Periapical tissue response to two calcium hydroxide-containing endodontic sealers

Area of Science:

• Endodontics
• Dental Materials Science
• Histology

Background:

• Root canal sealers are crucial for the success of endodontic treatment.
• Evaluating the biocompatibility and tissue response of different sealers is essential for clinical application.

Purpose of the Study:

• To histologically evaluate the periapical tissue response to three root canal sealers: Sealapex, CRCS, and zinc oxide-eugenol.
• To compare the tissue reactions associated with gutta-percha and sealer obturation using lateral condensation.

Main Methods:

• 120 dog teeth underwent root canal cleaning, shaping, and obturation with gutta-percha and one of the three sealers.
• Histological examination of periapical tissues was performed at 30 and 180 days post-procedure.

Main Results:

• Sealapex and CRCS elicited periapical tissue responses comparable to zinc oxide-eugenol.
• Inflammatory cell infiltration and connective tissue ingrowth occurred when filling materials reached apical stops.
• New hard tissue deposition led to partial apical closure, irrespective of the sealer used.
• Sealer particles were found beyond the apex in Sealapex and CRCS groups.
• Overfilling consistently induced chronic inflammatory reactions in periapical tissues.

Conclusions:

• Sealapex, CRCS, and zinc oxide-eugenol exhibit similar biocompatibility in terms of periapical tissue response.
• Overfilling of root canal sealers can lead to adverse inflammatory reactions.
• Apical hard tissue deposition and partial closure are favorable tissue responses observed regardless of sealer type.