Relationship between hypertension and periapical lesion: an in vitro and in vivo study

Abstract

The aim of this study was to compare potential aspects of periapical lesion formation in hypertensive and normotensive conditions using hypertensive (BPH/2J) and wild-type control (BPN/3J) mice. The mandibular first molars of both strains had their dental pulp exposed. At day 21 the mice were euthanized and right mandibular molars were used to evaluate the size and phenotype of apical periodontitis by microCT. Proteins were extracted from periapical lesion on the left side and the expressions of IL1α, IL1β and TNFα were analyzed by ELISA. Bone marrow stem cells were isolated from adult mice femurs from 2 strains and osteoclast differentiation was evaluated by tartrate-resistant acid phosphatase (TRAP) in vitro. The amount of differentiated osteoclastic cells was nearly double in hypertensive mice when compared to the normotensive strain (p < 0.03). Periapical lesion size did not differ between hypertensive and normotensive strains (p > 0.7). IL1α, IL1β and TNFα cytokines expressions were similar for both systemic conditions (p > 0.05). Despite the fact that no differences could be observed in periapical lesion size and cytokines expressions on the systemic conditions tested, hypertension showed an elevated number of osteoclast differentiation.

Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials

“…However, the hypertension group showed elevated osteoclast differentiation in vitro. 48 In conclusion, there is evidence suggesting that endodontic infection and cardiovascular diseases are correlated. However, more studies should be conducted to better understand the pathways and possible targets related to those interactions, in order to control the consequences of both diseases.…”

“…These studies assessed the alterations represented by coronary artery disease, 44,45,46 acute coronary syndrome, 4 and hypertension. 47,48 There are some studies in the literature that associated the presence of AP with cardiovascular diseases. Caplan et al 46 evaluated whether incident radiographically evident lesions of endodontic origin were related to the development of coronary heart disease (CHD) in 708 patients.…”

“…Some in vivo and in vitro studies have been developed to elucidate this relationship. 48,87 In addition, animal models that simulate systemic conditions, such as diabetes mellitus and hypertension, have also been employed. 48,87 d. Diabetes and dental materials Diabetes mellitus is a metabolic disease considered to be a modulator of endodontic infections, 88 and it is responsible for altering the immune and inflammatory response, undermining the healing process, and promoting damage to body organs and tissues, including the dental pulp and periapical tissues.…”

Infecção endodôntica associada a alterações no sistema cardiovascular

“…Martins et al 12 realizando estudos in vitro e in vivo analisaram a relação da hipertensão com a lesão periapical. Foram utilizados ratos hipertensos e normotensos, nos quais a polpa do primeiro molar inferior foi exposta por 21 dias, sendo avaliada a situação sérica referente a interleucinas e fatores de crescimento.…”

Oral Health and Cardiovascular Disorders

“…Periapical disease was associated with hypertension and stroke [57,58]. Comparing aspects of periapical lesion formation in hypertensive and normotensive conditions using hypertensive and wild-type control mice, no differences were noticed in periapical lesion size and cytokines expressions, but hypertensive rats showed an elevated number of osteoclasts, responsible for bone destruction [59]. The link between bone destruction and hypertension is angiotensin II, able to upregulate RANKL expression in osteoblasts [59].…”