Response to Pulp Vitality Tests in Teeth Submitted to Orthodontic Movement, Adjacent to the Cleft Area.

OBJECTIVE: To evaluate the pulp vitality in teeth adjacent to the cleft area submitted to orthodontic movement into the alveolar graft area in individuals with complete unilateral cleft lip and palate (CUCLP). DESIGN: Cold sensitivity, vertical, and horizontal percussion tests were conducted on the teeth adjacent to the cleft and the contralateral teeth. SETTING: Endodontics Sector in the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP). PATIENTS: One hundred patients with CUCLP and hypodontia of the upper lateral incisor in orthodontic movement and after successful alveolar bone graft in the cleft area. MAIN OUTCOME MEASURES: The cleft study group (SG) was composed of 200 teeth, adjacent to the cleft area. The control group (CG) consisted of 200 contralateral teeth. Statistical analysis was performed using the chi-square test for comparisons between groups (P < .05). RESULTS: In the SG, 82.0% of teeth presented positive response to the cold sensitivity testing, 13.5% had negative response, and 4.5% had marked response, with statistically significant difference in relation to the CG. The vertical and horizontal percussion tests on teeth in the SG revealed the same results, in which 95.0% presented negative response and 5.0% responded positively, without significant difference compared to teeth in the CG, for both tests. CONCLUSIONS: Teeth adjacent to the cleft area presented changes in the physiological conditions of the pulp, which were observed by reduction of positive response to the cold sensitivity testing or presence of pulp hypersensitivity in cases of marked response.

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts.

BACKGROUND: Dental treatment is fundamental in the rehabilitation of individuals with orofacial clefts, due to their oral condition; when indicated, endodontic therapy allows elimination of infection of the root canal system. Aim: To analyze, by a retrospective study, the most prevalent type of orofacial cleft, the etiological factors most commonly related to the endodontic treatment need, as well as their success and failure rates. MATERIAL AND METHODS: This study analyzed data from 136 records (76 females and 60 males) with mean age of 19 years and 7 months, who met the inclusion criteria. Data were collected including the type of cleft, etiological factors that led to the need of endodontic treatment, as well as their success and failure rates. The statistical analysis was performed by the chi-square, Kruskal-Wallis, Fisher's Exact and Batista Pike tests. RESULTS: Among the etiological factors, were pulp involvement due to caries, endodontic treatment for prosthetic rehabilitation, tooth resorptions, for orthodontic movement, dental trauma and indication of internal tooth bleaching; the most prevalent factor was pulp involvement due to caries. Among all data analyzed, cleft lip and palate presented the highest percentage, and there was predominance of treatment success compared to failure. CONCLUSIONS: The well-conducted root canal treatment is necessary for dental rehabilitation, maintaining the masticatory function and esthetic harmony of these individuals. Key words:Cleft lip, Cleft palate, Endodontics.

Dental hypersensitivity in individuals with cleft lip and palate: Origin and therapies.

Background. Dental hypersensitivity is due to the exposure of the dentin layer after wear of enamel or cementum, exposing the dentinal tubules and the nerve endings of odontoblasts within these tubules. The present study aimed to assess the factors related to dental hypersensitivity in individuals with cleft lip and palate and the most common therapy received. Methods. The medical records of 536 patients with cleft lip and/or palate (281 males, 255 females) with a mean age of 18 were analyzed in a single center. The inclusion criterion was patients reporting dental hypersensitivity from May 2015 to October 2019. The origin of dental hypersensitivity was evaluated considering orthodontic movement, periodontal diseases, and reversible and irreversible pulpitis. The therapy indicated by the dental professionals for dental hypersensitivity were recorded. Descriptive statistics were performed. Results. Of 61 teeth with dental hypersensitivity, 10 were attributed to orthodontic movement, 21 to periodontal problems, 27 to reversible pulpitis, and three to irreversible pulpitis. The most used therapies were the application of fluoride varnish and prophylaxis, dentifrice indication for dental sensitivity, free gingival grafts, pulpectomy, desensitizing agent application, conservative endodontic treatment (direct pulp protection), and restoration of non-carious cervical lesions. Conclusion. Reversible pulpitis was the most prevalent etiologic factor of dental hypersensitivity in individuals with cleft lip and palate. Dentifrices for dental sensitivity and fluoride varnish application were frequently recommended.

Success or failure of endodontic treatments: A retrospective study.

