Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis.
OBJECTIVE
The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs' teeth with apical periodontitis.


METHODS
Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn's tests (alpha = 0.05).


RESULTS
Although statistically significant difference was found only for the inflammatory infiltrate (P < .05), Group 1 presented more exuberant mineralized formations, more structured apical and periapical connective tissue, and a more advanced repair process than Group 2.


CONCLUSIONS
From the histological observations, sodium hypochlorite irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary.
da Silva
Lea Assed Bezerra
LA
Department of Paediatric Dentistry, Preventive and Community Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. lea@forp.usp.br
Nelson-Filho
Paulo
P
da Silva
Raquel Assed Bezerra
RA
Flores
Daniel Silva Herzog
DS
Heilborn
Carlos
C
Johnson
James D
JD
Cohenca
Nestor
N
D016301:Alveolar Bone Loss / Q000473:pathology; D000539:Alveolar Process / Q000473:pathology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D003238:Connective Tissue / Q000473:pathology; D003786:Dental Pulp Cavity / Q000473:pathology; D003804:Dentin / Q000473:pathology; D003809:Dentin, Secondary / Q000473:pathology; D004285:Dogs; D004338:Drug Combinations; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008911:Minocycline / Q000008:administration & dosage / Q000627:therapeutic use; D018919:Neovascularization, Physiologic / Q000502:physiology*; D010485:Periapical Periodontitis / Q000628:therapy*; D010486:Periapical Tissue / Q000098:blood supply*; D010513:Periodontal Ligament / Q000473:pathology; D011312:Pressure; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D012388:Root Canal Irrigants / Q000008:administration & dosage / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000379:methods*; D012391:Root Resorption / Q000473:pathology; D012973:Sodium Hypochlorite / Q000008:administration & dosage / Q000627:therapeutic use; D007507:Therapeutic Irrigation / Q000379:methods; D019227:Tooth Apex / Q000473:pathology; D014945:Wound Healing / Q000502:physiology
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D008795:Metronidazole; D002939:Ciprofloxacin; D012973:Sodium Hypochlorite; D008911:Minocycline