Apical periodontitis(AP) develops as a result of the host's immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin(ALEO) an...Apical periodontitis(AP) develops as a result of the host's immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin(ALEO) and potentially to systemic metabolic alterations. Misdiagnosed ALEO is not infrequent due to the lack of diagnostic tools to differentiate apical lesions of different natures. Despite the conservative endodontic treatment shows a high success rate, there are refractory cases that can not be identified early enough during follow up. This evidences the need to develop complementary diagnostic tools, such as oral fluid biomarker analysis. Gingival crevicular fluid(GCF) is a serum transudate that becomes an exudate under inflammatory conditions, carrying molecules from local periodontal tissuesand general circulation than can be harvested noninvasively. We aimed to review the available literature analyzing GCF composition in AP patients to evaluate whether GCF has any potential for complementary diagnosis. To the date, only few studies addressing changes of GCF components in AP are available. Most studies support GCF modifications in specific components in APaffected teeth, suggesting that it might reflect periapical inflammation. GCF has potential for diagnostic tool, treatment follow-up and eventually to assess systemic comprise.展开更多
Although the role of cathepsin C (Cat C) in inflammation is gradually being elucidated, its function in periapical periodontitis, which is one of the most common infectious diseases worldwide, has not been studied. Th...Although the role of cathepsin C (Cat C) in inflammation is gradually being elucidated, its function in periapical periodontitis, which is one of the most common infectious diseases worldwide, has not been studied. This study evaluated a surgically-induced model of periapical periodontitis in cathepsin C (Cat C) knock-down (KD) mice, which was constructed with a tetracycline operator, to evaluate the role of Cat C in the pathogenesis and progression of periapical periodontitis. Our results showed, for the first time, that there was a statistically significant increase in the expression of Cat C as periapical periodontitis progressed;this increase started from 1 week after surgery and reached a peak at 3 weeks after surgery, before gradually decreasing. The volume of periapical bone resorption in Cat C KD mice was significantly smaller than that in wild-type mice at 3 and 4 weeks after surgery (P<0.05). Inflammatory cell infiltration into the apical tissues of wild-type mice was also significantly higher than that of Cat C KD mice. The expression of receptor activator of nuclear factor-j B ligand (RANKL) in wild-type mice was also higher than that in Cat C KD mice. The difference in the number of osteoclasts in the apical area between the two groups was statistically significant after 2 weeks. Correlation analysis showed that there was a significant correlation between Cat C and RANKL expression (r= 0.835). Therefore, our data indicated that Cat C promoted the apical inflammation and bone destruction in mice.展开更多
Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treat...Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).展开更多
目的:探讨iRoot BP plus与MTA根尖屏障术治疗年轻恒牙慢性根尖周炎的效果。方法:将122例年轻恒牙慢性根尖周炎患者随机分为试验组(n=61,患牙61颗)和对照组(n=61,患牙61颗),试验组行iRoot BP plus根尖屏障术,对照组行MTA根尖屏障术,比较...目的:探讨iRoot BP plus与MTA根尖屏障术治疗年轻恒牙慢性根尖周炎的效果。方法:将122例年轻恒牙慢性根尖周炎患者随机分为试验组(n=61,患牙61颗)和对照组(n=61,患牙61颗),试验组行iRoot BP plus根尖屏障术,对照组行MTA根尖屏障术,比较2组患者术后3、6、9、12个月的旧根尖周指数(old periapical index,O-PAI)、根尖透射区面积、疗效、治疗次数、炎症因子水平。采用SPSS 19.0软件包对数据进行统计学分析。结果:术后12个月,试验组和对照组的O-PAI评级为(1.48±0.36)、(1.71±0.42),根尖透射区面积为(0.51±0.14)、(1.09±0.31),2组O-PAI评级和根尖透射区面积相比差异显著(P<0.05)。术后3、6、12个月,2组患者的O-PAI评级逐渐降低(P<0.05),根尖透射区面积逐渐减少(P<0.05)。术后12个月,试验组和对照组的成功率为98.36%、88.52%,组间差异显著(P<0.05)。试验组和对照组患者的治疗次数为(3.64±0.58)、(4.72±0.61)次,组间差异显著(P<0.05)。术后3个月,试验组和对照组患者的血清hs-CRP水平为(6.89±1.13)、(7.25±1.40)mg/L,与治疗前相比差异显著(P<0.05);治疗3个月后,试验组和对照组患者的血清IL-6水平为(82.04±19.62)、(87.52±20.85)mg/L,与治疗前相比差异显著(P<0.05)。2组患者治疗前、后的血清IL-6、hs-CRP水平组间相比,差异无显著性(P>0.05)。结论:iRoot BP plus根尖屏障术治疗年轻恒牙慢性根尖周炎有助于降低O-PAI指数,减少术后就诊次数,术后成功率更高。展开更多
基金Supported by Project grants from Scientific and TechnologicInvestigation Resource(FONDECYT),Santiago,Chile,No.N°1090461 and 1120138
文摘Apical periodontitis(AP) develops as a result of the host's immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin(ALEO) and potentially to systemic metabolic alterations. Misdiagnosed ALEO is not infrequent due to the lack of diagnostic tools to differentiate apical lesions of different natures. Despite the conservative endodontic treatment shows a high success rate, there are refractory cases that can not be identified early enough during follow up. This evidences the need to develop complementary diagnostic tools, such as oral fluid biomarker analysis. Gingival crevicular fluid(GCF) is a serum transudate that becomes an exudate under inflammatory conditions, carrying molecules from local periodontal tissuesand general circulation than can be harvested noninvasively. We aimed to review the available literature analyzing GCF composition in AP patients to evaluate whether GCF has any potential for complementary diagnosis. To the date, only few studies addressing changes of GCF components in AP are available. Most studies support GCF modifications in specific components in APaffected teeth, suggesting that it might reflect periapical inflammation. GCF has potential for diagnostic tool, treatment follow-up and eventually to assess systemic comprise.
