who underwent VSARR in our hospital from 2016 to 2022. Results     Finally 14 patients were collected, including 8 males and 6 females, with a median age of 22 years ranging from 12-48 years. Among them, 5 patients had severe aortic valve regurgitation, 4 moderate regurgitation, and 5 mild or no regurgitation. Six patients had sinus of valsalva dilation, and 8 significant dilation of the ascending aorta. One patient had residual shunt due to ventricular septal defect, and 9 severe pulmonary valve regurgitation. The David procedure was performed in 10 patients, Yacoub procedure in 2 patients, and Florida sleeve in 2 patients. There was no perioperative mortality in the group. The median follow-up time was 2.9 years (ranging from 0.4 to 6.0 years). One patient had mild aortic valve regurgitation, and the rest had minimal or no regurgitation. One patient had mild stenosis of the left ventricular outflow tract, and the rest patients had no obvious stenosis. Conclusion     VSARR is a satisfactory treatment for aortic root dilation in patients with TOF, with no significant increase in the incidence of left ventricular outflow tract stenosis or aortic regurgitation during mid-term follow-up.

In vitro study on cyclic fatigue resistance of three types of nickel titanium files in preparation for bending root canals / 口腔疾病防治

Objective@#The purpose of this study was to investigate the differences in the anti cyclic fatigue performance of Woride KS (WKS), Proteper Gold (PTG), and Hyflex CM (HCM) nickel titanium instruments with different tip diameters in curved root canal models, and to provide reference for the targeted selection of suitable nickel titanium instruments in clinical preparation of curved root canals.

Research progress on invasive cervical resorption / 口腔疾病防治

@#Tooth absorption can be divided into physiological absorption and pathological absorption. Root absorption of mature deciduous teeth is physiological absorption. Pathological absorption includes internal absorption and external absorption. Internal absorption, also known as intramedullary absorption, includes inflammatory absorption and alternative absorption. External tooth absorption originates from the outer surface of the root or the neck of the tooth and can be divided into inflammatory absorption, alternative absorption, pressure resorption and invasive cervical resorption. Invasive cervical resorption (ICR) is pathological damage caused by many factors, which usually begins in the cemento-enamel junction and extends peripherally or horizontally in the dentin. It hardly invades the pulp. Orthodontic devices, trauma, bleaching, systemic diseases, and the use of certain medications can all lead to invasive cervical resorption. The clinical manifestations of ICR are usually asymptomatic or not obvious, and most of which are found in imaging examinations. Because caries and internal absorption are often misdiagnosed through plain apical radiography, cone beam computed tomography (CBCT) can help to better understand the situation of invasive cervical resorption. Because the pathogenesis and etiology of invasive cervical resorption are not fully understood, clinical negligence and inadequate treatment of invasive cervical resorption can even cause unnecessary tooth loss. This article reviews the latest research progress on the histopathologic features, pathogenic mechanism, susceptibility factors, diagnosis and treatment of ICR, with special emphasis on susceptibility factors and their mechanisms.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Application of modified mucogingival surgery in the treatment of gingival recession / 口腔疾病防治

@#With the increasing demand for beauty, the treatment of gingival recession has become a common request among patients. Clinically, gingival recession is mainly treated by surgery. The common surgical methods include free gingival grafting, pedicled flap technology and double flap technology (subepithelial connective tissue transplantation combined with coronally advanced flaps). If patients with indications are selected, satisfactory surgical results will be obtained. However, there are still some shortcomings in the above mentioned methods, such as the root coverage effect not being satisfactory. In recent years, researchers have put forward some improved schemes to minimize the shortcomings of the above methods to treat different degrees of gingival recession. A gingival unit graft containing gingival papilla and free gingiva can improve the blood supply of the recipient area and improve the effect of root coverage. It can obtain better root coverage for slight retraction, widening of the angular gingiva and deepening of the vestibular sulcus, but there may be issues with inconsistent color and shape of the gingiva after surgery, as well as poor aesthetic effects. Modified coronally advanced flaps, flaps prepared by the technique of half-thickness, full-thickness and half-thickness, and modified coronally advanced envelope flap technology are designed with the most serious retraction teeth as the center in the case of multiple gingival retractions, both of which can improve the effect of root covering. Tunnel technology and modified tunnel technology, without severing the gingival papilla and tunneling the gingival flap to accommodate the graft, can effectively reduce tissue damage and promote wound healing. This paper reviews the literature and summarizes the outcome of the modified surgery techniques in the treatment of gingival recession. These treatment options for gingival recession are proposed with the aim of improving clinical work, and some suggestions for the treatment of gingival recession to achieve a stable root coverage effect are put forward. In the future, the development direction of mucogingival surgery is to reduce trauma and have a stable curative effect.

