Browsing by Author "Cardoso, Miguel"
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- Antimicrobial properties and bioactivity potential of smart nanoparticles for dental applicationsPublication . Correia, Bruna L.; Malekshiri, Moslem; Bartolomeu, Maria; Silva, Virgília; Oliveira, Ana; Noites, Rita; Cardoso, Miguel; Mendes, Karina; Gomes, Ana T. P. C.; Duarte, Ana Sofia
- Biodentine for furcation perforation repair: an animal study with histological, radiographic and micro-computed tomographic assessmentPublication . Cardoso, Miguel; Pires, Maria dos Anjos; Correlo, Vitor; Reis, Rui; Paulo, Manuel; Viegas, CarlosIntroduction: Biodentine has been scarcely studied as a furcation perforation (FP) repair material, mostly by in vitro methodologies. This animal study aimed to compare the histological responses, radiographic, and micro-computed tomographic (micro-CT) outcomes after FP repair with Biodentine or ProRoot MTA (MTA) in dogs’ teeth. Methods and Materials: Fifty teeth from five dogs were divided into 4 groups: MTA (n=20, FP repaired with ProRoot MTA), BDT (n=20, FP repaired with Biodentine), PC (n=5, positive control, FP without repair) and NC (n=5, negative control, without perforation). The animals were euthanized after 4 months. Histological assessment included inflammatory cell infiltration, hard tissue resorption, hard tissue repair, and cement repair in the furcation area. Immediate postoperative and 4 months follow-up radiographs were compared for radiolucency in the furcation region. The volume of extruded material was quantified using micro-CT images. Results: The tested materials showed equivalent radiographic response, together with similar hard tissue resorption and repair but, BDT group showed significantly less inflammation, lower volume of extruded material and higher cement repair than MTA group. Conclusion: The outcomes of this study, taken together with other favorable results in literature, are highly suggestive that Biodentine is a promising biomaterial to be used for FP repair.
- Cytotoxicity assessment of endodontic sealers: metabolic activity, morphology and chromosomal alterationsPublication . Tavares, Inês Moura; Ribeiro, Ilda P.; Pais, Cláudia; Laranjo, Mafalda; Jardim, Ana; Mascarenhas, Alexandra; Zuzarte, Mónica; Cardoso, Miguel; Girão, Henrique; Botelho, Maria Filomena; Melo, Joana B. de; Carreira, Isabel M.; Noites, RitaIntroduction: Endodontic treatment aims to eliminate infection of the root canals and fill the dental pulp space, being, the obturation of root canals an important step. The study of the toxicity/biocompatibility of the sealers used to fill the root canals is crucial since they are applied into direct contact with periradicular tissues.There are several types of sealers, categorized according to their main chemical constituents. The aim of this study was to evaluate the cytotoxicity of three root canal sealers, AH Plus, Bio MTA+ and Bio C, on immortalized human gingival fibroblasts. Methods: To study the cytotoxicity of the sealers we performed a Methyltetrazolium (MTT) assay, a study of cell's morphology and a cytogenetic study. Cells were placed in contact with material-conditioned media, for 24 h, at three different concentrations (1, 10 and 100 mg/ml) for the MTT assay. Cell morphology and cytogenetic studies were performed at 100 mg/ml. Cells in normal culture medium were analyzed as control group. Results: MTT assay revealed a cytotoxic effect of Bio MTA+ and Bio C with a growing decrease of metabolic activity with increasing compound concentration, reaching 50% with 100 mg/ml. Regarding the cells morphology, Bio C was the compound that showed a more drastic effect, with a decrease in cell confluence and several morphological changes. AH Plus and Bio MTA+ did not seem to affect the cell confluence, however morphology changes were observed, as compromised cell membranes and loss of cell content. Cytogenetic study was thus far only performed with AH Plus. Since there was a severe decrease of mitotic index after treatment, it was not yet possible to obtain sufficient metaphases, even after several cytogenetic harvesting procedures, but, so far, no relevant structural or numerical changes were observed. Discussion: This preliminary study allowed us to verify that these root canal sealers exhibit some cytotoxicity, depending on the concentration used. Although more studies are still needed, this work could be important to both, help in the selection of the most appropriate compounds for clinical practice and to determine the maximum recommended amounts of each sealer.