CONTEXT: Well-conducted endodontic therapy is necessary for the dental rehabilitation of the individuals with cleft lip and palate. AIM: The aim of this study was to verify the success and failure index of endodontic treatments performed in the Endodontic Sector of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, (HRAC/USP), Bauru, Brazil. MATERIALS AND METHODS: The preservation records (at least 2 years) of the endodontic treatments performed in the HRAC/USP were verified, indicating the success or failure of the treatment, and these treatments were divided into three groups (vital pulp, necrotic pulp, and endodontic retreatment). The Chi-square statistical test was applied with a significance level of 5%. RESULTS: A total of 1216 endodontic treatments were quantified with a minimum of 2 years of prenatal care at HRAC/USP. The vital pulp group had a success rate of 99.4% (535 treatments) and 0.6% failure (3 treatments), 98.6% of success in the necrotic pulp group (577 treatments) and 1.4% failure (8 treatments), and 95.6% success rate (89 treatments) and 4.4% failure (4 treatments) in the endodontic reintervention group. CONCLUSION: From the results found, we can conclude that there was a high success rate in the treatments and endodontic retreatments performed in the Endodontics Sector of the HRAC/USP, considering that well-conducted endodontic therapy is extremely important in the oral rehabilitation of individuals with cleft lip and palate.

CAMPANELLIProgrammed Death 1 (PD-1) and PD-1 Ligand (PD-L1) Expression in Chronic Apical Periodontitis.

OBJECTIVE: This study aimed to examine programmed death protein 1 (PD-1) and programmed death lig-and 1 (PD-L1) expression on leukocytes from chronic apical periodontitis, and to determine the levels of cytokines in the apical periodontitis lesions. METHODS: Leukocytes from healthy gingival tissue (n=16) and chronic apical periodontitis (n=10) were eval-uated using flow cytometry. The PD-1 and PDL-1 expressions were evaluated using flow cytometry. The cy-tokine levels were evaluated by enzyme-linked immunosorbent assay. Data were analyzed using one-way ANOVA. The statistical significance level was set at P<0.05. RESULTS: Results showed that the apical periodontitis lesions are more infiltrated by PD-1+ and PDL1+ lym-phocytes than the control samples. In addition, the PDL-1 expression was detected on macrophages in the apical periodontitis lesions, and was significantly higher compared to leukocytes from healthy gingival tis-sue. The IFN-γ, TGF-ß, IL-10, and TNF-α levels were significantly higher in the apical periodontitis lesions com-pared to control samples. CONCLUSION: The PD-1, PD-L1, and CTLA-4 molecules are evident in apical periodontitis, and can be an impor-tant immune checkpoint in chronic periapical periodontitis.

Recognition of Candida albicans by gingival fibroblasts: The role of TLR2, TLR4/CD14, and MyD88.

Recent evidence indicates that nonprofessional immune cells such as epithelial cells, endothelial cells, and fibroblasts also contribute to innate immunity via secretion of cytokines. Fibroblasts are the principal type of cell found in the periodontal connective tissues and they are involved in the immune response during periodontal disease. The role of fibroblasts in the recognition of pathogens via Toll-like receptors (TLRs) has been established; however, few studies have been conducted concerning the involvement of innate immune receptors in the recognition of Candida albicans by gingival fibroblast. In the current study, we investigate the functional activity of TLR2, cluster of differentiation 14 (CD14), and myeloid differentiation primary response gene 88 (MyD88) molecules in the recognition of C. albicans by gingival fibroblast. First, we identified that gingival fibroblasts expressed TLR2, TLR3, and TLR4. Our results showed that TLR agonists had no effect on these receptors' expression by TLR2, MyD88, and CD14-deficient cells. Notably, C. albicans and a synthetic triacylated lipoprotein (Pam3CSK4) induced a remarkable increase of TLR3 expression on MyD88-deficient gingival fibroblasts. TLR4 expression levels were lower than TLR2 and TLR3 levels and remained unchanged after TLR agonist stimulation. Gingival fibroblasts presented morphological similarities; however, TLR2 deficiency on these cells leads to a lower proliferative response, whereas the deficiency on CD14 expression resulted in lower levels of type I collagen by these cells. In addition, the recognition of C. albicans by gingival fibroblasts had an effect on the secretion of cytokines and it was dependent on a specific recognition molecule. Specifically, tumor necrosis factor-α (TNF-α) production after the recognition of C. albicans was dependent on MyD88, CD14, and TLR2 molecules, whereas the production of interleukin-1ß (IL-1ß) and IL-13 was dependent on TLR2. These findings are the first to describe a role of gingival fibroblast in the recognition of C. albicans and the pathways involved in this process. An understanding of these pathways may lead to alternative treatments for patients with periodontal disease.