Improvement effect and mechanism of total flavonoids from Rosa multiflora root on vascular injury in rheumatoid arthritis model rats / 中国药房

OBJECTIVE To study the improvement effect of total flavonoids from Rosa multiflora root on vascular injury in rheumatoid arthritis （RA） model rats and its potential mechanism. METHODS Female Wistar rats were randomly divided into normal control group， model group， aspirin group （positive control， 30 mg/kg）， low-dose and high-dose groups of total flavonoids from R. multiflora root （4.15， 8.30 g/kg， by crude drug）， with 10 rats in each group. Except for the normal control group， the RA model was induced in other groups by collagen induction and high-fat diet. After 14 days of modeling， they were given corresponding drug solution/0.5% sodium carboxymethyl cellulose solution intragastrically， once a day， for 36 consecutive days. The total body score， arthritis index （AI） and swollen joint count （SJC） of the rats were evaluated regularly. After the last medication， serum levels of interleukin-6 （IL-6）， intercellular adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule- 1 （VCAM-1） were determined. The pathological morphological changes in the vascular tissue of thoracic aorta were observed； the protein expression of Toll-like receptor 4 （TLR4） and the protein phosphorylation levels of Janus kinase 2 （JAK2） and signal transduction and activator of transcription 3 （STAT3） in vascular tissue of thoracic aorta were measured. RESULTS Compared with the normal control group， serum levels of IL-6， ICAM-1 and VCAM-1， protein expression of TLR4， and the protein phosphorylation levels of JAK2 and STAT3 in vascular tissue of thoracic aorta were increased significantly in model group （P＜ 0.01）. The atherosclerotic plaque （atheroma）， cholesterol crystal， lymphocyte infiltration and a small number of unbroken foam cell aggregation could be seen in the vascular tissue of thoracic aorta. Compared with the model group， total body score （except for the low-dose group）， AI and SJC were decreased significantly in groups of total flavonoids from R. multiflora root on the 28th day （P＜0.05 or P＜0.01）； total body score，AI and SJC were decreased significantly in low-dose group of total flavonoids from R. multiflora root on the 49th day （P＜0.05 or P＜0.01）； the other quantitative indicators in serum and vascular tissue were significantly reversed in groups of total flavonoids from R. multiflora root （P＜0.05 or P＜0.01）， and pathological damage of vascular tissue was significantly relieved. CONCLUSIONS Total flavonoids from R. multiflora root can significantly improve vascular injury in RA model rats， and its mechanism may be related to reducing the protein expression of TLR4 in vascular tissue and inhibiting the activation of IL-6/JAK2/ STAT3 signaling pathway.

The mechanism of chlorogenic acid against neuropathic pain induced by cisplatin / 药学学报

This study aimed to investigate the analgesic effect of chlorogenic acid on cisplatin-induced neuropathic pain and explored the underlying molecular mechanisms. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Xinxiang Central Hospital, in compliance with the Institutional Animal Care Guidelines. Von Frey hair and a radiant heat was employed to measure mechanical allodynia and thermal hyperalgesia; Western blot was used to examine transient receptor potential vanilloid type-1 (TRPV1) protein expression in the rat dorsal root ganglion (DRG); patch clamp was used to record TRPV1 currents in DRG neurons. The experimental results showed that chlorogenic acid could attenuate cisplatin-induce mechanical allodynia and thermal hyperalgesia in rats. The expression of TRPV1 protein in DRGs was increased in cisplatin-treated rats, while chlorogenic acid also could reverse cisplatin-induced the upregulation of TRPV1 protein. Forthermore, chlorogenic acid could attenuate cisplatin-mediated the upregulation of TRPV1 current density. These above results indicated that chlorogenic acid could alleviate cisplatin-induced pain hypersensitivity through inhibition of the expression and function of TRPV1 in rats.

A new suberin from roots of Ephedra sinica Stapf / 药学学报

Six compounds were isolated from the roots of Ephedra sinica Stapf using various chromatographic techniques such as silica gel column chromatography, thin layer chromatography and semi-preparative HPLC. Their chemical structures were identified by analysis of physicochemical properties and spectral data, and determined as (Z)-docosanylferulate (1), (E)-docosanylferulate (2), bis (2-ethylheptyl) phythalate (3), 2,2′-oxybis (1,4-di-tert-butylbenzene) (4), diisobutyl phthalate (5), bis (2-ethylhexyl) phthalate (6). Among them, compound 1 is a new compound, compounds 2-4 were first isolated from Ephedra. A corticosterone-induced PC-12 cell injury model was used for compound activity screening. The results showed that compounds 1 and 5 significantly improved corticosterone-induced PC-12 cell injury and significantly increased 5-HT7 receptor protein expression in the cells, indicating potential antidepressant activity.