Bone Tissue Response to a Methacrylate-Based Endodontic Sealer: A Histological and Histometric Study

doi:10.1097/01.don.0000145431.59950.64

Journal of Endodontics

Volume 31, Issue 6, June 2005, Pages 457-459

https://doi.org/10.1097/01.don.0000145431.59950.64 Get rights and content

Abstract

Biocompatibility of endodontic sealers is a prime requisite for successful endodontic therapy. The purpose of this study was to evaluate the reaction of bone to a methacrylate-based endodontic sealer. Silicone tubes, filled with a methacrylate-based sealer and silicone rods used as controls, were implanted in the tibias of white male Wistar rats. Ten and 60 days after implantation the reaction of the bone was analyzed by means of histological and histometric methods. After 10 days the amount of reactionary bone in contact with the methacrylate-based sealer was significantly lower than that observed for the controls (p < 0.05). Cell counts demonstrated that the number of inflammatory cells that were in contact with the sealer were significantly higher (p < 0.05). After 60 days, no significant differences were observed in the amount of reactionary bone that was in contact with either material. The initial inflammatory reaction observed for the methacrylate-based sealer was resolved. Furthermore the cell counts demonstrated no statistically significant differences (p > 0.05) between the methacrylate based sealer and control.

Section snippets

Materials and Methods

After autoclaving, silicone tubes closed at one end (Raholin SRL, V. Madero, Buenos Aires, Argentina) and measuring 1 mm long with an outer diameter of 1 mm and a lumen of 0.5 mm, were filled flush with freshly mixed ER. The ER was handled aseptically and mixed according to the manufacturer’s instructions. Twenty (²⁰) white male Wistar rats weighing approximately 100 g each had one sample of the experimental material implanted in the right tibia. A solid silicone rod of the same length and

Results

At the end of the 10 and 60-day observation periods wound healing was clinically satisfactory for all cases and all implants remained in situ. The mean values of the BDF measurements are listed in Table 1. The results of an ANOVA for BDF demonstrated a statistically significant difference between experimental and control material at the 10-day period of observation. The amount of reactionary bone formation in direct contact with ER (Fig. 1B) was significantly less (p < 0.05) than what was

Discussion

Based on previous findings (⁹) the intraosseous implantation of endodontic filling materials in rat tibias provides a suitable model to evaluate biocompatibility of materials (9, 10). The analysis of BDF constitutes a sensitive indicator of bone damage under different experimental conditions (9, 11). The implantation periods used in this study, a short and long-term time interval, are according to the recommended standard practices for biological evaluation of dental materials (¹²). The fact

Acknowledgments

The authors thank Professor R. Macchi for the statistical analysis of the data and to D. Gimenes and P. Villavicencio for their valuable collaboration and technical assistance.