CCR5-Dependent Homing of T Regulatory Cells to the Tumor Microenvironment Contributes to Skin Squamous Cell Carcinoma Development.

Squamous cell carcinoma (SCC) is one of the most common human cancers worldwide. Recent studies show that regulatory T cells (Treg) have a critical role in the modulation of an antitumor immune response, and consequently the SCC development. Because the accumulation of Tregs at the tumor site is, in part, due to selective recruitment through CCR5- and CCR5-associated chemokines, we investigated the role of CCR5 in the SCC development. Our findings showed that CCR5-deficient mice (CCR5KO) were efficient in controlling papilloma's incidence when compared with wild-type mice. Analysis of tumor lesions in wild-type (WT) and CCR5KO mice revealed that lack of CCR5 lead to significant reduction in frequency of Tregs and increased of CD4 T cells into the tumors. Moreover, the adoptive transfer of naturally occurring Tregs CD4+CD25+CCR5+, CD4+CD25-CCR5+ or CD8+CCR5+ conventional T cells to CCR5KO mice resulted in an increased papilloma incidence. Interestingly, adoptive transfer of WT CD4+CD25+CCR5+ cells to CCR5KO mice induced more undifferentiated SCC lesions, characterized by higher infiltration of macrophages and dendritic cells. In this study, we also demonstrated that Treg migration to the tumor microenvironment is mediated by CCR5, and these cells are promoting tumor growth via inhibition of antitumor cells such as cytotoxic CD8+ T cells. Our findings reinforce the therapeutic potential of CCR5 inhibition for cancer treatment, and indicate an attractive approach for SCC treatment. Mol Cancer Ther; 16(12); 2871-80. ©2017 AACR.

CCR5-dependent homing of T Regulatory Cells to the tumor microenvironment contributes of skin squamous cell carcinoma develpment

Squamous cell carcinoma (SCC) is one of the most common human cancers worldwide. Recent studies show that regulatory T cells (Treg) have a critical role in the modulation of an antitumor immune response, and consequently the SCC development. Because the accumulation of Tregs at the tumor site is, in part, due to selective recruitment through CCR5- and CCR5-associated chemokines, we investigated the role of CCR5 in the SCC development. Our findings showed that CCR5-deficient mice (CCR5KO) were efficient in controlling papilloma's incidence when compared with wild-type mice. Analysis of tumor lesions in wild-type (WT) and CCR5KO mice revealed that lack of CCR5 lead to significant reduction in frequency of Tregs and increased of CD4 T cells into the tumors. Moreover, the adoptive transfer of naturally occurring Tregs CD4+CD25+CCR5+, CD4+CD25-CCR5+ or CD8+CCR5+ conventional T cells to CCR5KO mice resulted in an increased papilloma incidence. Interestingly, adoptive transfer of WT CD4+CD25+CCR5+ cells to CCR5KO mice induced more undifferentiated SCC lesions, characterized by higher infiltration of macrophages and dendritic cells. In this study, we also demonstrated that Treg migration to the tumor microenvironment is mediated by CCR5, and these cells are promoting tumor growth via inhibition of antitumor cells such as cytotoxic CD8+ T cells. Our findings reinforce the therapeutic potential of CCR5 inhibition for cancer treatment, and indicate an attractive approach for SCC treatment.

Ventajas y desventajas de la técnica de cono único / Advantages and disadvantages of the single cone technique

