Final irrigation with bioglass solution in regenerative endodontic procedure induces tissue formation inside the root canals, collagen maturation, proliferation cell and presence of osteocalcin

Abstract

AimTo evaluate the influence of an experimental solution of cobalt‐doped F18 bioactive glass (F18Co) on tissue repair following regenerative endodontic procedure (REP) in rat molars.MethodologyThe F18Co solution was prepared at a ratio of 1:5 F18Co powder to distilled water. The right or left upper first molars of 12 Wistar rats were used, where the pulps were exposed, removed, and irrigated with 2.5% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA) (5 min each). Subsequently, the molars were divided into two groups (n = 6): REP‐SS and REP‐F18Co, where they received a final irrigation (5 min) with saline solution (SS) or F18Co solution, respectively. Then, intracanal bleeding was induced, and the tooth was sealed. Untreated molars were used as controls (n = 3). At 21 days, the rats were euthanized, and the specimens were processed for analysis of mineralized tissue and soft tissue formation inside the root canal using haematoxylin‐eosin. The presence and maturation of collagen were evaluated by Masson's trichrome and picrosirius red staining. Immunolabelling analyses of proliferating cell nuclear antigen (PCNA) and osteocalcin (OCN) were performed. The data were submitted to the Mann–Whitney U‐test (p < .05).ResultsThere was a similar formation of mineralized tissue in thickness and length in REP‐SS and REP‐F18Co groups (p > .05). Regarding the presence of newly formed soft tissue, most specimens of the REP‐F18Co had tissue formation up to the cervical third of the canal, whilst the REP‐SS specimens showed formation up to the middle third (p < .05), and there was higher maturation of collagen in REP‐F18Co (p < .05). The number of PCNA‐positive cells found in the apical third of the root canal was significantly higher in the F18Co group, as well as the OCN immunolabelling, which was severe in most specimens of REP‐F18Co, and low in most specimens of REP‐SS.ConclusionThe final irrigation with F18Co bioactive glass solution in REP did not influence mineralized tissue formation but induced soft tissue formation inside the root canals, with higher collagen maturation, and an increase in PCNA‐positive cells and OCN immunolabelling.

Clinical significance of the main methods of root canal irrigation in endodontics: a systematic review

“…The success of endodontic treatment depends on eradicating microbes (if present) from the root canal system and preventing reinfection. The root canal is formed with manual and rotary instruments under constant irrigation to remove inflamed and necrotic tissue, microbes/biofilms, and other debris from the root space [1,2]. The main purpose of instrumentation is to facilitate effective irrigation, disinfection, and filling.…”

“…The main purpose of instrumentation is to facilitate effective irrigation, disinfection, and filling. Several studies using advanced techniques such as microcomputed tomography have demonstrated that proportionally large areas of the main root canal wall remain untouched by instruments, emphasizing the importance of chemical means to clean and disinfect all areas of the root canal [1][2][3].…”

“…In the context of endodontic treatments, endodontic therapy aims to remove debris from the pulp tissue resulting from root preparation and microorganisms from the root canals, seeking complete cleaning and antisepsis [1,2]. Irrigation is one of the most important aspects of the biomechanical preparation of the root canal, since, through this procedure, the irrigating solution can reach places where instruments cannot reach, due to the complex anatomy of the root system [1,3].…”

“…The arsenal of irrigation solutions designed for endodontic treatment and commercially available is broad. The choice of the correct solution depends on the combination of the properties of the solution associated with the effects to be obtained with irrigation, according to the clinical condition [1][2][3]. In cases where the pulp is mortified and there is an infection, irrigating solutions have the function of promoting asepsis, dissolving the necrotic tissue, and facilitating its removal, in addition to neutralizing the bacterial toxin [4][5][6].…”