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O tratamento endodôntico modifica os níveis séricos de marcadores inflamatórios de risco cardiovascular em indivíduos com periodontite apical assintomática? uma revisão sistemática e meta-análise

2026-09-12T04:45:27Z

Título: O tratamento endodôntico modifica os níveis séricos de marcadores inflamatórios de risco cardiovascular em indivíduos com periodontite apical assintomática? uma revisão sistemática e meta-análise Autor: ARAÚJO, Randerson Silva Primeiro orientador: SOUZA, Soraia de Fátima Carvalho Abstract: Introduction: Cardiovascular diseases, the leading global cause of death, are associated with asymptomatic apical periodontitis, which plays a contributing role in the onset of chronic low grade systemic inflammation, potentially impacting the overall health of the individual. Chronic low-grade systemic inflammation involves increased blood levels of inflammatory markers, which play a role in the origin and development of cardiovascular alterations, becoming useful in predicting cardiovascular risk. However, there is no consensus on whether these markers—such as inflammatory cytokines [Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-6 (IL-6)], cell adhesion molecules [Intercellular Adhesion Molecule-1 (ICAM-1) and Vascular Cell Adhesion Molecule-1 (VCAM-1)], and C-reactive protein (CRP)—are reduced with endodontic treatment. This study aimed to summarize the available evidence on the effect of endodontic treatment on serum levels of inflammatory markers associated with cardiovascular risk. Methods. This systematic review and meta-analysis followed PRISMA guidelines and were registered in PROSPERO under the number CRD42023391374. Observational studies including cohorts and case-controls, as well as experimental studies including controlled clinical trials and before-and after, with asymptomatic apical periodontitis patients, were included, without restrictions on age, race, gender, or socioeconomic status. Excluded were cross-sectional studies, case reports, expert opinions, technical reports, editorials, reviews, studies not measuring inflammatory markers in serum before and after endodontic treatment, studies involving acute endodontic conditions, and patients with comorbidities or without control of behavioral risk factor exposures. A systematic search was conducted in PubMed/Medline, Embase, Web of Science, Scopus, BVS (Medline, IBECS, BBO, LILACS), and grey literature sources, with no language or publication date restrictions, in October and November 2022. After removing duplicates, two independent reviewers assessed titles and abstracts. Eligible studies were read in full. Data extraction was performed by two independent reviewers, as well as risk assessment using the Newcastle-Ottawa Scale (NOS) adapted for intervention studies. Additionally, the quality of evidence and strength of recommendation was assessed using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation). Discrepancies were resolved by consensus or third party adjudication. Random-effects meta-analyses with DerSimonian and Laird estimator were conducted to estimate pooled mean differences (MD) and 95% confidence intervals (CI) of inflammatory marker concentrations between groups undergoing endodontic treatment and controls. Subgroup analyses were conducted to investigate differences in estimates between studies with and without their control group, using an external control group. Heterogeneity among studies was assessed using Cochran's Q test and I2. Due to the limited number of studies, publication bias analyses were not feasible. All analyses were performed using Stata version 14.0, considering alpha=5%. Results: A total of 2,101 publications were identified. After removing duplicates and evaluating titles and abstracts, 12 studies were eligible. After full-text reading, five studies evaluating serum levels of inflammatory markers before and after endodontic treatment, compared to healthy controls, were included in the systematic review and meta-analysis. Various inflammatory markers were analyzed, including CRP, IL-6, TNF-α, VCAM-1, and ICAM-1. Based on NOS, all studies showed a moderate risk of bias. The evidence level, according to GRADE, was considered very low for all evaluated outcomes. Meta-analysis results indicated that endodontic treatment possibly reduced serum levels of CRP [MD=0.50 (95% CI: -0.64, 1.65)] and VCAM-1 [MD=0.03 (95% CI: -0.15, 0.21)] to values similar to controls, but did not affect IL-6 [MD=6.26 (95% CI: 4.26, 7.87)], TNF-α [MD=7.26 (95% CI: 3.61, 10.91)], and ICAM-1 [MD= 44102.04 (95% CI: -122551.39, 34347.32)]. Heterogeneity among studies was observed in most meta-analyses (I2>50% and P<0.10), even in subgroup analyses. Conclusion: Available evidence suggests the possibility that endodontic treatment may reduce serum levels of CRP and VCAM 1. However, with few studies, a risk of bias, and a very low evidence level, confidence in the effect estimate is limited, indicating a significant degree of uncertainty in these findings. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

