Action of intracanal medications with N-acetyl cysteine on lipid mediators and inflammatory cytokines present in primary endodontic infections

Abstract

The purpose of endodontic treatment in cases of apical periodontitis (AP) is to reducemicroorganisms in the root canal system in order to reduce the periapical inflammatory process, favoring repair in the region. This randomized clinical study aims to evaluate, in teeth with pulp necrosis and apical periodontitis, the levels of lipid mediators - specifically Resolvin D2 and Maresina MaR1 - and to quantify inflammatory cytokines in treatment protocols using different intracanal medications. For this, 36 single-rootedpermanent teeth from patients with primary endodontic infection and AP will beselected and prepared using a single reciprocating file instrument and irrigation with 2.5% sodium hypochlorite. After instrumentation, the canals will be filled for 14 days with the intracanal medications to be evaluated: calcium hydroxide Ca(OH)2 + saline solution (n=12); Ca(OH)2 + N-acetyl cysteine (NAC) (n=12); and chlorhexidine (CHX) + NAC (n=12). Samples for analysis of cytokines and lipid mediators will be collectedfrom the periapical fluid after biomechanical preparation (S1) and after intracanalmedication (S2) for further analysis of lipid mediators from mass spectroscopy andcytokines through an immunoassay with microspheres of the multiplex type. The data obtained will be tabulated and subsequently submitted to statistical tests according to the normality of the data.