Frederico C Martinho1, Cinthya C Gomes2, Gustavo G Nascimento3, Ana P M Gomes4, Fábio R M Leite3. 1. Department of Restorative Dentistry, Endodontic Division, São José dos Campos Dental School, State University of São Paulo - UNESP, Eng Francisco José Longo, 777, São José dos Campos, São Paulo, CEP 12245-000, Brazil. Frederico.martinho@fosjc.unesp.br. 2. Department of Restorative Dentistry, Endodontic Division, Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil. 3. Department of Semiology, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. 4. Department of Restorative Dentistry, Endodontic Division, São José dos Campos Dental School, State University of São Paulo - UNESP, Eng Francisco José Longo, 777, São José dos Campos, São Paulo, CEP 12245-000, Brazil.
Abstract
OBJECTIVE: This clinical study compared the effectiveness of 7- and 14-day intracanal medications in the reduction of bacteria/endotoxins from primarily infected root canals and determined their antigenicity against macrophages through the levels of cytokines. METHODS: Seventy-two primarily infected teeth were randomly divided into six groups according to medication and time of application: 7-day groups = G1, Ca(OH)2 + saline solution (SSL); G2, Ca(OH)2 + 2% chlorhexidine (CHX) gel; and G3, 2% CHX gel and 14-day groups = G4, Ca(OH)2 + SSL; G5, Ca(OH)2 + 2% CHX gel; and G6, 2% CHX gel (all groups, n = 12). Bacterial and endotoxin samples were collected from root canals and inflammatory cytokines of macrophages supernatants. Culture techniques were used to determine bacterial counts and limulus amebocyte lysate (LAL) assay to quantify endotoxins. IL-1β, TNF-α, and PGE2 were measured by ELISA-assay. RESULTS: With regard to the bacterial reduction, no differences were found between all protocols tested (p > 0.05). The CHX protocols (G3 and G6) exhibited the lowest effectiveness against endotoxins (p < 0.05). All protocols were effective in lowering the levels of IL-1β, TNF-α, and PGE2 (p < 0.05), with no difference between the medications tested on days 7 or 14 (p > 0.05). Particularly, the 7-day CHX-protocol (G3) exhibited the lowest effectiveness in lowering the levels of most cytokines compared to the 14-day protocols (G6) (p < 0.05). CONCLUSIONS: All the 7- and 14-day intracanal medications were effective in reducing bacteria and endotoxins as well as in lowering the levels of inflammatory cytokines, with CHX showing limited effectiveness against endotoxins. Moreover, 7-day CHX-protocol exhibited the lowest effectiveness in lowering the levels of most cytokines compared to the 14-day protocols. CLINICAL SIGNIFICANCE: Seven-day CHX protocol is the less effective protocol and should be carefully applied by the clinician.
OBJECTIVE: This clinical study compared the effectiveness of 7- and 14-day intracanal medications in the reduction of bacteria/endotoxins from primarily infected root canals and determined their antigenicity against macrophages through the levels of cytokines. METHODS: Seventy-two primarily infected teeth were randomly divided into six groups according to medication and time of application: 7-day groups = G1, Ca(OH)2 + saline solution (SSL); G2, Ca(OH)2 + 2% chlorhexidine (CHX) gel; and G3, 2% CHX gel and 14-day groups = G4, Ca(OH)2 + SSL; G5, Ca(OH)2 + 2% CHX gel; and G6, 2% CHX gel (all groups, n = 12). Bacterial and endotoxin samples were collected from root canals and inflammatory cytokines of macrophages supernatants. Culture techniques were used to determine bacterial counts and limulus amebocyte lysate (LAL) assay to quantify endotoxins. IL-1β, TNF-α, and PGE2 were measured by ELISA-assay. RESULTS: With regard to the bacterial reduction, no differences were found between all protocols tested (p > 0.05). The CHX protocols (G3 and G6) exhibited the lowest effectiveness against endotoxins (p < 0.05). All protocols were effective in lowering the levels of IL-1β, TNF-α, and PGE2 (p < 0.05), with no difference between the medications tested on days 7 or 14 (p > 0.05). Particularly, the 7-day CHX-protocol (G3) exhibited the lowest effectiveness in lowering the levels of most cytokines compared to the 14-day protocols (G6) (p < 0.05). CONCLUSIONS: All the 7- and 14-day intracanal medications were effective in reducing bacteria and endotoxins as well as in lowering the levels of inflammatory cytokines, with CHX showing limited effectiveness against endotoxins. Moreover, 7-day CHX-protocol exhibited the lowest effectiveness in lowering the levels of most cytokines compared to the 14-day protocols. CLINICAL SIGNIFICANCE: Seven-day CHX protocol is the less effective protocol and should be carefully applied by the clinician.
Authors: Adriana L Santos; José F Siqueira; Isabela N Rôças; Ederson C Jesus; Alexandre S Rosado; James M Tiedje Journal: PLoS One Date: 2011-11-21 Impact factor: 3.240
Authors: Frederico C Martinho; Bruna J M Corazza; Rayana D Khoury; Esteban I F Orozco; Cassia C Toia; Felipe P Machado; Marcia C Valera Journal: Clin Oral Investig Date: 2022-06-20 Impact factor: 3.573
Authors: Marlos Barbosa-Ribeiro; Rodrigo Arruda-Vasconcelos; Lidiane M Louzada; Danielle G Dos Santos; Fernando D Andreote; Brenda P F A Gomes Journal: Clin Oral Investig Date: 2020-08-28 Impact factor: 3.573
Authors: Marlos Barbosa-Ribeiro; Rodrigo Arruda-Vasconcelos; Adriana de-Jesus-Soares; Alexandre Augusto Zaia; Caio Cezar Randi Ferraz; José Flávio Affonso de Almeida; Brenda P F A Gomes Journal: Clin Oral Investig Date: 2018-10-26 Impact factor: 3.573
Authors: Gustavo G Nascimento; Diego G D Rabello; Bruna J M Corazza; Ana P M Gomes; Eduardo G Silva; Frederico C Martinho Journal: Sci Rep Date: 2021-01-13 Impact factor: 4.379
Authors: Flavia F C Teixeira; Flavia G R Cardoso; Nadia S Ferreira; Ana P M Gomes; Bruna J M Corazza; Marcia C Valera; Frederico C Martinho Journal: Clin Oral Investig Date: 2021-07-13 Impact factor: 3.573