Comparison of digital and conventional radiographic techniques

This study aimed to evaluate the correlation between conventional and digital radiographic methods in the measurement of periapical lesions in primary molars and compares the time used to obtain the radiographic images betweenboth methods. Material and methods: This crossover study included children between 4 to 8-year-old with periapical lesion in primary mandibular molars. Fifteen molars were randomly assigned firstly to receive conventional or digital periapical radiograph during the steps of endodontic treatment. The time to obtain the radiographic image was evaluated in seconds and compared by the Mann-Whitney test. The periapical lesions measurement (mm2) were performed by the Image J software and the degree of correlation of measurement between both techniques was evaluated by the Spearman correlation test. Data was analyzed using the GraphPad Prism software (α = 0.05). Results: A strong positive correlation between the measurement of lesions occurred on conventional methods in comparison with the measurement on digital methods (r2=0.778; p<0.0006); however, the time to obtain the radiographic images was shorter in the digital method (p<0.0001). Conclusion: The digital method had a shorter amount of time to obtain the images and strong correlation for the lesions measurement in comparison to the conventional method. Therefore, the digital radiograph method is preferable for use in children

Immunohistochemical and mRNA expression of RANK, RANKL, OPG, TLR2 and MyD88 during apical periodontitis progression in mice

Objective: To evaluate and correlate, in the same research, the mRNA expression and the staining of RANK, RANKL, OPG, TLR2 and MyD88 by immunohistochemistry in the apical periodontitis (AP) progression in mice. Material and Methods: AP was induced in the lower first molars of thirty-five C57BL/6 mice. They were assigned to four groups according to their euthanasia periods (G0, G7, G21 and G42). The jaws were removed and subjected to histotechnical processing, immunohistochemistry and real-time reverse transcription-PCR (qRT-PCR). Data were analyzed with parametric and nonparametric tests (α=0.05). Results: An increase of positive immunoreactivity for RANK, RANKL, OPG, TLR2 and MyD88 was observed over time (p&lt;0.05). The RANKL expression was different between the groups G0 and G42, G21 and G42 (p=0.006), with G42 presenting the higher expression in both comparations. The OPG expression was statistically different between the groups G0 and G7, G7 and G21 and G7 and G42 (p&lt;0.001), with G7 presenting higher expression in all the time points. The TLR2 expression was different between the groups G0 and G42 (p=0.03), with G42 showing the higher expression. The MyD88 expression presented a statistical significant difference between groups G7, G21 and G42 compared with G0 (p=0.01), with G0 presenting the smallest expression in all the comparisons. The Tnfrsf11/Tnfrsf11b (RANKL/OPG) ratio increased with the AP progression (p=0.002). A moderate positive correlation between MyD88 and RANKL (r=0.42; p=0.03) and between MyD88 and TLR2 (r=0.48; p&lt;0.0001) was observed. Conclusion:The expression of the RANK, RANKL, OPG, MyD88 and TLR2 proteins as well as the ratio Tnfrsf11/Tnfrsf11b (RANKL/OPG) increased with AP progression. There was also a moderate positive correlation between the expression Myd88-Tnfrsf11 and Tlr2-Myd88, suggesting the relevance of Tlr2-Myd88 in bone loss due to bacterial infection

Systemic administration of rosiglitazone stimulates apoptosis of osteocytes and cementocytes, interfering in the development of induced periapical lesions in mice