El éxito del tratamiento endodóntico depende de una serie de factores, entre ellos, el de conseguir un buen sellado marginal apical, preparar los conductos radiculares con instrumentos rotatorios de níquel-titanio, obteniéndose preparados con diferentes conicidades de aquellas conseguidas a través de la instrumentación manual. El sellado tridimensional de los conductos radiculares es de fundamental importancia, pues; al ocupar el espacio creado por la instrumentación, la obturación, evita la infiltración del exudado periapical para el interior del conducto radicular. Como consecuencia, inviabiliza la sobrevivencia de microorganismos residuales, ofreciendo condiciones para que ocurra la reparación, contribuyendo de manera decisiva para el éxito de la terapéutica endodóntica. La técnica de cono único es una técnica que utiliza apenas un cono principal o maestro que puede tener diferentes conicidades, y que a lo largo de los años fue retomando su popularidad debido a la capacidad de adaptarse mejor a la conformación de los sistemas rotatorios de níquel-titanio (Ni-Ti) sin la necesidad de usar conos accesorios, reduciendo así el tiempo de trabajo, permitiendo una obturación másfácil y rápida, disminuyendo tanto la fatiga del paciente como la deloperador. En relación con la calidad de la obturación, la microfiltración apical y la penetración de bacterias, esta técnica es semejante a las otras técnicas existentes. La finalidad de este trabajo fue realizar una revisión de literatura abordando las ventajas y desventajas de la técnica de cono único para obturar los conductos radiculares. Llegando a la conclusión que la técnica de cono único presenta las ventajas de la posibilidad deun tratamiento endodóntico más rápido y con mayor comodidad para el paciente y el clínico.

The success of any endodontic treatment depends on a range of factors, including achieving good apical sealing, preparing the rootcanal using rotary nickel-titanium instruments in order to obtain mechanical preparations with tapers unlike those achieved using manual instrumentation. Three-dimensional sealing of the root canal is of theutmost importance, given that proper fi lling of the space created bythe instrumentation prevents the microleakage of periapical exudateinto the root canal. This in turn hampers the survival of residual and resistant microorganisms, thus contributing to the healing process andthe success of the endodontic therapy. The single-cone technique isone that uses a single principal or master cone with diff erent tapers.It has become popular among endodontists over the years due to itsgreater adaptability to the characteristics of nickel-titanium (NiTi)rotary systems without the need for accessory cones, which reducesworking time and allows easier and faster fi lling, causing less fatiguefor both the patient and the operator. However, in terms of qualityof the obturation, apical microleakage, and bacterial penetration,this technique provides similar results to those achieved using othertechniques. This review article is an attempt to highlight the advantages and disadvantages of using the single-cone technique to sealthe root canal, considering the qualities of the endodontic sealerused. The single-cone technique has the advantage of saving timeduring root canal fi lling and being more comfortable for the patientand the physician alike.

Actividad antimicrobiana y biocompatibilidad de los cementos endodónticos a base de hidróxido de calcio / Antimicrobial activity and biocompatibility of calcium hydroxide-based endodontic sealers

Uno de los objetivos de la endodoncia es la eliminación de los microorganismos de la endodoncia es la eliminación de los microorganismos y la prevención de la reinfección en el sistema de conductosradiculares. Una de las fases de la terapia endodóntica que permite laobtención de dichos objetivos es la obturación de los conductos radiculares;esto significa rellenarlos con un material inerte de la manera más hermética posible y un cemento que permita estimular el proceso de reparación apical y periapical. Los microorganismos pueden permanecer en el sistema de conductos radiculares inclusive después de los procesos de instrumentación e irrigación porque pueden presentar una anatomía compleja. En endodoncia, una de las propiedades deseadas en los cementos endodónticos es la acción antimicrobiana, para eliminar las bacterias resistentes. Los cementos a base de hidróxido de calcio son utilizados debido a su acción antimicrobiana y degradación deendotoxinas, entre otras propiedades. Estas premisas nos llevan a larealización de este trabajo, teniendo como objetivo evaluar la actividadantimicrobiana y la biocompatibilidad que presentan los cementos endodónticos a base de hidróxido de calcio a través de una revisión deliteratura. Después de la revisión podemos concluir que los cementosa base de hidróxido de calcio poseen biocompatibilidad y actividad antimicrobiana contra diversos tipos de microorganismos; sin embargo, pueden tener sus propiedades biológicas alteradas dependiendo de la etodología utilizada y del tiempo de aplicación.

One of the aims of endodontics is to eliminate microorganisms and prevent reinfection in the root-canal system. To achieve this, one of the procedures performed in endodontic therapy is the sealing of the root canals. This implies fi lling the root canal with as hermetic an inert material as possible and a sealer that encourages the process of apical and periapical repair. Microorganisms can remain in the root-canal system even after biomechanical preparation and irrigation, as they may have a complex anatomy. In endodontics, one of the desired properties of an endodontic sealer is antimicrobial activity to eliminate resistant bacteria. Calcium hydroxide-based sealers are used due to their antimicrobial activity and role in endotoxin degradation, among other properties. These were the premises that gave rise to this study, which aimed to evaluate the antimicrobial activity and biocompatibil-ity exhibited by a calcium hydroxide-based endodontic sealer based on a review of the literature. As a result of this review, we were able to conclude that while calcium hydroxide-based sealers do display biocompatibility and antimicrobial activity, their biological properties can vary depending on the method used and the time of application.

