title: Periapical inflammation subsequent to coronal inoculation of dog teeth root filled with resilon/epiphany in 1 or 2 treatment sessions with chlorhexidine medication.
abstract: BACKGROUND
  Therapeutic methods that inhibit microbial ingress into filled root canals are desirable. This in vivo study assessed the inhibition of periapical inflammation subsequent to coronal inoculation in canals medicated with 2% chlorhexidine gel and filled with Resilon/Epiphany (Pentron Clinical Technologies, Wallingford, CT).
  
  
  METHODS
  Six Beagle dogs each had 10 two-rooted premolars treated. In group 1 (n = 36 roots), 1 root/tooth had the canal conditioned with Primer Epiphany, filled with Epiphany sealer and Resilon core in 1 session, and coronally sealed with PhotacFil. In group 2 (n = 36 roots), the second root/tooth had the canal medicated with 2% chlorhexidine gel for 1 week and then filled and coronally sealed as in group 1. After 3 weeks, canals were exposed to the oral environment for 7 days, inoculated with isologous plaque, and coronally sealed. Negative controls treated as groups 1 and 2 remained sealed. Positive controls had canals unfilled and exposed. Seven months after inoculation, dogs were euthanized; jaw blocks processed for histologic examination; and periapical inflammation (PI) recorded as none, mild, or severe.
  
  
  RESULTS
  In groups 1 and 2, severe PI occurred in 5 of 65 roots (8%) and mild PI in 18 of 65 roots (28%) with a significantly higher (P = .031) PI incidence in group 2 than in group 1. Negative controls had only mild PI in 9 of 29 roots (31%). Roots medicated with 2% chlorhexidine gel had mild PI significantly more (P = .009) than roots filled in 1 session (more than 2-fold).
  
  
  CONCLUSIONS
  Intracanal medication with 2% chlorhexidine gel and root filling with Resilon/Epiphany did not effectively inhibit apical periodontitis subsequent to coronal inoculation.
authors.affiliation: Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. Electronic address: jsantos@fmed.uc.pt.
authors.forename: João M
authors.initials: JM
authors.lastname: Santos
authors.affiliation: Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
authors.forename: Paulo J
authors.initials: PJ
authors.lastname: Palma
authors.affiliation: Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
authors.forename: João C
authors.initials: JC
authors.lastname: Ramos
authors.affiliation: Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
authors.forename: António S
authors.initials: AS
authors.lastname: Cabrita
authors.affiliation: Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Shimon
authors.initials: S
authors.lastname: Friedman
mesh_terms: D000818:Animals; D001641:Bicuspid / Q000187:drug effects / Q000382:microbiology; D002710:Chlorhexidine / Q000627:therapeutic use*; D003773:Dental Plaque / Q000382:microbiology*; D003786:Dental Pulp Cavity / Q000187:drug effects / Q000382:microbiology; D003793:Dental Restoration, Permanent / Q000379:methods; D004285:Dogs; D005260:Female; D005899:Glass Ionomer Cements / Q000737:chemistry; D010485:Periapical Periodontitis / Q000145:classification / Q000382:microbiology*; D016300:Radiography, Bitewing / Q000379:methods; D012117:Resins, Synthetic / Q000737:chemistry; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D019228:Tooth Crown / Q000382:microbiology; D019553:Tooth, Nonvital / Q000382:microbiology / Q000628:therapy*
chemical_list: D005899:Glass Ionomer Cements; C081144:Photac-Fil; D012117:Resins, Synthetic; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; C486893:epiphany sealer; C486892:resilon sealer; D002710:Chlorhexidine
keywords: 1-session treatment; Resilon; chlorhexidine; coronal leakage; root canal filling