- Degree of contamination of gutta-percha points by Staphylococcus aureus (MRSA/MSSA) strainsPublication . Teles, Ana Moura; Pina, Cristina; Cardoso, Inês Lopes; Tramontana, Antea; Cardoso, Miguel; Duarte, Ana Sofia; Bartolomeu, Maria; Noites, RitaMethicillin-resistant Staphylococcus aureus (MRSA) is considered one of the most harmful bacteria to human health. Dentistry, like all healthcare disciplines, places great emphasis on preventing scenarios that may result in cross-infection. Although various tested and already used materials are suitable for filling the root canal system, Gutta-Percha (GP) remains the preferred and widely accepted gold standard. Objective: We performed an in vitro analysis of the contamination of GP points, regarding the strains of Methicillin-resistant (MRSA) and Methicillin-sensitive (MSSA) Staphylococcus aureus, using classical microbiology methods and molecular biology techniques. Methods: Gutta-Percha points of two different brands from opened packages (already in use for 1 month) were collected for analysis. The assessment involved incubating the GP points in Brain Heart Infusion (BHI) medium to detect microbial growth. Growing microorganisms were plated on a selective and differential chromogenic medium for MRSA/MSSA strains, and the identification of isolates was confirmed by Polymerase Chain Reaction (PCR). In the case of microbial growth, the GP point was submitted to a disinfection protocol. Results: From the 315 collected GP points, only 6 (1.9%) resulted in being positive for microbial growth. After confirmation by PCR, only one sample of the six GP points was contaminated by MRSA, and the remaining five were MSSA-contaminated. The disinfection protocol was effective in all contaminated GP points. Conclusions: The Gutta-Percha points from opened pre-sterilized packages showed a very low degree of contamination by MRSA/MSSA. However, the detection of MSSA and MRSA strains raises concerns about potential contamination in dental clinic environments, and this risk cannot be considered negligible.
- Extraradicular infection and apical mineralized biofilm: a systematic review of published case reportsPublication . Pérez, Alejandro R.; Rendón, Jaime; Ortolani-Seltenerich, P. S.; Pérez-Ron, Yetzangel; Cardoso, Miguel; Noites, Rita; Loroño, Gaizka; Vieira, Gaya C. S.Background/Objectives: Bacterial biofilms on root surfaces outside the apical foramen are linked to refractory apical periodontitis, as microorganisms can survive in extraradicular areas and cause persistent infections. This study aimed to precisely evaluate the relationship between extraradicular biofilm and persistent periapical periodontitis through an overview of case reports. Methods: A systematic search of PubMed, Web of Science, Scopus, Embase and ScienceDirect databases was conducted up to June 2023. Keywords included “extraradicular infection”, “wet canal”, “wet canals”, “extraradicular mineralized biofilms”, and “calculus-like deposit”. Only case reports meeting the inclusion criteria were analyzed. Results: Fifteen cases of extraradicular infection were identified, involving eight women and six men aged between 18 and 60 years. These cases included nine failed treatments confirmed through complementary methods such as histobacteriologic analysis, scanning electron microscopy (SEM), or polymerase chain reaction (PCR). Among these, four patients (six teeth) exhibited calculus-like deposits. Conclusions: Extraradicular biofilm is strongly associated with failed endodontic treatments, leading to persistent infections. A structured decision-making approach is essential. Before considering apical surgery, clinicians should prioritize intraradicular infection control through thorough irrigation, antimicrobial medicaments, and adjunctive disinfection techniques. When extraradicular biofilms or mineralized calculus are present, and symptoms persist after optimal intracanal disinfection, apical surgery should be performed.