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The purpose of this study was to evaluate the subcutaneous connective tissue reaction in rats to a mineral trioxide aggregate (MTA)-based endodontic sealer Fillapex (Angelus, Londrina, PR, Brazil) and compare it with Grossman sealer (Farmadental, Buenos Aires, Argentina).
Sterile medical-grade silicone tubes containing the test materials were implanted in 24 Wistar rats. After 10, 30, and 90 days, the animals (n = 8 per period) were euthanized, and the implants along with their surrounding tissues were dissected, fixed, and processed for histologic evaluation. A 4-category evaluation system was used to evaluate the microscopic observations. The tissue response on the lateral walls of the silicone tubes was used as the negative control. The data were analyzed for statistical significance using the Wilcoxon signed rank, Kruskal-Wallis, and Dunn tests.
Fillapex showed a severe tissue reaction for all 3 observation periods. Grossman sealer showed similar features after 10 and 30 days, but the reaction decreased slightly after 90 days. In contrast, the negative controls did not show adverse reactions in any sample of the 3 time periods. After 10 and 30 days, no statistically significant differences were found between Fillapex and Grossman sealer (P > .05); however, the difference was significant after 90 days (P < .05). For all experimental periods, there were statistically significant differences between both Fillapex and Grossman sealer and the negative controls (P < .05).
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On extrusion, endodontic sealers might come into close contact with the periapical tissues for long periods. The objective of this study was to test possible mutagenicity of resin-based endodontic sealers by evaluating their potential to induce DNA double-strand breaks (DSBs).
Human gingival fibroblasts were exposed to subtoxic concentrations of eluates from 1 epoxy resin–based endodontic sealer (AH Plus Jet) and 2 methacrylate-based endodontic sealers (EndoRez and Real Seal). As control, Calcicur, a Ca(OH)₂-based sealer, was used. The γ-H2AX immunofluorescence assay was used to microscopically detect DNA DSBs, and a custom algorithm was developed to quantify them.
The cytotoxicity of the 24-hour eluates could be ranked in the following order: AH Plus Jet > Real Seal > EndoRez >> Calcicur. The γ-H2AX assay revealed that 1.3%–4.3% of the cell nucleus was occupied by foci when the cells were exposed to the eluates of the endodontic sealers. This was not significantly different from the negative control group in which the cells had been exposed to medium (2.1%).
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Recent studies linked to the production of implants focus on the development of porous materials, as they provide good biological fixation to the surrounding tissue through bone tissue ingrowth into the porous network.
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In the present study, Zr–Ti–Nb foams of two compositions (Zr–34.4%Ti–1.6%Nb and Zr–34.5%Ti–5.5%Nb) were fabricated starting from hydride–dehydride powdered metal using space-holding fillers. Both foams displayed an interconnected porous structure with a porosity of 70%. The average pore size was around 260 μm. The Young's modulus and the compressive plateau stress were observed to vary with the Nb content in the range of 0.3–1.4 GPa and 11–32 MPa, respectively. All alloys tested – in porous and solid forms – showed excellent biocompatibility in subcutaneous as well as in bone tissues. The alloy with more Nb content showed pronounced osteoinductive properties.
Subcutaneous connective tissue reaction to methacrylate resin-based and zinc oxide and eugenol sealers
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Citation Excerpt :
PCS was used as the positive control because its toxicity has been previously determined by in vitro (20, 21) and in vivo experiments (22, 23). SIRODs were used as the negative control because they have been proven to be biocompatible (5, 6, 24, 25), a finding that was confirmed in this study. The initial inflammatory reaction of SIRODs may be a consequence of the surgical trauma.
An evaluation was made of the connective tissue reaction in rats after subcutaneous implantation of methacrylate resin-based sealers (EndoREZ [Ultradent Products, Inc, South Jordan, UT] with a polymerization accelerator and RealSeal [Sybron Dental Specialties, Orange, CA]) and Pulp Canal Sealer (Sybron Dental Specialties), a zinc oxide and eugenol-based sealer used as the control.
Silicone tubes containing the test materials were implanted in 24 Wistar rats. Solid silicone rods of the same size served as the negative controls. After 10, 30, and 90 days, the animals (n = 8 per period) were euthanized and the implants with surrounding tissues dissected and processed for routine histological evaluation. A four-category evaluation system was used to measure and record the microscopic observations according to the thickness of a fibrous capsule, the vascular changes, and the various types of inflammatory cells.
Initially, a severe inflammatory reaction was observed of the soft tissues in direct contact with both EndoREZ/Accelerator and Real Seal. The severity decreased over time and was resolved at the end of the experiment. Pulp Canal Sealer showed a severe tissue reaction for all observation periods. The negative controls showed an initial mild to moderate inflammatory reaction. After 30 days, healthy fibrous connective tissue was observed, which increased over time. After 10 days, no statistically significant differences between the experimental groups were observed. After 90 days, EndoREZ and RealSeal were statistically significantly less toxic than Pulp Canal Sealer (p > 0.05).
After 90 days, both methacrylate resin-based sealers were considered biologically acceptable when implanted in subcutaneous connective tissues of the rat. Pulp Canal Sealer remained toxic for the duration of the study.
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This study evaluated the response of periapical tissues to the endodontic sealer EndoREZ in root canal fillings short of or beyond the apical foramenlike communication. Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to create an apical foramenlike communication, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramenlike opening by the lateral condensation of gutta-percha and EndoREZ, originating 2 experimental groups: G1, EndoREZ/short of the apical foramenlike opening, and G2, EndoREZ/beyond the apical foramenlike opening. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown and Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramenlike communication and apical opening of accessory canals, apical cementum resorptions, intensity of the inflammatory infiltrate, presence of giant cells, and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (P = .05). Comparing the 2 groups, the best result (P = .05) was obtained with root canal filling with EndoREZ short of the apical foramenlike opening. In conclusion, limiting the filling material to the root canal space apically was important to determine the best treatment outcome when EndoREZ was used as the sealer.
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Citation Excerpt :
The severity of the reaction decreased over time. Zmener and colleagues30 conducted a histologic and histometric study in which silicone tubes filled with EndoREZ were implanted in the tibias of rats for a period of 10 days and 60 days. At the 10-day observation period, the number of inflammatory cells in contact with the sealer was significantly higher.

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Basic Research-TechnologyBone Tissue Response to a Methacrylate-Based Endodontic Sealer: A Histological and Histometric Study

Abstract

Section snippets

Materials and Methods

Results

Discussion

Acknowledgments

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

J Endod

Opinions and practices of American Endodontic Diplomates

Dent J

Basic Research-Technology
Bone Tissue Response to a Methacrylate-Based Endodontic Sealer: A Histological and Histometric Study