INFLUÊNCIA DO MEIO DE ARMAZENAMENTO SOBRE AS PROPRIEDADES FÍSICO QUIMICAS E BIOATIVIDADE DE CIMENTOS ENDODÔNTICOS

2026-08-20T13:31:06Z

Título: INFLUÊNCIA DO MEIO DE ARMAZENAMENTO SOBRE AS PROPRIEDADES FÍSICO QUIMICAS E BIOATIVIDADE DE CIMENTOS ENDODÔNTICOS Autor: MENESES, Thais Gomes de Moraes Primeiro orientador: BAUER, José Roberto de Oliveira Abstract: Bioceramic sealers were introduced in endodontics in order to overcome the biological limitations that conventional endodontic sealers present. Current literature shows that bioceramic endodontic sealers have good radiopacity, fluidity, working time, pH alkalinization capacity, antibacterial activity and biocompatibility. However, it has as a disadvantage, solubility higher than the required standard ISO 6876/2012, which determines that an endodontic sealer must not exceed 3% of mass loss after immersion in distilled water. However, criticisms have been made of this methodology since distilled water does not represent the medium to which these materials are actually exposed. Therefore, modifications in the sorption and solubility tests have been carried out using a phosphate saline solution (PBS) as a storage medium, concluding that bioceramic sealers are less soluble when immersed in PBS. It is speculated that the lower solubility is justified by the deposition of a layer of hydroxyapatite that fills the voids generated by the solubility. The present study proposed to evaluate the influence of a high concentrated storage medium (SBF) on the properties of sorption, solubility, fluid absorption, bioactivity and pH alkalinization capacity of a bioceramic sealer (BioRoot RCS) and a resin-based cement epoxy (AH Plus). 24 samples were made for each sealer tested, which were subsequently randomly divided into 3 experimental groups (n = 8). The samples were desiccated for 30 days, weighed and stored in containers containing 5ml of distilled water, PBS or SBF. The pH readings and weighings were performed after 24 hours, 48 hours, 7, 30, 60 and 90 days. To analyze the formation of precipitates, 2 specimens from each group were selected and taken for observation using scanning electron microscopy (SEM) and composition reading by dispersive energy spectroscopy (EDS). The data of sorption / solubility / fluid absorption were found in TwoWay Analysis of Variance (Solution vs. Cement) and Holm-Sidak test ( = 0.05) for contrast medium. An analysis of pH, SEM and EDS, were performed descriptively. The AH Plus was not influenced by the storage solution, for all evaluated properties (p> 0.05). BioRoot presents greater solubility when immersed in SBF, followed by water and PBS, which are not differentiating between themselves. There was formation of precipitates on the surface of the BioRoot sample only in PBS and SBF. AH Plus maintained a neutral pH, while BioRoot was able to alkalinize the medium. Therefore, the storage medium influenced by physicalchemical properties and the bioactive potential of bioceramic sealer. However, conventional tests of sorption, solubility and fluid absorption performed in distilled water should not be indicated for bioceramic sealers, since they do not present evidence on in vivo behavior and still mask their bioactivity, which is the main differential material. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Influência de diferentes substâncias irrigadoras do canal radicular na resistência de união de pinos de fibra de vidro anatomizados

