Abstract
Introduction
The objective of this study was to investigate the expression of matrix metalloproteinases
(MMPs) in apical periodontitis and during the periapical healing phase after root
canal treatment.
Methods
Apical periodontitis was induced in dog teeth, and root canal treatment was performed
in a single visit or by using an additional calcium hydroxide root canal dressing.
One hundred eighty days after treatment the presence of inflammation was examined,
and tissues were stained to detect bacteria. Bacterial status was correlated to the
degree of tissue organization, and to further investigate molecules involved in this
process, tissues were stained for MMP-1, MMP-2, MMP-8, and MMP-9. Data were analyzed
by using one-way analysis of variance followed by Tukey test or Kruskal-Wallis followed
by Dunn test.
Results
Teeth with apical periodontitis that had root canal therapy performed in a single
visit presented an intense inflammatory cell infiltrate. Periapical tissue was extremely
disorganized, and this was correlated with the presence of bacteria. Higher MMP expression
was evident, similar to teeth with untreated apical periodontitis. In contrast, teeth
with apical periodontitis submitted to root canal treatment with calcium hydroxide
presented a lower inflammatory cell infiltrate. This group had moderately organized
connective tissue, lower prevalence of bacteria, and lower number of MMP-positive
cells, similar to healthy teeth submitted to treatment.
Conclusions
Teeth treated with calcium hydroxide root canal dressing exhibited a lower percentage
of bacterial contamination, a lower MMP expression, and a more organized extracellular
matrix, unlike those treated in a single visit. This suggests that calcium hydroxide
might be beneficial in tissue repair processes.
Key Words
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© 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
