In Vivo Comparative Evaluation of Periapical Healing in Response to a Calcium Silicate and Calcium Hydroxide Based Endodontic Sealers

Abstract

Background: The composition of the root canal filling materials together with the apical limit of the root canal obturation affect the complete periapical healing after root canal therapy.

Aim: This study was performed to evaluate and compare the periapical healing in response to calcium-silicate (iRoot SP) and calcium-hydroxide (Apexit) based-sealers.

Material and methods: Seventy-two upper premolars root canals of six dogs were used. The teeth were randomly assigned to four groups: Group one: roots were obturated using gutta-percha and Apexit-sealer; Group two: roots were obturated using gutta-percha&iRoot SP-sealer; Group three: the teeth were left open without obturation; Group four: where healthy teeth were used as a negative control. Teeth were evaluated after one, two and three months. The newly formed mineralised apical tissue and the periapical inflammatory infiltrate of the obtained photomicrographs were evaluated, and scorings were statistically-analysed.

Results: The mean percentage of the periapical inflammatory infiltrates and mineralisation scoring after one, two and three months evaluation period were not significantly different among the four groups (P > 0.05).

Conclusions: Regardless of the sealer used, iRoot SP and Apexit promote healing of periapical tissues. IRoot SP sealer showed early insignificant more partial and almost full healing after two and three months.

Keywords: Bioceramic sealer; Calcium hydroxide; Root canal sealer.

Figure 1

Photomicrograph of representative HE-stained microscopic sections in specimen filled with iRoot SP sealer after: (A) one month, showing healing with connective tissue (C.T.) with no signs of bone formation (x100); (B) two months showing bone formation appeared as scattered osteocytes (arrows) (x100) and (C) three months, showing new bone formation foci with no signs of inflammation (x200)

Figure 2

Photomicrograph of representative HE-stained microscopic sections in specimen filled with Apexit sealer after: (A) one month showing moderate inflammatory areas (thin arrows), moderate angiogenesis (thick arrows) with some calcified foci (* ) (x100 ); (B) two months showing new blood vessels formation with mild mineralization and mild inflammation (*) (x100) and (C) three months showing the root tip (*) with periodontal ligament regeneration (thin arrow ) new bone formation (thick arrow ) (x100)