Elsevier

Journal of Endodontics

Volume 40, Issue 12, December 2014, Pages 1989-1994
Journal of Endodontics

Basic Research
Histologic Evaluation of the Effects of Emdogain Gel on Injured Root Apex in Rats

https://doi.org/10.1016/j.joen.2014.08.024Get rights and content

Abstract

Introduction

This study investigated the effects of Emdogain gel (EMD) on the injured open apex within periapical lesions.

Methods

Periapical lesions were induced in rats by opening the pulp chambers of the mandibular first molars and filing the apical foramen through the distal root canal with #25 K-files to make an open apex. The teeth were exposed to the oral environment for 7 days. Then we irrigated the distal root canals and divided them into EMD-treated and propylene glycol alginate–treated groups. The rats were killed 7, 14, and 28 days after treatment and examined histochemically.

Results

In the EMD-treated rats, more cells expressed transforming growth factor-β1 or bone morphogenetic protein-2 at 7 days after treatment, and the regeneration of cementum and bone was observed around the root apex at 14 days after treatment. Conversely, in the propylene glycol alginate–treated group, few cells expressed transforming growth factor-β1 or bone morphogenetic protein-2, and apical periodontal tissue recovery was rarely seen within the periapical lesions throughout the experiment.

Conclusions

These results suggest that EMD does not irritate injured periapical tissue and may create a favorable environment that promotes the healing of destroyed periapical tissues.

Section snippets

Animal Preparation

All animal protocols were approved by the Animal Care and Use Committee of the Faculty of Dental Science, Kyushu University, and the experiments were carried out in accordance with the animal experiment guidelines of Fukuoka Dental College.

Experimental apical periodontitis was induced in 35 five-week-old-male Wistar rats by opening the pulp chamber of the left mandibular first molar and penetrating and filing the apical foramen through the distal root canal with #25 K-files to make an open

Zero Days before Treatment

Prominent neutrophil infiltration was observed near the destroyed root apex. Many ED1-positive macrophages were observed around the abscess and adjacent to the bone surface (Fig. 1A). Numerous Il-1β–expressing macrophages were observed near the abscess (data not shown). A few cells expressing TGF-β1 or BMP-2 were scattered throughout the lesion. Near the bone surface, there was very little TGF-β1 or BMP-2 expression (data not shown).

PGA-treated Group

Throughout the experiment, large abscesses were observed near

Discussion

In cases of root apex that has been destroyed, calcium hydroxide is conventionally used clinically. However, the pulp tissues become very irritated, and a necrotic layer forms as a result of the alkaline action of calcium hydrate (20). Although calcium hydroxide forms reparative dentin, its structure is porous (21). The formation of pores increases the risk of bacterial infection (22). Moreover, Olsson et al (23) claimed that calcium hydroxide–based materials did not give satisfactory results.

Acknowledgments

The authors thank the members of the Section of Operative Dentistry and Endodontology, Department of Odontology, Fukuoka Dental College.

This study was partly supported by Grant-in-Aid for Scientific Research (no. 24592890) from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan and the MEXT-supported Program for Strategic Research Foundations at Private Universities (S1001059), 2010–2015.

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

References (34)

  • F. Goldberg et al.

    Evaluation of the dentinal bridge after pulpotomy and calcium hydroxide dressing

    J Endod

    (1984)
  • R.K. Scarparo et al.

    Apical periodontium response to enamel matrix derivative as an intracanal medication in rat immature teeth with pulp necrosis: radiographic and histologic findings

    J Endod

    (2012)
  • N.T. Bennett et al.

    Growth factors and wound healing: part II—role in normal and chronic wound healing

    Am J Surg

    (1993)
  • X. Wang et al.

    Histologic characterization of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis

    J Endod

    (2010)
  • E. Gemmell et al.

    Cytokine and prostaglandins in immune homeostasis and tissue destruction in periodontal disease

    Periodontol 2000

    (1997)
  • A. Yoshimura et al.

    SOCS proteins, cytokine signaling and immune regulation

    Nat Rev Immunol

    (2007)
  • S.S. Socransky et al.

    New concepts of destructive periodontal disease

    J Clin Periodontol

    (1984)
  • Cited by (10)

    • Application of Enamel Matrix Derivative (Emdogain) in Endodontic Therapy: A Comprehensive Literature Review

      2018, Journal of Endodontics
      Citation Excerpt :

      In terms of regeneration or revascularization, EMD has been used as an intracanal medication in the rat model to study its effects on experimentally induced apical periodontitis. Matsumoto et al (32) found that the EMD-treated teeth exhibited an elevated level of TGF-β1, bone morphogenetic protein 2, and regeneration of cementum and bone around the root apex after 2 weeks compared with the control animals. Osteoprotegerin/receptor activator nuclear kappa B ligand plays a role in periapical lesions and can be modified with certain therapeutic regimens (69).

    • Clinical approach to regenerative endodontics

      2021, Regenerative Approaches in Dentistry: An Evidence-Based Perspective
    View all citing articles on Scopus
    View full text