THE EFFECT OF N-ACETYLCYSTEINE AS AN INTRACANAL MEDICATION ON INFLAMMATORY CYTOKINES, LIPID MEDIATORS AND BONE MARKERS IN TEETH WITH PRIMARY ENDODONTIC INFECTION

Abstract

Molecular events involving periapical lesions are fundamental to both the developmentand repair of these lesions after endodontic treatment. Thus, the aim of this study willbe to evaluate the action of intracanal medications containing calcium hydroxide[Ca(OH)2] and N-acetylcysteine (NAC) on inflammatory and lipid mediators, as well astheir influence on bone markers in patients with primary endodontic infection. Singlerooted teeth with primary endodontic infection and periapical lesions confirmed byradiography and cone beam computed tomography (CBCT) will be selected. Theclinical signs and symptoms present before, during and after treatment will beassessed, and the selected teeth will have their canals prepared using reciprocatingsingle file instruments and irrigation with 2.5% sodium hypochlorite followed byintracanal medications (ICM): 1) Ca(OH)2 + chlorhexidine (CHX); 2) NAC + Ca(OH)2;NAC + CHX. Interstitial fluid will be collected after biomechanical preparation and after14 days of using the ICMs in order to assess the inflammatory cytokines interleukin(IL) 1 ², IL 6, tumor necrosis factor alpha and fibroblast growth factor - 23 (FGF 23);the quantification of lipid mediators resolvin and maresin; and bone markers (RANK/RANKL, osteoprotegerin (OPG), sclerostin, osteocalcin (OCN) and Dickkopf1 protein(DKK1)). The data will be evaluated using statistical tests, according to the normalityof the data obtained.