Radix entomolaris û um desafio no tratamento endodôntico û relato de caso / Radix entomolaris û a challenge in endodontic treatment û case report

Os indivíduos com fissura labiopalatina apresentam maior incidência de anomalias dentárias, levando a maior dificuldade na reabilitação dos mesmos. No seguinte relato de caso, descreve-se o sucesso da terapia endodôntica frente a um caso de radix entomolaris (raiz supranumerária) em um molar inferior; a intervenção endodôntica foi realizada num indivíduo do gênero feminino, 23 anos de idade, leucoderma, com fissura pós-forame incisivo incompleta, matriculada no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP). O planejamento do caso foi o tratamento endodôntico radical, visto que o diagnóstico era de pulpite irreversível. Na análise radiográfica foi constatada a presença de uma raiz supranumerária. Realizou-se abertura coronária, e posteriormente foi localizado um canal excêntrico do lado lingual, confirmando a suspeita da imagem radiográfica inicial (radix entomolaris). Os canais radiculares foram instrumentados utilizando o sistema rotatório Hyflex CM, associado à irrigação passiva com ultrassom e hipoclorito de sódio concentrado a 1%. Todos os canais foram obturados com cones de guta-percha #40 com conicidade 0.04 e cimento AH Plus, utilizando a técnica de cone único. Na radiografia de controle de 6 meses, o dente encontrava-se restaurado, sem rarefação periapical visível radiograficamente e assintomático, o que presume o sucesso do tratamento...

In individuals with cleft lip/palate there is an increased incidence of dental anomalies, which can hamper the management in oral rehabilitation of these patients. The following case report describes the success of an endodontic therapy in a case of radix entomolaris (supernumerary root) on a lower molar. Endodontic treatment was carried out in a twentythree-year-old woman, leucoderma, with incomplete post foramen cleft, registered in the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/ USP). The treatment plan was radical endodontic treatment, whereas the diagnosis was acute irreversible pulpitis. Based on the radiographic analysis, supernumerary root could be observed. Coronal opening was held, an eccentric canal on the lingual side was placed, confirming the initial radiographic image (radix entomolaris). The root canals were instrumented using the rotary system HyFlex CM, combined with a passive irrigation with ultrasound and 1% sodium hypochlorite. All root canals were filled with gutta-percha cones # 40 with taper 0.04 and sealer AH Plus, using the single cone technique. Six months later, the tooth was restored and through the control radiograph it could be observed healthy periapical tissue around the roots. The individual was also asymptomatic, assuming that the treatment was successful...

Um novo conceito na instrumentação de canais radiculares ­ sistema HyFlex® cm™ / A new concept in root canal instrumentation ­ HyFlex® cm™ system

Para o sucesso do tratamento endodôntico é essencial a perfeita limpeza, conformação e desinfecção do canal radicular, obtendo-se uma forma cônica, respeitando a sua forma original, promovendo assim, condições necessárias para que o sistema de canais radiculares possa ser hermeticamente obturado. O preparo biomecânico sofreu grandes transformações nos últimos anos, sendo a instrumentação manual gradualmente substituída pelos sistemas mecanizados. Uma das principais inovações em Endodontia foi a introdução da liga de níquel-titânio (NiTi) para fabricação de instrumentos endodônticos, permitindo que os mesmos trabalhassem dentro dos canais radiculares. Apesar das apreciáveis propriedades mecânicas da liga de NiTi convencional, a separação dos instrumentos continua sendo uma preocupação. Entre os novos sistemas mecanizados de NiTi que visam amenizar esta problemática, vale destacar os que apresentam uma liga melhorada por processos térmicos. Dentre deles o sistema HyFlex® CM™ (ColténeEndo/Whaledent, Inc, Cuyahoga Falls, OH, EUA) torna-se uma excelente alternativa por sua alta resistência à fadiga cíclica e possibilidades de serem pré-curvados. Por tanto, o objetivo deste trabalho é apresentar o sistema HyFlex® CM™ através de um caso clínico (AU).

