Mechanisms of bone remodeling and therapeutic strategies in chronic apical periodontitis

Xu-tao, Luo; Wan, Qianxue; Liu, Cheng; Xu, Ruoshi

doi:10.3389/fcimb.2022.908859

Cited by 24 publications

(14 citation statements)

References 175 publications

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“…Te results of the expression of TNF-α in this study are confrmed by other studies that reinforce the participation of this cytokine in periradicular infammatory processes [20,24]. It is believed that the presence of TNF-α causes the progression of lesions and induces bone resorption through the activation of local osteoclasts [24]. Te lower immunoexpression of this proinfammatory cytokine found in our study may be compatible with the chronic phase of AP [25].…”

Section: Discussionsupporting

confidence: 89%

Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients

Sarmento

Andrade

Gomes

et al. 2023

International Journal of Dentistry

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Diabetes mellitus has been regarded as a condition capable of influencing the evolution of periapical lesions. Therefore, this study evaluated the immunoexpression of IL-1β, TNF-α, and IL-17 in apical periodontitis from type 2 diabetic patients through immunohistochemistry. Twenty-six periapical lesions were selected, and the images obtained through immunohistochemistry reactions were analyzed. The statistical significance was set at p < 0.05 . IL-1β expression was considered focal (54%), weak to moderate (38%), and strong (8%) in diabetics, and focal (46%), weak to moderate (31%), and strong (23%), in controls. TNF-α was focal (85%) and weak to moderate (15%) in diabetics, and focal (92%) and weak to moderate (8%), in controls. IL-17 was focal (8%), weak to moderate (46%), and strong (46%) in diabetics, and focal (62%), weak to moderate (8%), and strong (30%), in controls. The quantitative analysis revealed greater expression of IL-17, with a significant difference between IL-17 × IL-1β × TNF-α p = 0.0009 in the diabetic group. The cytokines IL-1β and TNF-α did not express statistical differences between the tested groups. The IL-17 showed higher immunoexpression in the diabetic group p = 0.047 , which may suggest higher bone resorption activity in chronic apical periodontitis in this group of patients.

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Section: Discussionsupporting

confidence: 89%

Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients

Sarmento

Andrade

Gomes

et al. 2023

International Journal of Dentistry

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“…Under normal circumstances, the stress distribution of the tooth is mainly concentrated on the tooth root ( Agrawal et al, 2021 ). When apical periodontitis occurs, the structure of the tooth root is gradually destroyed ( Márton and Kiss, 2000 ; Xu et al, 2019 ; Luo et al, 2022 ), so the stress and strain on the tooth root may be reduced. In this study, we found the stress and strain at the tooth root to be significantly greater than at the tooth cervix at 0 and 14 days, which corresponds to the stress and strain distribution of the tooth under normal conditions.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the biomechanical differences in the occlusal movement of wild-type and BMP9 knockout mice with apical periodontitis

Peng

Ma²,

Cao³

et al. 2022

Front. Bioeng. Biotechnol.

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Apical periodontitis is a common clinical disease caused by bacteria; bacterial metabolites can cause an imbalance in bone homeostasis, bone mass reduction, and tooth loss. Bone resorption in apical periodontitis causes a concentration of stress in the tooth and periodontal tissues during occlusion, which aggravates the disease. Emerging evidence indicates that bone morphogenetic protein 9 (BMP9), also known as growth differentiation factor 2(Gdf2), may play an important role in tooth and dentoalveolar development. Herein, we investigated the role of BMP9 in the development of apical periodontitis and its effects on the biomechanics of dentoalveolar bone. Apical periodontitis models were established in five BMP9 knockout (KO) mice and five C57BL/6 WT (wild-type) mice. At baseline and 14, 28, and 42 days after modeling, in vivo micro-computed tomography analysis and three-dimensional (3D) reconstruction were performed to evaluate the apical lesion in each mouse, and confirm that the animal models were successfully established. Finite element analysis (FEA) was performed to study the stress and strain at the alveolar fossa of each mouse under the same vertical and lateral stress. FEA revealed that the stress and strain at the alveolar fossa of each mouse gradually concentrated on the tooth cervix. The stress and strain at the tooth cervix gradually increased with time but were decreased at day 42. Under the same lingual loading, the maximum differences of the stress and strain at the tooth root in KO mice were greater than those in WT mice. Thus, these findings demonstrate that BMP9 could affect the biomechanical response of the alveolar fossa at the tooth root in mice with apical periodontitis. Moreover, the effects of BMP9 on the biomechanical response of the alveolar bone may be site-dependent. Overall, this work contributes to an improved understanding of the pathogenesis of apical periodontitis and may inform the development of new treatment strategies for apical periodontitis.

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“…Orthodontic tooth movement (OTM) requires bone remodeling, which results from complex processes of aseptic inflammation. Recent works have confirmed a close relationship between the immune and skeletal systems [ 1 , 2 , 3 , 4 , 5 ]. Studies have shown that bone remodeling involves osteoclasts’ (OC) and osteoblasts’ (OB) differentiation and activation, mediated by immune system [ 1 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 95%

Influence of Different Orthodontic Brackets on Cytokine and Cortisol Profile

et al. 2023

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Background and Objectives: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction between the immune and skeletal systems. In addition, various orthodontic appliances including fixed systems affect the sublingual microbial composition, and the likelihood of developing inflammatory reactions of the gums is high, especially early in the treatment period. It is known that these systems have both positive and negative effects on the humoral and cellular immune responses. The main aim of the study was to evaluate the influence of self-ligating and conventional brackets on the salivary concentrations of cytokines (IL-6, osteoprotegerin (OPG), TNF-alpha, and IFN-gamma) and cortisol as a marker of stress. Materials and Methods: Forty patients were analyzed at baseline (T0) and 2 months (T2) after fixing self-ligating (Ormco Damond Q) and conventional brackets (Ormco Mini Diamond). Salivary cytokine and cortisol concentrations were evaluated by commercial ELISA kits. Results: Outcomes of our study showed that after two months of treatment with either of these brackets, IFN-gamma and IL-6 levels did not change. However, TNF-alpha decreased with self-ligating brackets (13.36 to 8.32, p = 0.002). The self-ligating bracket system also affects OPG concentration and cortisol levels 2 months after orthodontic activation. The level of OPG in the group of self-ligating brackets decreased significantly (8.55 to 2.72, p = 0.003). Cortisol concentration was significantly higher in the self-ligation group (25.72 to 48.45, p = 0.001) due to the effect of sustained strength movements. Conclusions: Thus, the use of self-ligating and conventional brackets has a different effect on the concentration of cortisol and cytokines (OPG and TNF-alpha) in saliva 2 months after their fixation. Further longitudinal studies are necessary to explore why OPG levels are decreased in case of self-ligating cases and how OPG levels are related to clinical improvement.

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Mechanisms of bone remodeling and therapeutic strategies in chronic apical periodontitis

Cited by 24 publications

References 175 publications

Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients

Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients

Comparison of the biomechanical differences in the occlusal movement of wild-type and BMP9 knockout mice with apical periodontitis

Influence of Different Orthodontic Brackets on Cytokine and Cortisol Profile

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