2026-06-16T12:52:39Z

Título: Influência de diferentes substâncias irrigadoras do canal radicular na resistência de união de pinos de fibra de vidro anatomizados Autor: SOUSA, Nielsen Barros Primeiro orientador: SANTANA, Ivone Lima Abstract: The aim of this study was to evaluate the effect of using different irrigating solutions on bond strength of relining on fiber post (FP). Bovine mandibular incisors were selected. All specimens had their crowns sectioned for standardization of root remaining in the final length of 17mm. After storage in distilled water under cooling, the roots were divided into 3 groups (n=10) by type of irrigating solutions used in endodontic treatment: Group I: endodontically treated teeth and irrigated with saline solution; Group II: endodontically treated teeth and irrigated with solution of Sodium Hypochlorite (NaOCl) 2.5%; Group III: endodontically treated teeth and irrigated with a solution of Chlorhexidine (CHX) 2%. The strategy of standardized endodontic working length with 16mm deep. The conduits were desobturados with heated pluggers and drills type Largo. This procedure allowed the use of FP that were anatomised with composite resin cement and cemented with dual cure resin. After endodontic treatment, the specimens were stored for seven days under humid conditions at 37°C, and sectioned at the cervical, middle and apical thirds in six parts. Then submitted to the mechanical test push-out in a universal testing machine at a crosshead speed of 0.5mm/min. Data were collected and subjected to analysis of variance (ANOVA) followed by Tukey's test with a significance level of 5% (p<0,05). Group II had a mean bond strength (13.63 ±4.51 P=0.041) higher than other groups in the cervical third. It was concluded that the type of irrigator can influence adherence FP anatomised to the root canal walls. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

AVALIAÇÃO IN VITRO DA ATIVIDADE ANTIFÚNGICA DE EXTRATOS VEGETAIS SOBRE CANDIDA SPP.

2026-06-08T12:48:22Z

Título: AVALIAÇÃO IN VITRO DA ATIVIDADE ANTIFÚNGICA DE EXTRATOS VEGETAIS SOBRE CANDIDA SPP. Autor: NUNES, Marjorie Adriane da Costa Primeiro orientador: PEREIRA , Antônio Luiz Amaral Abstract: Candida yeasts are often associated with normal oral mucosa. However, in specific situations, such as immunological, chemical and mechanical changes, can trigger infections called candidiasis. When associated with the use of prostheses, candidiasis is called denture stomatitis. Candida biofilm is considered the main etiological factor in denture stomatitis basis of the prosthesis and its removal is necessary by the use of chemical cleaners associated or not to antifungal agents. Given this, the objective of this study was to evaluate the antifungal potential of plant extracts on Candida spp. and on biofilm formed in acrylic resin specimens. We conducted laboratory study, in vitro, by analyzing the performance of plant extracts (Passiflora edulis leaves and Psidium guajava L., peel Schinus terebinthifolius Raddi, mesocarp Orbignya phalerata Mart. And leaves and bark of Anacardium occidentale L. ) at a concentration of 100mg / ml of standard strains C. albicans (ATCC90028) and C. glabrata (ATCC2001). The antimicrobial activity was evaluated by the agar diffusion method, determination of minimum inhibitory concentration (MIC) by microdilution broth method, followed by the subcultures in agar to determine the concentration Fungicide Min. The positive controls were 0.12% chlorhexidine gluconate and fluconazole 128 mg / mL. It was also evaluated the effect of Psidium guajava extract of C. albicans biofilm (ATCC90028) formed on acrylic resin specimens. The specimens were submitted to the treatments: herbal extract of Psidium guajava in the concentration of 300mg / ml (15 min); Sodium hypochlorite (NaOCl) 0.5% (10 min) as positive control and negative control as distilled and deionized water (15 min). The number of viable Candida cells was expressed as colony forming units (CFU) / mm2. The Psidium guajava L. extract presented halos of inhibition of 17.08 mm for C. albicans and C. glabrata to 20.41 mm. The other extracts did not form inhibition zones for the tested strains. The MIC and MFC of Psidium guajava extract for C. albicans was 15mg / ml and 30mg / ml respectively and C. glabrata 3.75mg / ml and 15mg / ml. With respect to the effect of the extract on the biofilm, it was observed a significant reduction in CFUs acrylic resin specimens when compared to the negative control group. It was concluded in this study that the extract of Psidium guajava leaves showed antifungal activity against strains of C. albicans and C. glabrata and that it significantly reduced the biofilm formed on the acrylic resin specimens. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação