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Selenium intracanal dressing: effects on the periapical immune response

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Abstract

Objectives

To evaluate the selenium (Se) behavior when used as an endodontic dressing in teeth with pulp necrosis. Additionally, its effects was also compared with the calcium hydroxide (C.H.), which is used globally as a root canal dressing, and the combination of the C.H. with Se (C.H. + Se).

Materials and methods

The sample consisted of 60 patients requiring endodontic treatment who were divided into groups, i.e., without intracanal medication (empty) and with medications as follows: selenium (Se), calcium hydroxide (C.H.), and calcium hydroxide + selenium (C.H. + Se) (n = 15). After the coronary opening, three absorbent paper points were placed in the RCS and maintained for 2 min for microbial evaluation. Following the cleaning and shaping procedures, new paper points were introduced into the root canal system, passing passively through the root apex (2 mm) into the periapical tissues for 2 min, for immune evaluation. The collections were performed again 15 days later. Real-time PCR quantified the expression of the prokaryotic 16S ribosomal RNA. The 16S mRNA was evaluated before the cleaning and shaping procedures and 15 days later in the groups treated with or without medication.

Results

A significant reduction in the microbial load was observed only in the groups that received endodontic dressing (p < 0.05). The cytokines IFN-γ, TNF-α, IL-1α, IL-17A, IL-10, IL-6 and MCP-1, were also quantified by real-time PCR. There was an increase in the gene expression level of the cytokines (T15) TNF-α and IL-10 in the C.H. group compared to the other groups (p < 0.05). The IFN-γ mRNA expression was reduced in the groups treated with the medications (Se, C.H., and C.H. + Se).

Conclusions

The findings of the present study indicate that in the case of treatment over multiple sessions, the use of root canal dressing is essential to avoid the root canal system (RCS) microbial recolonization. Selenium potentiated the effects of calcium hydroxide inducing an anti-inflammatory response in periapical tissues.

Clinical relevance

Se is a mineral essential for the formation of the amino acid selenocysteine, which is directly involved in the maintenance of the immune response. Selenium has been widely used in the medical field in the treatment of cancer, as an activator of bone metabolism, and as a stimulator of the immune system. In this study, it was shown that the incorporation of Se, whether as intracanal medication alone or in conjunction with other medications, may potentiate periapical tissue repair after RCS cleaning and shaping procedures.

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Acknowledgments

This work was supported by the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The authors also wish to thank the post-graduate program at the School of Dentistry of UFMG. LQV and APRS are CNPq fellows.

Funding

The work was supported by the Fundação de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

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Authors and Affiliations

  1. Department of Operative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Marcela Carvalho Espaladori, Julia Mourão Braga Diniz, Warley Luciano Fonseca Tavares & Antônio Paulino Ribeiro Sobrinho

  2. Department of Endodontics, School of Dentistry, Itaúna University, Itaúna, MG, Brazil

    Luciana Carla Neves de Brito

  3. College of Dental Medicine, Nova Southeastern University, Davie, FL, USA

    Toshihisa Kawai

  4. Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Leda Quercia Vieira

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  1. Marcela Carvalho Espaladori
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  2. Julia Mourão Braga Diniz
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  3. Luciana Carla Neves de Brito
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  4. Warley Luciano Fonseca Tavares
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  6. Leda Quercia Vieira
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  7. Antônio Paulino Ribeiro Sobrinho
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Correspondence to Antônio Paulino Ribeiro Sobrinho.

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All procedures performed in studies involving human participants were under the ethical standards of the institutional and/or national research committee (The Research Ethics Committee of the Federal University of Minas Gerais, CAAE: 89043918.3.0000.5149) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Espaladori, M.C., Diniz, J.M.B., de Brito, L.C.N. et al. Selenium intracanal dressing: effects on the periapical immune response. Clin Oral Invest 25, 2951–2958 (2021). https://doi.org/10.1007/s00784-020-03615-8

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