O tecido ósseo é um tipo especializado de tecido conjuntivo que desempenha funções essenciais para a sobrevivência do indivíduo, sendo composto predominantemente por osteócitos. Dentre os tecidos mineralizados do corpo, o cemento é um dos menos estudados e compreendidos. A apoptose em células do tecido ósseo têm sido relatada após o uso de Tiazolidinedionas (TZD), uma classe de medicamentos utilizada no tratamento do diabetes melitus tipo 2, representadas pela Rosiglitazona. Assim, os objetivos desse estudo foram: avaliar, in vivo, um protocolo de administração sistêmica da Rosiglitazona em camundongos a fim de estimular a apoptose de osteócitos em maxilares; o efeito da apoptose de osteócitos induzida por Rosiglitazona na formação e progressão de lesões periapicais em camundongos nos períodos experimentais de 7, 21 e 42 dias; e demonstrar a ocorrência de apoptose em cementócitos de camundongos os quais receberam ou não a Rosiglitazona. Foram utilizados camundongos wild type (C57BL/6) com 4 a 5 semanas de idade. No primeiro estudo, a etapa 1 foi realizada para definição de protocolo de administração sistêmica da Rosiglitazona para indução de apoptose em maxilares de camundongos. Os animais (n=24) receberam a Rosiglitazona via oral por 1, 2 ou 3 semanas (gavagem, dose de 10mg/kg) ou não (PBS+10%DMSO). Foram utilizadas as técnicas de TUNEL e DAPI para quantificação de células apoptóticas. Posteriormente, na etapa 2, lesões periapicais foram induzidas nos primeiros molares inferiores de camundongos wild type (C57BL/6) (n=60) após a administração ou não da Rosiglitasona. A câmara pulpar dos dentes foi exposta à microbiota da cavidade bucal pelos períodos de 7, 21 e 42 dias e os grupos foram divididos da seguinte forma: G1) veículo + lesão 7 dias; G2) veículo + lesão 21 dias; G3) veículo + lesão 42 dias; G4) TZD + lesão 7 dias; G5) TZD + lesão 21 dias; G6) TZD + lesão 42 dias. Foram realizadas avaliações em microscopia convencional para análise descritiva das lesões periapicais; microscopia de fluorescência para mensuração das lesões periapicais; histoenzimologia para a atividade da fosfatase ácida resistente ao tartarato (TRAP) e marcação de osteoclastos; absortometria radiológica de dupla energia (DXA) para avaliação da densidade mineral óssea (DMO) em osso longo e análise da expressão gênica de marcadores de osteócitos (Sost, Hyou1 e Dmp1). No segundo estudo, foram utilizadas as técnicas de TUNEL e DAPI para quantificação de cementócitos apoptóticos em dentes de camundongos wild type (n=12) que receberam ou não a Rosiglitazona. Na etapa 1 do primeiro estudo, pôde-se observar que a administração sistêmica da Rosiglitazona por 2 semanas promoveu a apoptose de osteócitos de forma mais expressiva quando comparada ao período de 1 semana, porém sem diferença significativa com o período de 3 semanas (p>0,05). Já na etapa 2, nos grupos os quais receberam a Rosiglitazona, pôde-se observar uma tendência a lesões periapicais maiores, porém sem diferença estatisticamente significante em comparação com animais que não receberam esse medicamento (p>0,05), além de promover, aos 21 dias de progressão da lesão periapical, maior número de osteoclastos e maior expressão dos genes Sost e Hyou1, sem diferença estatisticamente significante para a expressão do gene Dmp1, bem como na DMO dos fêmures. Adicionalmente, no segundo estudo, foi observado que, em camundongos que receberam a Rosiglitazona por 2 semanas, os cortes histológicos corados em TUNEL e DAPI demonstraram maior razão de cementócitos apoptóticos/cementócitos totais comparado ao grupo controle. Após as metodologias empregadas e os parâmetros analisados, pôde-se concluir que o uso sistêmico da Rosiglitazona estimulou a apoptose de osteócitos e cementócitos interferindo na formação e progressão