Selenium intracanal dressing: effects on the periapical immune response

Area of Science:

• Endodontics
• Microbiology
• Immunology

Background:

• Root canal dressing is crucial for preventing microbial recolonization during multi-session endodontic treatment.
• Selenium (Se) plays a vital role in immune response and has diverse medical applications.
• Calcium hydroxide (C.H.) is a globally used root canal dressing.

Purpose of the Study:

• To evaluate selenium (Se) behavior as an endodontic dressing in teeth with pulp necrosis.
• To compare the effects of Se, C.H., and a combination of C.H. + Se.
• To assess the impact of these dressings on microbial load and periapical immune response.

Main Methods:

• Sixty patients undergoing endodontic treatment were divided into four groups: empty, Se, C.H., and C.H. + Se.
• Microbial samples were collected from the root canal system (RCS) before and after cleaning and shaping.
• Immune response was evaluated by quantifying cytokine gene expression (16S rRNA, IFN-γ, TNF-α, IL-10) in periapical tissues using real-time PCR.

Main Results:

• Endodontic dressings significantly reduced microbial load compared to the empty group (p < 0.05).
• The C.H. group showed increased gene expression of TNF-α and IL-10 compared to other groups (p < 0.05).
• IFN-γ mRNA expression decreased in groups treated with Se, C.H., and C.H. + Se.

Conclusions:

• Intracanal medication is essential to prevent microbial recolonization in multi-session endodontic therapy.
• Selenium potentiates calcium hydroxide, inducing an anti-inflammatory response in periapical tissues.
• Incorporation of Se as an intracanal medication may enhance periapical tissue repair.