Clinical Effectiveness of Root Canal Medication on Periapical Inflammatory Status

Objectives: Objectives: 1) To investigate the inflammatory profile of apical periodontitis disease by the levels of IL-1beta, IL-6, TNFalfa, correlating them with the presence of clinical and radiographic features; 2) To investigate the levels of MMP1, MMP9 and their complexes [MMP1/ TIMP1, MMP1/TIMP2, MMP9/TIMP1 e MMP9/TIMP2] in apical peridontitis disease, correlating them with the development of clinical and radiographic features; 3) To correlate the levels of IL-1beta, IL-6, TNF-alpha with their respectively antagonists receptors - IL1-RA, IL6-RA, s TNF-RI present in apical peridontitis. 4) To evaluate the effectiveness of different root canal medications in selected inflammatory biomarkers presente in apical periodontitis.
Methods: . Methods: Twenty primarily infected root canals showing apical periodontitis disease were selected. Chemomechanical preparation were performed with Mtwo Rotary NiTi files + NaOCl 2.5%. Afterwards, teeth were randonly devided into 2 groups according to the root canal medication tested: GI [Ca(OH)₂ + Saline Solution] and GII [Ca(OH)₂ + chlorhexidine gel 2%]. Samples were taken from periapical intersticial fluid by using sterile/ apyrogenic paper point at two different times: after chemomechaical preparation (S1) and after 14-days of root canal medication (S2). Inflammatory biomarkers were dosage by ELISA-assay.
Results: Results: All inflammatory biomarkers investigated were found in 100% of periapical inflammatory lesions. Higher levels of MMPs (MMP1 and MMP9) and cytokines (IL-1beta, IL-6, TNF-alpha) were correlated with larger apical periododontitis lesion (>7 mm) (p<0.05). Both Ca (OH)2 medications (G1 and G2) exhibited inflammatory activity against some inflammatory biomarkers present in apical peiodonititis disease (p<0.05) with no differences among them (p>0.05).
Conclusions: Conclusion: All Ca(OH)2 medications tested exhibited inflammatory potential against inflammatory biomarkers present in apical periodontitis disease with no differences among them.