de lesões periapicais em camundongos.The bone tissue is a specialized type of connective tissue that provides essential functions for the survival of the individual, composed predominantly of osteocytes. Among the mineralized tissues in the body, the cementum is one of the most poorly studied and understood. Apoptosis in the bone tissue have been reported after the use of Thiazolidinediones (TZD), a class of drugs used in the treatment of diabetes mellitus type 2, represented by Rosiglitazone. Thus, the aims of this study were: evaluate, in vivo, a protocol for systemic administration of Rosiglitazone in mice in order to stimulate the apoptosis of osteocytes in jaws; the effect of apoptosis of osteocytes induced by Rosiglitazone in the formation and progression of periapical lesions in mice in the experimental periods of 7, 21 and 42 days; and demonstrate the occurrence of apoptosis in cementocytes of mice which received or not the Rosiglitazone. We used mice wild type (C57BL/6) with 4 to 5 weeks of age. In the first study, the phase 1 was performed for the protocol definition of systemic administration of Rosiglitazone for induction of apoptosis in mice jaws. The animals (n=24) received the Rosiglitazone orally for 1, 2 or 3 weeks (gavage, dose of 10mg/kg) or not (PBS+10%DMSO). We used the techniques of TUNEL and DAPI for quantification of apoptotic cells. Subsequently, in phase 2, periapical lesions were induced in the first lower molars of wild type (C57BL/6) mice (n=60) after the administration or not of Rosiglitasone. The pulp chamber was exposed to the oral microbiota during 7, 21 and 42 days, and the groups were divided as follows: G1) vehicle + periapical lesions 7 days; G2) vehicle + periapical lesions 21 days; (G3) vehicle + periapical lesions 42 days; (G4) TZD + periapical lesions 7 days; G5) TZD + periapical lesions 21 days; (G6) TZD + periapical lesions 42 days. Evaluations were conducted in conventional microscopy for descriptive analysis of periapical lesions; fluorescence microscopy for measurement of periapical lesions; histoenzimology to the activity of acid phosphatase resistant tartrate (TRAP) for osteoclasts measurement; dual-energy x-ray absorptiometry (DXA) for evaluation of bone mineral density (BMD) in long bone and analysis of gene expression of osteocytes markers (Sost, Hyou1 and Dmp1). In the second study, TUNEL and DAPI techniques were used for the quantification of apoptotic cementocytes in wild type (n = 12) mice that received Rosiglitazone or not. In the phase 1 of the first study it was observed that the systemic administration of Rosiglitazone for 2 weeks showed the apoptosis of osteocytes in a more expressive manner when compared to the period of 1 week with no significant difference with the period of 3 weeks (p>0,05). On phase 2, in the groups which received the Rosiglitazone, it was observed a tendency of larger periapical lesions, but without statistically significant difference compared with animals that did not receive this drug (p>0,05), besides promoting, at 21 days of periapical lesion progression, greater number of osteoclasts and greater expression of genes Sost and Hyou1, and absence of statistically significant differences in the expression of the gene Dmp1 nor in the BMD of the femurs. In addition, in the second study, it was observed that, in mice that received the Rosiglitazone for 2 weeks, sections stained by TUNEL and DAPI showed significantly higher ratio of apoptotic cementocytes/total cementocytes compared to control group. After the methodologies used and the parameters analyzed, it can be concluded that the systemic use of Rosiglitazone stimulated the apoptosis of osteocytes and cementocytes interfering in the formation and progression of periapical lesions in mice