- Factors associated with the prevalence of apical periodontitis: an observational studyPublication . Noites, Rita; Bartolomeu, Maria; Duarte, Ana Sofia; Perez, Alejandro; Cardoso, MiguelObjectives: Apical periodontitis is a lesion of endodontic origin caused by an immune response to necrotic and infected dental pulp. Since apical periodontitis can persist after endodontic treatment, radiographic diagnosis is crucial. This study evaluates factors associated with the prevalence of apical periodontitis in a Portuguese population using the full-scale periapical index. Methods: A cross-sectional study analyzed 402 medical records and panoramic radiographs from January to May 2023. The periapical status, presence of apical periodontitis, quality of endodontic treatment, quality of coronal restoration, presence of caries lesions, and presence of retained root fragments were assessed. The correlation between these variables was examined. Results: Among 9056 teeth, 4.7% presented apical periodontitis (periapical index ≥3), and 53.3% of participants had fewer than one apical periodontitis lesion. Of 437 teeth with endodontic treatment, 300 (69.6%) did not have apical periodontitis, while 131 (30.4%) had apical periodontitis. A significant statistical relationship (p<0.05) was observed between apical periodontitis and other dental conditions, including the presence of retained root fragments, caries lesions, the quality of endodontic treatment, and the quality of restoration. The strongest correlation was found between apical periodontitis and the quality of endodontic treatment (Cramer’s V = 61%), while no consistent correlations were observed with other variables. Conclusions: The prevalence of apical periodontitis was higher in teeth with endodontic treatment, with a strong correlation with treatment quality. The presence of caries lesions, coronal restorations, and retained root fragments also influenced the occurrence of apical periodontitis, reinforcing the need for further studies.
- Human gingival fibroblasts response to different endodontic sealers: an in vitro studyPublication . Noites, Rita; Tavares, Inês; Cardoso, Miguel; Carreira, Isabel M.; Duarte, Ana S.Endodontic treatment aims to eliminate infection of the root canals and fill the dental pulp space. The biocompatibility studies of the sealers used in root canals obturation are crucial since they are applied in direct contact with periradicular tissues. Objective: The aim of this study was to evaluate the cytotoxicity of three root canal sealers—AH Plus, Bio MTA+, and Bio C sealer—on immortalized human gingival fibroblasts. Methods: AH Plus, Bio MTA+, and Bio C sealers were evaluated through incubation in real-time and material-conditioned media. Cells were incubated for 24 h and 72 h, at three different concentrations (1, 10, and 100 mg/mL) of each sealer. The cytotoxic activity of the sealers was assessed by Methyl tetrazolium (MTT) and Sulforhodamine B (SRB) assays. Cell morphology and cytogenetic alterations were studied microscopically. Results: MTT and SRB assays revealed similar results within both approaches. Cell culture exposed to sealers through incubation in real-time revealed a cytotoxic effect of AH Plus at 100 mg/mL. Material- conditioned media study revealed a cytotoxic effect of Bio MTA+ and Bio C, increasing with higher compound concentration and reaching 50% with 100 mg/mL. Regarding the cell’s morphology, Bio C sealer revealed a decrease in cell confluence and several morphological changes. AH Plus and Bio MTA+ did not seem to affect the cell confluence however morphology alterations were observed. In the cytogenetic study, a severe decrease of the mitotic index and a large number of chromosomal aberrations were observed. The present study represents an advance in the understanding of the biocompatibility of AH Plus, Bio MTA+, and Bio C sealers. These sealers demonstrated some cytotoxicity, depending on the concentration used. Although more validation studies are still needed, this study brings very relevant results in terms of cytotoxicity, cell morphology, and cytogenetic alterations. Conclusions: These results could help in the selection of the most appropriate compounds to be used in clinical practice as well as to determine the maximum recommended amounts of each sealer. Clinical Relevance: This study highlights the potential cytotoxic effects of three commonly used root canal sealers on human gingival fibroblasts, with varying degrees of impact depending on the concentration used. The results emphasize the importance of careful consideration when selecting and applying these materials in clinical practice.
