Healing of Apical Lesions: How Do They Heal, Why Does the Healing Take So Long, and Why Do Some Lesions Fail to Heal?

Metzger, Zvi; Kfir, Anda

doi:10.1002/9781118914014.ch15

Cited by 2 publications

(1 citation statement)

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“…These host‐derived molecules in turn activate the osteoclasts and initiate bone resorption (Metzger 2000). It has been suggested that the diminishment of osteoclast activity can enhance osteogenic potential in the healing of bone defects (Metzger & Kfir 2014). The inhibition of osteoclasts coupled with the decreased number of macrophages in periapical lesions after S‐PRG and Ca(OH) 2 treatment implied the reduction in bone‐resorbing substances, which subsequently inhibited the extensive resorption of the surrounding bone.…”

Section: Discussionmentioning

confidence: 99%

The potential of a surface pre‐reacted glass root canal dressing for treating apical periodontitis in rats

et al. 2020

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AimTo evaluate the efficacy of a prototype root canal dressing containing surface pre‐reacted glass–ionomer (S‐PRG) fillers on repairing induced periapical lesions in a rat model. Calcium hydroxide [Ca(OH)2] was applied as a comparison in the healing process.MethodologyThe pulp chambers of the maxillary first molars in 64 male Wistar rats aged 16 weeks were opened to induce periapical lesions. After 28 days, the mesial canal of each tooth was prepared, irrigated with 2.5% sodium hypochlorite only (control group: irrigation) or followed by the respective dressing [Ca(OH)2 group, irrigation + Ca(OH)2; S‐PRG group, irrigation + S‐PRG] and restored with composite resin for 3 or 7 days (10/group). Four rats with healthy molars were used as blank controls. Descriptive analysis of the periapical radiographs, haematoxylin and eosin staining and immunohistochemical observation was performed 3 and 7 days after treatment. The periapical grey value, CD68 macrophages and osteoclasts (cathepsin‐K) were quantified and statistically analysed with Tukey’s honest significant difference test. A significant difference was achieved when P values were <0.05.ResultsS‐PRG and Ca(OH)2 dressings were associated with increased periapical grey values and inhibited osteoclast activity at 3 and 7 days; a significant difference in radiographic results and the number of osteoclasts was obtained at 3 and 7 days compared with the control group (P < 0.05). Reparative tissue was observed histologically in the space of the periapical resorbed necrotic area after S‐PRG and Ca(OH)2 treatment for 3 and 7 days. The number of macrophages was significantly decreased at 3 and 7 days in the S‐PRG and Ca(OH)2 specimens when compared with the controls (P < 0.05).ConclusionsIn a rat experimental model, the S‐PRG root canal dressing was comparable to Ca(OH)2 in promoting the healing of experimentally induced periapical lesions. S‐PRG paste has the potential to be used as an alternative intracanal dressing in teeth with apical periodontitis.

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Section: Discussionmentioning

confidence: 99%