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Introduction In this study, we examined the effect of mineral trioxide aggregate (MTA) on macrophage polarization and the potential involvement of Axl/nuclear factor kappa B (NF-κB) signaling in mediating the effect of MTA. Methods The human monocyte cell line THP-1 was cultured with MTA solution for 1, 2, or 3 days, and the population change of M2 macrophages was analyzed by flow cytometry. Expression of M2 cytokines was examined by enzyme-linked immunosorbent assay. Phagocytosis and angiogenesis-induction ability were also assayed. The involvement of Axl/NF-κB signaling in MTA-treated cells was examined by analyzing phosphorylation status of Axl, Akt, IKKα/β, and IκBα. Specific inhibitors for Axl/Akt/NF-κB signaling were added to MTA-treated THP-1 cells, and their cytokine expression change was examined. Results Flow cytometry analysis showed that MTA treatment increased CD206＋ cells in a time-dependent way. After MTA treatment, the expression of M2-related cytokines was up-regulated. MTA also enhanced phagocytic ability and the ability of THP-1 cells to induce angiogenesis. Treatment of MTA led to activate Axl/Akt/NF-kB signal axis by phosphorylation of Axl, Akt, IKKα/β, IκBα, and p65. In addition, MTA-induced interleukin 10, transforming growth factor beta, and vascular endothelial growth factor expression was suppressed as specific inhibitors were added. Conclusions Our findings indicate that MTA is able to induce macrophage polarization toward the M2 phenotype, with up-regulation of interleukin 10, transforming growth factor beta, and vascular endothelial growth factor, and that Axl/Akt/NF-κB signaling participates in this process. These results provide the cellular and molecular basis of MTA's anti-inflammatory action in clinical applications.

Background/purpose Condensing osteitis (CO) is a common lesion of the jaw bone. This study surveyed the occurrence of mandible CO and its distribution in the mandible in a Taiwanese population. Materials and methods Panoramic radiographs and clinical information of 1098 patients at the Dental Department of Tri-Service General Hospital (Taipei, Taiwan) were collected. The patient data were analyzed to determine the CO disease status, patient age distribution, sex, CO location in the mandible, and the status of the affected tooth. Results Seventy-five CO lesions were identified in 63 patients. The prevalence of CO in the mandible was 5.7%. Eight (10.7%) CO cases were associated with teeth that had crowns and/or bridges, 16 (21.3%) CO cases were associated with teeth that had caries or restorations; 22 (29.3%) CO cases were associated with teeth that had received root canal therapy, nine (12%) CO cases were associated with teeth with periodontal diseases, and 20 (26.7%) CO cases were located in the tooth extraction area. The percentage of females and males was 65.3% and 34.7%, respectively. Ten (13.3%) CO cases and 65 (86.7%) CO cases were identified in the premolar and molar area, respectively. The most common site of CO was in the first molar region. Conclusion In our study population, the CO lesion occurs more commonly in female patients who were in their 60s. The mandibular 1 st molar and teeth that had received root canal therapy had the highest association with CO. The CO distribution, as determined from this study, can provide valuable information for future clinical references.