- P32 - Endodontic treatment of a geminated canine - case reportPublication . Cardoso, Miguel; Duarte, Mariana; SottoMayor, Diana; Siqueira, Giovana; Noites, RitaBackground Dental gemination is a designation used to identify a disturbance occurred during odontogenesis that causes changes in the shape of the tooth. It is recognized as a failed attempt by a single tooth germ to divide by invagination, resulting in a single wide tooth with a bifd crown. It is a rare condition that occurs with greater prevalence in the primary dentition and afects mostly incisor teeth. Its etiology is not clearly understood, although there is evidence that it may be related to genetic factors, trauma and with some syndromes. Despite being generally asymptomatic, it can manifest clinical alterations like malocclusion, impaction of adjacent teeth and even greater susceptibility to caries and periodontal destruction. Case report A 22-year-old female patient with Fahr’s Syndrome was referred to the endodontic appointment at the Clinica Dentária Universitária of Universidade Católica Portuguesa in Viseu, presenting tooth 23 with symptoms compatible with a state of irreversible pulpitis. Periapical radiographs and CBCT confrmed the diagnosis of geminated tooth with irreversible pulpitis. Endodontic treatment was performed using an operative microscope. The preparation was performed with ProTaperTM Gold F5 using 2.5% sodium hypochlorite irrigation. In the obturation, two techniques were used, continuous wave compaction in the apical third and gutta-percha injection with vertical compaction in the remain canal. The crown was restored with a direct composite. After six months, the tooth maintained the function and there was no symptomatology. The radiograph was normal, predicting a good evolution. Informed consent was obtained for publication. Conclusion Dental gemination is an anomaly diagnosed through clinical and radiological criteria. A careful clinical and radiographic examination, as well as the use of an operative microscope, increases the probability of success and improves the prognosis of endodontic treatment. The recognition and adequate treatment of this anomaly allowed to restore the patient’s function and aesthetics.
- P7 - Evaluation of extruded material in furcation perforation repair with micro-computed tomographyPublication . Cardoso, Miguel; Noites, Rita; Correlo, Vitor; Viegas, CarlosBackground Furcation perforations are pathological conditions of complex treatment and, currently, bioceramics are good options for furcation perforations repair. The aim of this study was to compare the volume of extruded material with micro-computed tomographic (microCT) after Furcation Perforation (FP) repair with Biodentine (BDT) or ProRoot MTA (prMTA) in dogs’ teeth. Materials and methods Forty dogs’ teeth were divided into 2 groups: prMTA (n=20, FP repaired with ProRoot MTA), BDT (n=20, FP repaired with Biodentine). All animal procedures were approved by the institutional Ethical Committee and conformed with the ethical guidelines and regulations of the national Directorate-General for Food and Veterinary (Process number 0421/000/000/2014). The animals were euthanized after 4 months. The volume of extruded material was quantifed using microCT images. Statistical analysis was performed using independent-samples t-test in SPSS™. All diferences were considered signifcant at P≤0.05. Results Total volume of extruded material was signifcantly lower in BDT group than in prMTA group (BDT: 1.42±0.80mm3; prMTA: 2.27±1.67mm3; P=0.049). In both test material groups, microCT showed continuity between the extruded repair material and the surrounding bone. Along with the study’s included outcomes, further evaluation of microCT images allowed the identifcation of new mineralized tissue bridges over the remaining radicular pulp tissue in specimens of both test groups. Conclusions The greater amount of extruded material found for prMTA group is consistent with its lengthier setting time, which may contribute to the unintended compaction of the unset material into the furcation defect. Even though Biodentine presented lesser extrusion, a concomitant histologic study revealed similar results concerning mineralized tissue formation.
- P9 - Antimicrobial properties and bioactivity potential of smart nanoparticles for dental applicationsPublication . Correia, Bruna L.; Malekshiri, Moslem; Bartolomeu, Maria; Silva, Virgília; Oliveira, Ana; Noites, Rita; Cardoso, Miguel; Mendes, Karina; Gomes, Ana T. P. C.; Duarte, Ana SofiaTooth decay is one of the greatest causes of tooth loss in the world. This not only afects the patient’s quality of life but also carries an economic burden associated with the need for multiple reinterventions. Endodontic treatment aims to preserve teeth by cleaning, disinfecting and flling/sealing the root canal. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases. Several new biomaterials for dentistry have been developed, however their bioactivity is often misunderstood. Our work focuses on the biological characterization of novel bioactive glass nanoparticles, including the evaluation of their antimicrobial and biocompatibility properties. Candida albicans (ATCC 11225) and Enterococcus faecalis (ATCC 29212) were included to evaluate the antimicrobial potential by the drop plate method [1]. The cytotoxicity was tested using the MC3T3-E1 cell line, through the resazurin reduction assay. The novel bioactive glass nanoparticles demonstrated antimicrobial activity against C. albicans and E. faecalis, being able to inhibit their growth but also, in some incubation times, decreased the survival of these microorganisms. After 24 h of incubation of MC3T3-E1 osteoblast cells with bioactive glass nanoparticles conditioned medium, around 48% cell viability was achieved. These novel bioactive glass nanoparticles have shown promising properties which may fnd applications on diferent areas of clinical dentistry.