Artigo
Clinical Influence of Different Intracanal Medications on Th1-type and Th2-type Cytokine Responses in Apical Periodontitis
Registro en:
Journal Of Endodontics. New York: Elsevier Science Inc, v. 41, n. 2, p. 169-175, 2015.
0099-2399
10.1016/j.joen.2014.09.028
WOS:000349424300006
4363297368746273
Autor
Martinho, Frederico Canato [UNESP]
Nascimento, Gustavo G.
Leite, Fabio R. M.
Gomes, Ana P. M. [UNESP]
Freitas, Lilian F.
Camoes, Izabel C. G.
Resumen
Introduction: This clinical study assessed the influence of different intracanal medications on Th1-type and Th2-type cytokine responses in apical periodontitis and monitored the levels of bacteria from primarily infection during endodontic procedures. Methods: Thirty primarily infected teeth were randomly divided into 3 groups according to the medication selected: chlorhexidine (CHX), 2% CHX gel; Ca(OH)2/SSL, Ca(OH)2 + SSL; and Ca(OH)2/CHX, Ca(OH)2 + 2% CHX gel (all, n = 10). Bacterial sample was collected from root canals, and the interstitial fluid was sampled from lesions. Culture techniques were used to determine bacterial counts (colony-forming units/mL). Th1 (tumor necrosis factor-a, interferon-gamma, and interleukin [IL]-2) and Th2 cytokines (IL-4, IL-5, and IL-13) were measured by enzyme-linked immunosorbent assay. Results: All intracanal medication protocols were effective in reducing the bacterial load from root canals (all P < .05) and lowering the levels of Th1-type cytokines in apical lesions (all P < .05), with no differences between them (P > .05). Both Ca(OH)2 treatment protocols significantly increased the levels of Th2-type cytokines (P < .05), with no differences between them (P > .05). Thus, chlorhexidine medication showed the lowest effectiveness in increasing the levels of Th2-type cytokine. After treatment, regardless of the type of medication, the linear regression analysis indicated the down-regulation of Th2-type cytokines by Th1-type cytokines. Conclusions: All intracanal medication protocols were effective in reducing bacterial load and lowering the levels of Th1-type cytokines. Thus, the use of Ca(OH)2 medications contributed to the increase in the Th2-type cytokine response in apical periodontitis. Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) UNESP UNIV Estadual Paulista, Endodont Div, Dept Restorat Dent, Sao Paulo, Brazil State Univ Campinas UNICAMP, Endodont Div, Dept Restorat Dent, Piracicaba Dent Sch, Sao Paulo, Brazil Univ Fed Pelotas, Sch Dent, Dept Semiol &Clin, Periodont Div, Pelotas, RS, Brazil Fluminense Fed Univ UFF, Dept Restorat Dent, Endodont Div, Niteroi, RJ, Brazil UNESP UNIV Estadual Paulista, Endodont Div, Dept Restorat Dent, Sao Paulo, Brazil FAPESP: 2012/19536-5 FAPESP: 2013/04354-1 CNPq: 23038009469/2012-24