For the success of endodontic treatment, perfect cleaning, shaping and disinfection of the root canal are essential as well as getting a conical shape, similar to its original shape, enabling the conditions for hermetic sealing of the root canal system. The step that has undergone major changes in recent years was the biomechanical preparation with gradual mechanized systems to "substitute" the manual preparation. One of the main innovations in Endodontics was the introduction of nickel-titanium (NiTi) for manufacturing endodontic instruments. Despite the good mechanical properties of conventional NiTi alloy, fracture of the instruments remains a concern. Among the new mechanized systems of NiTi, treated by thermal processes which improved NiTi alloy, the HyFlex® CM™ system (ColténeEndo / Whaledent, Inc, Cuyahoga Falls, OH, USA) becomes an excellent alternative to endodontic therapy. Therefore, the objective of this study was to present a clinical case using mechanized instrumentation with HyFlex® CM™ system (AU).

Inflammasome activation is critical to the protective immune response during chemically induced squamous cell carcinoma.

Chronic inflammation affects most stages of tumorigenesis, including initiation, promotion, malignant differentiation, invasion and metastasis. Inflammasomes have been described as involved with persistent inflammation and are known to exert both pro and antitumour effects. We evaluated the influence of apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) and caspase (CASP)-1 in the antitumor immune response using a multistage model of squamous cell carcinoma (SCC) development. Absence of ASC and CASP-1 resulted in an earlier incidence and increased number of papilloma. Loss of inflammassome function in mice resulted in decreased presence of natural killer (NK), dendritic (DC), CD4(+), CD8(+) and CD45RB(+) T cells in the tumor lesions as well as in lymph nodes (LN) compared with WT mice. Increased percentage of CD4(+)CD25(+)Foxp3(+) T cells was associated with association with inflammasome loss of function. Moreover, significant differences were also found with neutrophils and macrophage infiltrating the lesions. Myeloperoxidase (MPO), but not elastase (ELA), activity oscillated among the groups during the SCC development. Levels of proinflammatory cytokines IL-1ß, IL-18, Tumor Necrosis Factor (TNF)-α and Interferon (IFN)-γ were decreased in the tumor microenvironment in the absence of inflammasome proteins. These observations suggest a link between inflammasome function and SCC tumorigenesis, indicating an important role for inflammasome activation in the control of SCC development.

Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans.

This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C. albicans). Human single-rooted teeth contaminated with C. albicans were treated with calcium hydroxide, 2% chlorhexidine gel, calcium hydroxide plus 2% chlorhexidine gel, or saline (0.9% sodium chloride) as a positive control. The samples obtained at depths of 0-100 and 100-200 µm from the root canal system were analyzed for C. albicans load by counting the number of colony forming units and for the percentage of viable C. albicans using fluorescence microscopy. First, the antimicrobial activity of calcium hydroxide and the 2% chlorhexidine gel was evaluated by counting the number of colony forming units. After 14 days of intracanal medication, there was a significant decrease in the number of C. albicans colony forming units at a depth of 0-100 µm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment. However, there were no differences in the number of colony forming units at the 100-200 µm depth for any of the medications investigated. C. albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis. Antifungal activity against C. albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only. Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C. albicans.

Reconhecimento de Candida albicans por fibroblastos murinos: envolvimento de receptores de reconhecimento de patógenos (TLR2 e CD14) e a proteína adaptadora MyD88 / The recognition of Candida albicans by fibroblasts: Toll like receptors pathogens (TLR2 and CD14) abt the MyD88 protein evaluation

Os tecidos pulpar e periodontal são frequentemente agredidos por fatores ambientais como calor, trauma mecânico e micro-organismos, sendo estes considerados o fator etiológico principal das periodontopatias e periapicopatias. Dentre as células residentes desses tecidos, especial atenção tem sido dada ao papel dos fibroblastos no desenvolvimento da resposta imune. Fibroblastos são células que respondem à estímulos microbianos e existem evidências do papel de receptores do tipo Toll (TLR) no reconhecimento desses estímulos. Dessa forma, o presente trabalho teve como objetivo principal avaliar o reconhecimento de Candida albicans por fibroblastos gengivais e pulpares. Para tal, fibroblastos isolados a partir de tecido gengival e pulpar de camundongos do grupo controle e deficientes de TLR2, CD14 e MyD88 foram avaliados quanto à expressão de TLRs e moléculas de superfície, resposta proliferativa e produção de citocinas (TGF-β, IL-1β, TNF-α, IL-13 e IL-6), após a estimulação com agonistas de TLR2, TLR4 e C. albicans. Fibroblastos gengivais e pulpares, apesar de provenientes de tecidos diferentes, apresentaram características morfológicas semelhantes. Contudo, a cinética de crescimento dos fibroblastos gengivais deficientes de MyD88 foi mais lenta, e fibroblastos pulpares demoraram mais tempo para surgir a partir dos fragmentos de tecido. A ausência de TLR2 e da molécula adaptadora MyD88 não afetaram a produção de colágeno Tipo I pelos fibroblastos gengivais. Entretanto, fibroblastos deficientes de CD14 apresentaram baixa produção de colágeno. Ademais, os fibroblastos gengivais expressaram TLR2, TLR3, TLR4, assim como as moléculas de adesão ICAM-1 e CD44. A ausência de TLR2 e CD14 interferiu na resposta proliferativa de fibroblastos gengivais e pulpares, respectivamente. O reconhecimento de C. albicans por fibroblastos gengivais e pulpares modulou a produção das citocinas. A produção de TNF-α foi...

