Biocompatibility assessment of different root-end filling materials implanted subcutaneously in rats: An in vivo study

Abstract

BACKGROUND: Root-end filling materials are used in surgical endodontic treatment to seal the teeth periapically. Ideally, these materials should prevent bacterial leakage by tightly sealing the canal, be biocompatible with the periapical tissues, and preferably stimulate the regeneration of dentin, contributing to the success of treatment. OBJECTIVES: The purpose of this study was to evaluate and compare the biocompatibility of the GuttaFlow® Bioseal cement in relation to MTA Angelus® and Zical® after implantation into the subcutaneous tissue of rats. MATERIAL AND METHODS: Eighteen male albino rats were used in the study. Four polyethylene tubes were implanted in the backs of the rats (3 tubes containing the test materials and 1 empty tube as a control). Nine animals were sacrificed at each interval of 7 and 30 days, and the implants were removed with the surrounding tissue. The samples were evaluated for stromal inflammatory response, fibrous tissue formation, vascular reactivity, and the presence of multinucleated giant cells (MNGCs). RESULTS: On day 7, the capsules in all subgroups revealed moderate to severe inflammatory reactions with the presence of inflammatory cells, multiple irregular collagen fibers, dilated blood vessels, and MNGCs. However, on day 30, tissue organization was more evident with a reduction in the inflammatory response. In this time interval, the tissue in contact with GuttaFlow Bioseal showed progressive healing with a wellformed fibrous capsule. Conversely, the tissue close to MTA Angelus revealed a fibrous capsule of limited organization with mild pericapsular fibrosis and vascular congestion. Zical showed a mild to moderate persistent inflammatory reaction and vascular reactivity. CONCLUSIONS: The 3 cements demonstrated more severe irritation at the beginning that became milder with time. GuttaFlow Bioseal yielded better tissue organization than MTA Angelus and Zical. Thus, these findings strongly suggest that GuttaFlow Bioseal is a promising material for root-end filling.