基金This work was supported by the Open Research Fund Program of State Key Laboratory of Oral Disease,Sichuan Univeristy,China(SKLOD2019OF06).
文摘Although the role of cathepsin C (Cat C) in inflammation is gradually being elucidated, its function in periapical periodontitis, which is one of the most common infectious diseases worldwide, has not been studied. This study evaluated a surgically-induced model of periapical periodontitis in cathepsin C (Cat C) knock-down (KD) mice, which was constructed with a tetracycline operator, to evaluate the role of Cat C in the pathogenesis and progression of periapical periodontitis. Our results showed, for the first time, that there was a statistically significant increase in the expression of Cat C as periapical periodontitis progressed;this increase started from 1 week after surgery and reached a peak at 3 weeks after surgery, before gradually decreasing. The volume of periapical bone resorption in Cat C KD mice was significantly smaller than that in wild-type mice at 3 and 4 weeks after surgery (P<0.05). Inflammatory cell infiltration into the apical tissues of wild-type mice was also significantly higher than that of Cat C KD mice. The expression of receptor activator of nuclear factor-j B ligand (RANKL) in wild-type mice was also higher than that in Cat C KD mice. The difference in the number of osteoclasts in the apical area between the two groups was statistically significant after 2 weeks. Correlation analysis showed that there was a significant correlation between Cat C and RANKL expression (r= 0.835). Therefore, our data indicated that Cat C promoted the apical inflammation and bone destruction in mice.
文摘Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).
文摘目的:探讨iRoot BP plus与MTA根尖屏障术治疗年轻恒牙慢性根尖周炎的效果。方法:将122例年轻恒牙慢性根尖周炎患者随机分为试验组(n=61,患牙61颗)和对照组(n=61,患牙61颗),试验组行iRoot BP plus根尖屏障术,对照组行MTA根尖屏障术,比较2组患者术后3、6、9、12个月的旧根尖周指数(old periapical index,O-PAI)、根尖透射区面积、疗效、治疗次数、炎症因子水平。采用SPSS 19.0软件包对数据进行统计学分析。结果:术后12个月,试验组和对照组的O-PAI评级为(1.48±0.36)、(1.71±0.42),根尖透射区面积为(0.51±0.14)、(1.09±0.31),2组O-PAI评级和根尖透射区面积相比差异显著(P<0.05)。术后3、6、12个月,2组患者的O-PAI评级逐渐降低(P<0.05),根尖透射区面积逐渐减少(P<0.05)。术后12个月,试验组和对照组的成功率为98.36%、88.52%,组间差异显著(P<0.05)。试验组和对照组患者的治疗次数为(3.64±0.58)、(4.72±0.61)次,组间差异显著(P<0.05)。术后3个月,试验组和对照组患者的血清hs-CRP水平为(6.89±1.13)、(7.25±1.40)mg/L,与治疗前相比差异显著(P<0.05);治疗3个月后,试验组和对照组患者的血清IL-6水平为(82.04±19.62)、(87.52±20.85)mg/L,与治疗前相比差异显著(P<0.05)。2组患者治疗前、后的血清IL-6、hs-CRP水平组间相比,差异无显著性(P>0.05)。结论:iRoot BP plus根尖屏障术治疗年轻恒牙慢性根尖周炎有助于降低O-PAI指数,减少术后就诊次数,术后成功率更高。
文摘粪肠球菌是难治性根尖周炎(refractory apical periodontitis,RAP)的主要致病菌,该细菌可耐受严苛环境,引发根尖周免疫炎症反应,造成根管内外持续性感染。粪肠球菌黏附于根管牙本质壁形成生物膜,其耐药和抗冲刷能力显著增强,是介导其致病的关键因素。粪肠球菌与牙本质的黏附包括非特异性和特异性黏附,后者由黏附相关毒力因子介导,主要包括肠球菌胶原结合蛋白(adhesin of collagen from enterococci,Ace)、表面蛋白(extracellular surface protein,Esp)、明胶酶(gelatinase,GelE)和丝氨酸蛋白酶(serine prtease,SprE)、菌毛以及聚集物质,且受到多个双组份系统调控。Fsr双组份系统在群体密度增加时可以促进gelE及sprE的表达,GelE进一步减少表面肠球菌胶原结合蛋白Ace,而GrvRS双组份系统则在响应血清环境时直接下调ace的表达。CroRS双组份系统及WalRK双组份系统也可能分别促进和抑制包括ace及gelE在内的多种毒力因子的表达,进而影响粪肠球菌的黏附性。此外,根管机械/化学预备、根管内环境因素等均可对粪肠球菌牙本质黏附产生影响。根管治疗中避免粪肠球菌的引入和使用干扰黏附的药物可以有效预防粪肠球菌的黏附,而多种活化荡洗方法也可以有效增加根管内粪肠球菌的清除率。针对粪肠球菌牙本质黏附关键因子与调控因素为靶点设计合理药物,有望为根管感染控制提供新的思路与手段。本文就粪肠球菌与牙本质的黏附性及其影响因素进行综述。