Pulpal and periapical tissue are frequently injured by heat, mechanical trauma and microorganisms, which are considered the main etiological factor of periodontal and endodontic diseases. Among these tissue resident cells, special attention has been given to fibroblasts in the immune response. Fibroblasts are cells that recognize pathogens through Toll like receptors (TLR). The aim of this study was to evaluate the recognition of Candida albicans by pulpal and gingival fibroblasts from TLR2, CD14, MyD88 knockout mice and control group mice. The results were analyzed concerning the expression of TLR(s) and surface molecules, proliferative response and citokynes production (TGF-β, IL-1β, TNF-α, IL-13 e IL-6) after the cells stimulation with TLR2, TLR4 and C.albicans agonists. Gingival and Pulpal fibroblasts, even isolated from different tissue, showed morphological similarities; however, gingival fibroblast deficient of MyD88 show lower proliferative response and pulpa l fibroblasts needed more time to detach from tissue fragments. The production of Type I collagen was affected in gingival cells deficient of CD14. Gingival fibroblasts expressed TLR2, TLR3, TLR4, and the adhesion molecules (ICAM-1 and CD44). The absence of TLR2 and CD14 interfered with the proliferative response of pulpal and gingival fibroblasts, respectively. The recognition of C. albicans by gingival and pulpal fibroblasts modulated the citokynes production. TNF-α production after the recognition of C. albicans was dependent from MyD88, CD14 and TLR2 molecules, whereas the production of IL-1β and IL-13 was dependent of TLR2.

Inflammatory events during murine squamous cell carcinoma development.

BACKGROUND: Squamous cell carcinoma (SCC) is one of the most common human cancers worldwide. In SCC, tumour development is accompanied by an immune response that leads to massive tumour infiltration by inflammatory cells, and consequently, local and systemic production of cytokines, chemokines and other mediators. Studies in both humans and animal models indicate that imbalances in these inflammatory mediators are associated with cancer development. METHODS: We used a multistage model of SCC to examine the involvement of elastase (ELA), myeloperoxidase (MPO), nitric oxide (NO), cytokines (IL-6, IL-10, IL-13, IL-17, TGF-ß and TNF-α), and neutrophils and macrophages in tumour development. ELA and MPO activity and NO, IL-10, IL -17, TNF-α and TGF-ß levels were increased in the precancerous microenvironment. RESULTS: ELA and MPO activity and NO, IL-10, IL -17, TNF-α and TGF-ß levels were increased in the precancerous microenvironment. Significantly higher levels of IL-6 and lower levels of IL-10 were detected at 4 weeks following 7,12-Dimethylbenz(a)anthracene (DMBA) treatment. Similar levels of IL-13 were detected in the precancerous microenvironment compared with control tissue. We identified significant increases in the number of GR-1+ neutrophils and F4/80+/GR-1- infiltrating cells in tissues at 4 and 8 weeks following treatment and a higher percentage of tumour-associated macrophages (TAM) expressing both GR-1 and F4/80, an activated phenotype, at 16 weeks. We found a significant correlation between levels of IL-10, IL-17, ELA, and activated TAMs and the lesions. Additionally, neutrophil infiltrate was positively correlated with MPO and NO levels in the lesions. CONCLUSION: Our results indicate an imbalance of inflammatory mediators in precancerous SCC caused by neutrophils and macrophages and culminating in pro-tumour local tissue alterations.

Bacterial leakage evaluation of root canals filled with different endodontic sealers.

