Physical Properties, Antimicrobial Activity and In Vivo Tissue Response to Apexit Plus

Abstract

We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against Enterococcus faecalis was performed. Polyethylene tubes containing Apexit Plus or Sealapex, and without material (control group) were implanted into the subcutaneous tissue of rats. At 7, 15, 30, and 60 days of implantation, the specimens were paraffin-embedded and the number of inflammatory cells (ICs) and the amount of birefringent collagen (BC) were quantified. The von Kossa reaction followed by immunohistochemistry for detection of alkaline phosphatase (ALP) was also performed. Statistical analysis was performed with ANOVA and Tukey test (p ≤ 0.05). The flow value of Apexit Plus was greater than Sealapex, whereas the radiopacity (3.44 mm Al) was lower than Sealapex (6.82 mm Al). Apexit Plus showed lower solubility and shorter initial and final setting (p < 0.0001), whereas the antimicrobial activity was significantly greater than Sealapex. Although the number of ICs was higher in Apexit Plus (p = 0.0009) at 7 days, no significant difference was detected between Apexit Plus and Sealapex at 15, 30, and 60 days. All groups showed higher values for BC in the capsules over time. ALP-immunolabelled cells were observed, mainly around von Kossa-positive structures, either in the capsules of Apexit Plus or Sealapex. Therefore, our results revealed that Apexit Plus exhibited a greater effectiveness against Enterococcus faecalis and better physical properties than Sealapex, except for the radiopacity. In vivo findings indicate that Apexit Plus is biocompatible and presents potential bioactivity in the subcutaneous tissue.

Biocompatibility and bioactive potential of the NeoMTA Plus endodontic bioceramic-based sealer

“…From the first 3 hours until day 7, the pH varied from 11.2 to 10.8 in a solution containing NeoMTA Plus [ 5 ] and from 9.5 to 9.2 in a solution with MTA Fillapex [ 10 ]. Despite its antimicrobial effect, as is expected in root canal sealers [ 23 26 ], the alkaline pH induces IC recruitment and the release of proinflammatory cytokines, leading to an inflammatory reaction [ 11 18 23 ]. However, the release of substances from sealers may also have a deleterious effect on connective tissue components (cellular and extracellular matrix) activating the immune and inflammatory systems [ 17 19 20 ].…”

“…The hue definition considered in the birefringence was as follows: red/orange, 2–38 and 230–256; yellow, 39–51; and green, 52–128. The amount of collagen was represented by the percentage of birefringent areas of the total area (expressed in pixels) calculated by ImageJ ® analysis software [ 21 22 23 ].…”

“…Two non-serial sections were analyzed using the von Kossa histochemical reaction and the sections were subsequently counterstained with picrosirius red according to a previously described protocol [ 18 20 23 ]. Unstained sections were also analyzed under polarized illumination to investigate the presence of structures exhibiting birefringence in the capsules [ 23 24 25 ].…”

Identification of Phenolic Compounds and Determination of Antioxidant Activity in Extracts and Infusions of Salvia Leaves

“…These tests allow to classify the means to groups that differ significantly. One of the most recommended is the Tukey’s HSD test [ 21 , 22 , 23 , 24 ].…”

“…In this paper, the Tukey’s HSD (honestly significant difference) test for unequal sample size (used in many publications) was used as a post-hoc test [ 21 , 22 , 23 , 24 ].…”