Absence of IL-22 interferes with the oral microbiota and the progression of induced periapical lesions in mice teeth

Introdução: O objetivo deste trabalho foi caracterizar a composição da microbiota bucal e a formação e progressão de lesões periapicais induzidas experimentalmente em dentes de camundongos knockout para IL-22 (IL-22 KO) comparados com animais wild-type (WT). Material e Métodos: Inicialmente, foi realizada a avaliação do perfil microbiano da cavidade bucal dos animais (40 espécies de micro-organismos), no dia das exposições pulpares, por meio de técnica de biologia molecular (Checkerboard DNA-DNA hybridization). Em seguida, lesões periapicais foram induzidas nos primeiros molares inferiores dos camundongos e, decorridos os períodos de 7, 21 e 42 dias, os animais foram submetidos à eutanásia em câmara de CO2. As mandíbulas foram então removidas e submetidas ao processamento histotécnico. A seguir, cortes representativos de cada dente foram corados com hematoxilina e eosina (HE), para descrição do tecido pulpar e das regiões apical e periapical, em microscopia óptica convencional e mensuração da área das lesões periapicais em microscopia de fluorescência. Além disso, cortes sequenciais foram avaliados por meio de: histoenzimologia para a marcação de osteoclastos (TRAP), coloração de Brown & Brenn (para identificação de bactérias) e imunohistoquímica (para identificação de RANK, RANKL e OPG). Os escores da quantidade de células bacterianas, para cada uma das 40 espécies avaliadas, foram submetidos à analise estatística empregando o teste não-paramétrico de Mann-Whitney para amostras independentes, para comparação entre os grupos. Os resultados numéricos obtidos na análise morfométrica da área das lesões periapicais e do número de osteoclastos foram submetidos à análise estatística \"one-way\" ANOVA e pós-teste de Bonferroni. Para todas as análises foi adotado o nível de significância de 5%. Resultados: Em relação ao perfil microbiano encontrado na cavidade bucal dos animais, foi possível observar diferença estatisticamente siginificante entre os dois grupos de animais para 6 espécies bacterianas (p<0,05), sendo 5 dessas espécies mais encontradas nos animais WT e apenas 1 encontrada em maior quantidade nos animais IL-22 KO. Já em relação à análise microscópica, o grupo dos animais WT mostrou diferença estatisticamente significante entre 7 e 42 dias e entre 21 e 42 dias, com aumento progressivo no tamanho das lesões e no número de osteoclastos (p<0,05). No grupo dos animais IL-22 KO, houve um aumento do tamanho da lesão e do número de osteoclastos entre 7 e 21 dias, seguido de diminuição desses parâmetros entre 21 e 42 dias, com diferença significante (p<0,05) entre 7 e 21 dias. Além disso, na comparação entre os dois tipos de animais, foram encontradas diferenças significantes (p<0,05) em relação ao tamanho das lesões periapicais e ao número de osteoclastos aos 42 dias, sem diferenças em relação à localização de bactérias e imunohistoquímica. Conclusões: Esse estudo demonstrou diferenças na composição da microbiota bucal dos animais WT e IL-22 KO, o que pode ter influenciado na formação das lesões periapicais. Além disso, a ausência da IL-22 em camundongos interferiu na progressão das lesões periapicais, assim como no número de osteoclastos, sugerindo a participação da IL-22 na resposta imune e inflamatória do hospedeiro à infecção dos canais radiculares.Introduction: The aim of this study was to evaluate the participation of the IL-22 on the formation and progression of experimentally induced periapical lesions in teeth of IL-22 knockout (IL-22 KO) compared to wild-type (WT) mice. Methods: Initially, it was performed the evaluation of the microbial profile present in the oral cavity of animals (40 bacterial species), on the day of pulpal exposures, by means of molecular biology technique (checkerboard DNA-DNA hybridization). Then, the periapical lesions were induced in the inferior first molars of the mice and, after the periods of 7, 21 and 42 days, the animals were euthanized in a CO2 chamber. The jaws were removed and subjected to histotechnical processing. The following sections were representative stained with hematoxylin and eosin (HE) for description of the pulp tissue, apical and periapical regions in conventional optical microscopy and measurement of the area of periapical lesions in fluorescence microscopy. Moreover, sequential specimens were evaluated through: histoenzimology for osteoclasts (TRAP) Brown & Brenn staining (for bacteria identification) and immunohistochemistry (for RANK, RANKL and OPG identification). The scores of the amount of bacterial cells, for each one of the 40 species assessed, were subjected to statistical analysis using the nonparametric Mann-Whitney test for independent samples for comparison between groups. The numerical results of the morphometric analysis of the area of the periapical lesions and the number of osteoclasts were subjected to statistical analysis one-way ANOVA and Bonferroni\'s post-test. For all the statistical analysis the significance level of 5% was adopted. Results: Regarding the microbial profile found in the oral cavity of the animals, it was observed statistically siginificant differences between the two groups of animals for 6 bacterial species (p<0.05), with 5 species showing higher levels in the WT group and only 1 specie found in higher levels in the IL-22 KO animals. Concerning the microscopical analysis, the group of WT mice showed a statistically significant difference between 7 and 42 days and between 21 and 42 days, with a gradual increase in the size of periapical lesions and number of osteoclasts (p<0.05). In the group of IL-22 KO animals, an increase in lesion size and number of osteoclasts between 7 and 21 days was observed, followed by a decrease of these parameters between 21 and 42 days, with significant differences between 7 and 21 days (p <0.05). Moreover, when comparing the two types of animals, significant differences were found (p <0.05) about to the size of periapical lesions and number of osteoclasts at 42 days, without differences in localization of bacteria and immunohistochemistry. Conclusions: This study showed differences in the composition of the oral microbiota of the two types of animals that may have influenced the progression of periapical lesions. Moreover, the absence of IL-22 in mice interfered with the progression of periapical lesions, as well as in the number of osteoclasts, suggesting the involvement of this cytokine in host\'s immune and inflammatory response to the infection of root canals

Clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome

The purpose of this study was to report the clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. The patient had alopecia, delayed speech, low weight and height, cholestasis, and iron deficiency anemia. Furthermore, there were carious lesions and darkened spots on all primary molars. Microdontia of a premolar was observed at the radiographic examination. The patient and family had no commitment to her oral health and dental treatment at first appointments. Oral hygiene instructions, composite restorations, endodontic treatments, teeth extractions, and stainless steel crown installations were performed. The patient was followed up for 7 years through the present due to other possible future clinical findings associated with the syndrome. An improvement in social aspects was observed after removal of toothache and improved esthetics. Such patients need continuous periodic services, which contributes to improving the quality of life in both buccal and general aspects