Elsevier

Journal of Endodontics

Volume 41, Issue 10, October 2015, Pages 1619-1625
Journal of Endodontics

Basic Research
Histologic Analysis of the Influence of a Gelatin-based Scaffold in the Repair of Immature Dog Teeth Subjected to Regenerative Endodontic Treatment

https://doi.org/10.1016/j.joen.2015.01.033Get rights and content

Highlights

  • We compared the use of a blood clot with versus without Gelfoam for tissue repair.

  • Gelfoam increased the formation of cementumlike mineralized tissue.

  • Gelfoam enhanced the formation of connective tissue inside the canal.

  • Apical root development and inflammatory reaction were similar.

Abstract

Introduction

Regenerative endodontic treatment is a new and promising approach to manage immature teeth with necrotic pulps and apical periodontitis. The use of scaffolds is essential to treatment success, but many materials are difficult to acquire and have a high cost. This study assessed tissue repair in immature dog teeth with necrotic pulps and apical periodontitis after using a gelatin-based scaffold (Gelfoam; Pharmacia & Upjohn Co, Kalamazoo, MI).

Methods

Apical periodontitis was induced in 20 immature dog teeth. After disinfection with triple antibiotic paste for 2 weeks, canals were irrigated, dried, and filled with a blood clot alone (10 teeth) or combined with Gelfoam (10 teeth). Another 10 teeth were used as negative controls (no intervention). After 7 months, the dogs were euthanized. Histologic sections were stained with hematoxylin-eosin and analyzed in relation to tissue repair. Categoric data were analyzed using the Fisher exact test (P < .05), numeric data (histomorphometric analysis), and the Mann-Whitney U test.

Results

Histologic analysis revealed a higher percentage of roots with new cementumlike mineralized tissue and connective tissue inside the canal in the blood clot + Gelfoam group (P < .001). Histomorphometric analysis showed a higher area of mineralized tissue in the same group (P = .029). Apical extension of root and inflammation were similar between the experimental groups. The new tissue formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively.

Conclusions

The use of a gelatin-based scaffold (Gelfoam) combined with a blood clot improved repair in immature dog teeth with apical periodontitis subjected to regenerative endodontic treatment.

Section snippets

Methods

The research project was approved by the Animal Ethics Screening Committee of the Federal University of Santa Catarina (Florianópolis, Santa Catarina, Brazil). The second, third, and fourth mandibular premolars and the second and third maxillary premolars (n = 60 roots) of 3 beagle dogs aged 5–6 months were used.

Animals received preanesthesia with 0.5 mg/kg acepromazine hydrochloride (Ouro Fino, Cravinhos, SP, Brazil) and 4 mg/kg pethidine (Cristália, São Paulo, SP, Brazil) via intramuscular

Results

Intra- and interexaminer agreement yielded kappa = 1 for all parameters except inflammatory reaction, for which scores were 0.89 and 0.87, respectively.

At the end of the experiment, 3 teeth were lost in the blood clot group: 1 because of severe destruction of supporting tissues; 1 during histologic processing; and 1 because the MTA plug moved apically, preventing the assessment of the parameters under investigation. One tooth from the blood clot + Gelfoam group was also lost because of a

Discussion

Some previous studies have shown the usefulness and advantages associated with the use of scaffolds in regenerative endodontic procedures 24, 26. Scaffolds provide a structure and an initial support onto which cells can adhere, proliferate, differentiate, and form an extracellular matrix (27).

In the quest for ideal scaffolds, several materials have been tested 9, 25, 26, 28. However, most of them are difficult to acquire and have a high cost (24). The need to find a material that meets all the

Acknowledgments

The authors deny any conflicts of interest related to this study.

References (40)

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