Bone repair in defects filled with AH Plus sealer and different concentrations of MTA: a study in rat tibiae

Analysis of the cytotoxicity and bioactivity of CeraSeal, BioRoot™ and AH Plus® sealers in pre-osteoblast lineage cells

BACKGROUND

The objective of the present study was to evaluate in vitro the cytotoxicity and bioactivity of various endodontic sealers (CeraSeal, BioRoot™ and AH Plus®) in pre-osteoblast mouse cells (MC3T3 cells).

METHODS

MC3T3 cells (ATCC CRL-2594) were plated in 1 × 104 cells/well in 96-well plates in contact with endodontic sealers at concentrations of 1:10 and 1:100. Cell viability was evaluated by MTT assay after 24 and 48 h. In addition, sealer bioactivity was measured by RT-PCR for mediator of inflammation (Tnf, Ptgs2) and mineralization (Runx2, Msx1, Ssp1 and Dmp1) after 24 h and by Alizarin Red S Assay of mineralization after 28 days. Data were analyzed using one-way ANOVA followed by the Tukey's post-test at a significance level of 5%.

RESULTS

BioRoot™ presented 24-hour cytotoxicity (p < 0.05) at 1:10 concentration. In the period of 48 h, no endodontic cement was cytotoxic to the cells compared to the control (p > 0.05). TNF-α gene expression was induced by AH Plus® (p < 0.05), while Ptgs2 was induced by the CeraSeal and BioRoot™ (p < 0.05). The expression of Runx2 was stimulated by BioRoot™ and AH Plus® (p < 0.05). In contrast, the expression of Dmp-1 Dmp1 was higher for the CeraSeal and BioRoot™ (p < 0.05). Nonetheless, the sealers did not impact the formation of mineralization nodules (p > 0.05).

CONCLUSION

CeraSeal, BioRoot™ and AH Plus® sealers were not cytotoxic to MC3T3 cells within 48 h, but differentially induced the expression of genes related to inflammation and mineralization without impacting biomineralization by the cells.

A Review of the research methods and progress of biocompatibility evaluation of root canal sealers

The function of root canal sealer was to achieve an appropriate three-dimensional filling effect by filling the root canal and some irregular lumen, thereby inhibiting the residual bacteria. There were many types of sealers, but research to find the most suitable ones was still ongoing. In recent years, researchers had continuously improved the performance of sealers by developing new sealers or adding active ingredients to the sealers. However, most sealers exhibit varying degrees of cytotoxicity and tissue responses, which affect clinical therapy efficacy. This review describes different technical approaches, and recent research progress in the biocompatibility evaluation of root canal sealers and provides brief insights into this field by summarising the performance studies of different root canal sealers.

Effect of Vitapex Combined with AH-Plus Paste on Inflammation in Middle-Aged and Elderly Patients with Periodontal-Endodontic Disease

Aims. To investigate the effect of Vitapex combined with AH-plus paste on inflammation in middle-aged and elderly patients with periodontal-endodontic disease. Materials and Methods. A total of 80 teeth of middle-aged and elderly patients with the periodontal-endodontic disease who were treated in our hospital from June 2020 to June 2021 were selected as the research objects and were divided into comparison group and treatment group with 40 teeth each according to different treatment methods. Among them, the comparison group was filled with zinc oxide clove oil paste gutta-percha, and the treatment group was filled with Vitapex combined with AH-plus paste. The changes in apical cross-section sealing performance, periodontal pocket depth (PD), and gingival index (GI) of the two groups before treatment and after 6 months of follow-up were observed and compared, and X-ray analysis was performed. Results. There was no significant difference in the level of periodontal indexes and serum inflammatory indexes between the two groups before treatment ( $P>0.05$ ). After treatment, the levels of PD, BI, PLI, and GI in the two groups were significantly lower than before treatment ( $P<0.05$ ). The differences in IL-6, IL-10, TNF-α, and IL-1β after treatment were significant ( $P<0.05$ ). There was no significant difference in the root canal area data of each cross-section between the two groups when the root canal was filled with root filling paste at different positions from the apex ( $P>0.05$ ). After root canal filling with root canal paste, the cross-sectional area from different parts of the root canal in the treatment group was significantly smaller than comparison group ( $P<0.05$ ). After 6 months of treatment, it was found that CEJ-BD and CEJ-AC in the treatment group were significantly lower than those in the comparison group ( $P<0.05$ ). Conclusion. Vitapex combined with AH-plus paste filling can effectively treat middle-aged and elderly periodontal-endodontic disease, which provides a certain reference for the clinical treatment of middle-aged and elderly periodontal-endodontic disease.