Importance of bacterial endotoxin (LPS) in endodontics

Abstract

New knowledge of the structure and biological activity of endotoxins (LPS) has revolutionized concepts concerning their mechanisms of action and forms of inactivation. Since the 1980's, technological advances in microbiological culture and identification have shown that anaerobic microorganisms, especially Gram-negative, predominate in root canals of teeth with pulp necrosis and radiographically visible chronic periapical lesions. Gram-negative bacteria not only have different factors of virulence and generate sub-products that are toxic to apical and periapical tissues, as also contain endotoxin (LPS) on their cell wall. This is especially important because endotoxin is released during multiplication or bacterial death, causing a series of biological effects that lead to an inflammatory reaction and resorption of mineralized tissues. Thus, due to the role of endotoxin in the pathogenesis of periapical lesions, we reviewed the literature concerning the biological activity of endotoxin and the relevance of its inactivation during treatment of teeth with pulp necrosis and chronic periapical lesion.

Management of oral focal infection in patients with asthmatic symptoms

“…Endotoxins from vital or non vital, whole or fragmented bacteria act on macrophages, neutrophils and fibroblasts, 10 and mast cells 11 leading to the release of a large number of bioactive or cytokine chemical inflammatory mediators, such as tumor necrosis factor (TNF-α), interleukin-1 (IL-1), IL-5, IL-8, alpha-interferon and prostaglandins. Furthermore, LPS is cytotoxic and acts as a potent stimulator of nitric oxide (NO) production.…”

“…Furthermore, LPS is cytotoxic and acts as a potent stimulator of nitric oxide (NO) production. 9,10,12 According to Leonardo et al, 10 the bacterial endotoxin (LPS) adheres irreversibly to mineralized tissues, endodontic treatment and dressing only killed the bacteria. The inactivation of LPS by eliminating its biologically toxic potential that was the lipid A should be done with certain materials such as calcium hydroxide.…”

Calcium Hydroxide in Endodontics: An Overview

“…Anaerobic bacteria with their endotoxins on their cell walls also predominant in this microbial diversity and can be detected especially gram negative [8]. It is well established that the complete removal of bacteria from the root canal system is difficult even with the new endodontic techniques.…”

Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals

“…23 The intracanal medications maintained the antimicrobial action obtained by root canal preparation, acting on microorganisms that might have remained in the dentinal tubules and other areas of the root canal system. This study employed calcium hydroxide as intracanal medication considering its widespread use in endodontics because of its antimicrobial properties, 24,25 ability to induce mineralization, 26 and especially the effective action on LPS, 7,22,27 either pure or associated with other drugs. 9,14,23 Due to studies using phytotherapic drugs, this study employed Z. officinale extract as intracanal medication, associated or not with calcium hydroxide.…”