Effect of Intracanal Corticosteroids on Healing of Replanted Dog Teeth after Extended Dry Times

Abstract

This study investigated the effect of potent intracanal corticosteroids on periodontal healing of replanted avulsed teeth and evaluated the systemic absorption of these corticosteroids. Sixty-seven extracted dog premolar roots were randomly assigned to one of the following groups: groups 1-3 filled with gutta-percha and replanted immediately and after 40 and 60 minutes, respectively; groups 4 and 5 filled with 0.05% clobetasol; and groups 6 and 7 filled with 0.05 % fluocinonide. Groups 4 and 6 were replanted after 40 minutes and groups 5 and 7 after 60 minutes. After 4 months, roots were evaluated histologically for signs of periodontal healing. Roots treated with clobetasol and fluocinonide healed more favorably than roots filled with gutta-percha and were different from each other at 60 minutes. No change in the systemic corticosteroid blood concentration was observed in any group. Corticosteroids were efficacious in the beagle model as intracanal medicaments for promoting favorable postavulsion periodontal healing.

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

“…Endodontic considerations (62,(84)(85)(86)(87)(88)(89)(90)(91)(92)(93) If root canal treatment is indicated (teeth with closed apex), the ideal time to begin treatment is 7-10 days postreplantation. Calcium hydroxide is recommended as an intra-canal medication for up to 1 month followed by root canal filling with an acceptable material.…”

Effect of Fluocinolone Acetonide on Human Dental Pulp Cells: Cytotoxicity, Proliferation, and Extracellular Matrix Formation

“…The concentrations of fluocinolone acetonide in this study were in the physiologic range (0.0001-10 mg/mL), which should minimize those adverse effects (26). The previous studies revealed that corticosteroids are not absorbed systemically when they are applied intrapulpally (27,28). The risk of microbial proliferation has also been questioned (25,29,30).…”

Intracanal dressing and root canal filling materials in tooth replantation: a literature review

“…Several substances have been used as intracanal dressings, namely CH paste associated with hydrosoluble and non-hydrosoluble vehicles (9, 12, 14, 20-22, 25, 27-30, 32), antibiotics (24), corticosteroids (34), combinations of corticosteroids and antibiotics (15,19,23,26,31,33), and inhibitors of osteoclastic bone resorption such as calcitonin (35)(36)(37)(38), gallium nitrate, acetazolamide, and alendronate (16)(17)(18). Several substances have been used as intracanal dressings, namely CH paste associated with hydrosoluble and non-hydrosoluble vehicles (9, 12, 14, 20-22, 25, 27-30, 32), antibiotics (24), corticosteroids (34), combinations of corticosteroids and antibiotics (15,19,23,26,31,33), and inhibitors of osteoclastic bone resorption such as calcitonin (35)(36)(37)(38), gallium nitrate, acetazolamide, and alendronate (16)(17)(18).…”

“…Gutta-percha is the most frequently used root canal filling material (9,28,36,(39)(40)(41)(42)(43) in combination with zinc oxide and eugenol-based sealers (21,22,34,44,45) and CH-based sealers, such as Sealapex (37,38,46). The use of mineral trioxide aggregate (MTA) has also been investigated in immediate tooth replantation (47).…”