Inflammatory biomarkers in endodontic therapy using intracanal medication with chlorhexidine in teeth with primary endodontic infection and periapical lesion

Abstract

The aim of this study will be to clinically evaluate teeth with pulpal necrosis and apical periodontitis (AP), antimicrobial activity, levels of inflammatory markers (IL-1B and TNF-a), and metalloproteinase (MMPs) before and after the use of intracanal medications based on chlorhexidine. For this purpose, 24 teeth from patients with primary endodontic infection and AP will beselected. These teeth will be prepared using mechanized instrumentation, with a single reciprocating file and irrigation with 2.5% sodium hypochlorite. The treatment will be performed in two sessions. After completing the biomechanicalpreparation in the first session, the canals will be filled with intracanal medications (MIC): N-acetylcysteine (NAC) + chlorhexidine (CHX) (n=12) or calcium hydroxide [Ca(OH)2] + CHX (n=12). To assess microbial load samples will be collected from the interior of the root canals after coronal opening (S1), after biomechanical preparation (S2) and after 14 days of MIC (S3). To quantifyinflammatory cytokines, MMP-8 and MMP-13, samples will be colected from periapical interstitial fluid after biomechanical preparation (SF1) and after 14 days of ICM (SF2). The data will be analyzed using appropriate statistical testswith a significance level of 5%.