OBJECTIVE: The objective of this study was to evaluate the sealing ability of AH Plus, Epiphany, Acroseal, Endofill, and Polifil after active lateral condensation technique, by using a bacterial test, during 64 days. STUDY DESIGN: One hundred bovine incisors were cleaned and shaped; then they were filled with the endodontic sealers and adapted into a microcentrifuge tube. The setup root/microcentrifuge tube was added to glass flasks containing Brain Heart Infusion broth. A culture of Enterococcus faecalis was inserted into the upper chamber of each assembly. Daily leakage was evaluated through the broth turbidity. RESULTS: The results were submitted to statistical analysis (Kaplan-Meier method, Kruskal-Wallis and Dunn tests). CONCLUSIONS: AH Plus and Endofill had the worst sealing ability when compared with Polifil, which showed the least leakage. Acroseal and Epiphany showed a tendency toward having an intermediate behavior; however, there was no significant difference among Acroseal, Epiphany, and the other sealers.

In vitro antimicrobial activity of Acroseal, Polifil and Epiphany against Enterococcus faecalis.

Using the agar diffusion method, this study evaluated the in vitro antimicrobial activity of the commercial endodontic sealers Acroseal and Epiphany, a castor-oil based experimental sealer, Polifil, and a primer agent (Epiphany self-etching primer), against Enterococcus faecalis. Zinc oxide and eugenol cement (ZOE) served as control. Five wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the dishes at 37 degrees C for 24 h and 48 h, the diameter of the zones of microbial growth inhibition produced around the wells was measured (in mm) with a millimeter rule. After 48 h, the diameters of the zones of microbial growth inhibition were the same as those observed at 24 h, only the substances continued to diffuse. Epiphany and Polifil did not show antibacterial activity (no formation of zones of microbial growth inhibition). The primer produced the largest zones of inhibition (17.62 mm) followed by Acroseal (7.25 mm) and ZOE (7.12 mm). E. faecalis was resistant to Epiphany and Polifil, while the primer and Acroseal sealer were effective against this microorganism under the tested conditions.

In vitro antimicrobial activity of acroseal, polifil and epiphany against Enterococcus faecalis

Using the agar diffusion method, this study evaluated the in vitro antimicrobial activity of the commercial endodontic sealers Acroseal and Epiphany, a castor-oil based experimental sealer, Polifil, and a primer agent (Epiphany self-etching primer), against Enterococcus faecalis. Zinc oxide and eugenol cement (ZOE) served as control. Five wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the dishes at 37ºC for 24 h and 48 h, the diameter of the zones of microbial growth inhibition produced around the wells was measured (in mm) with a millimeter rule. After 48 h, the diameters of the zones of microbial growth inhibition were the same as those observed at 24 h, only the substances continued to diffuse. Epiphany and Polifil did not show antibacterial activity (no formation of zones of microbial growth inhibition). The primer produced the largest zones of inhibition (17.62 mm) followed by Acroseal (7.25 mm) and ZOE (7.12 mm). E. faecalis was resistant to Epiphany and Polifil, while the primer and Acroseal sealer were effective against this microorganism under the tested conditions.

Utilizando o método de difusão em ágar, este estudo avaliou in vitro a atividade antimicrobiana dos cimentos endodônticos comerciais: Acroseal e Epiphany, um cimento experimental à base do polímero da mamona, Polifil, e um agente primer (primer auto-adesivo do sistema Epiphany), contra Enterococcus faecalis. O cimento de óxido de zinco e eugenol (OZE) serviu como controle. Cinco poços por placa foram feitos em pontos eqüidistantes e imediatamente preenchidos com os materiais testados e controle. Após a incubação das placas aos 37ºC por 24 e 48 h foram medidas as zonas de inibição do crescimento bacteriano ao redor dos poços (em mm) com uma régua milimetrada. Após 48 h, os diâmetros das zonas de inibição do crescimento bacteriano foram os mesmos observados às 24 h, apenas as substâncias continuaram a se difundir. Epiphany e Polifil não apresentaram atividade antibacteriana (não ocorreu a formação das zonas de inibição do crescimento bacteriano). Os maiores halos de inibição foram atribuídos ao primer (17,62 mm), seguido do Acroseal (7,25 mm) e OZE (7,12 mm). E. faecalis foi resistente ao Epiphany e Polifil, enquanto que o primer e o cimento Acroseal foram eficientes contra esse microrganismo nas condições testadas.