Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Pallotta, Raul Capp; Machado, Manoel Eduardo de Lima; Reis, Norair Salviano dos; Martins, Guilherme Henrique Rosa; Nabeshima, Cleber Keiti

doi:10.1590/S1980-65232010000100012

Abstracts

PURPOSE: This study evaluated the inflammatory reaction caused by the implantation of iodoform and calcium hydroxide in the back of rats. These drugs may be used as intracanal dressings to eliminate residual bacteria of the root canal system. METHODS: Twenty albinic rats (Rattus norvegicus, var Wistar) were divided into four groups: control group 1 (CG1) had normal skin; control group 2 (CG2) had wounded tissue without drugs; in groups 3 and 4, iodoform (IG) and calcium hydroxide (CHG) were inserted into the wounds, respectively. After 3, 5 and 11 days, slices of the implanted areas were macroscopically and microscopically observed regarding to their qualitative and quantitative aspects. RESULTS: In the macroscopical analysis, the CHG showed a large area of necrosis and swelling, which progressively decreased; in the IG the presence of iodoform surrounded by normal tissue was observed. The qualitative and quantitative histological analysis showed that IG promoted a shorter delay in the inflammatory response than the CHG. CONCLUSION: The inflammatory reaction for iodoform had a peak period five days after the drug insertion. By comparison, calcium hydroxide showed a very large area of necrosis that could only be partially eliminated after eleven days.

Calcium hydroxide; Endodontics; inflammation; iodoform

OBJETIVO: O objetivo deste estudo foi avaliar a resposta inflamatória causada pela implantação do iodofórmio ou hidróxido de cálcio em dorso de ratos. Estas drogas podem ser usadas como curativo intracanal para eliminar bactérias residuais do sistema de canal radicular. METODOLOGIA: Foram utilizados 20 ratos albinos (Rattus norvegicus, var Wistar) e divididos em 4 grupos: grupo controle 1 (CG1) representado por tecido normal íntegro; grupo controle 2 (CG2) com ferida e sem medicação; nos grupos 3 e 4, Iodofórmio (IG) e hidróxido de cálcio (CHG) foram, respectivamente, inseridos nas feridas. Após três, cinco e onze dias, cortes microscópicos das áreas implantadas foram observados macroscópica e microscopicamente quanto a seus aspectos qualitativos e quantitativos. RESULTADOS: Na análise macroscópica, o CHG mostrou uma grande área de necrose e edema, o que diminuiu progressivamente, no GI, a presença de iodofórmio rodeada por tecido normal foi observado. A análise qualitativa e quantitativa histológica mostrou que IG promoveu um prazo mais curto na resposta inflamatória do que o CHG. CONCLUSÃO: A reação inflamatória de iodofórmio teve um período de pico de cinco dias após a inserção de drogas. Em comparação, o hidróxido de cálcio mostrou uma grande área de necrose que só poderia ser parcialmente eliminada após onze dias.

Hidróxido de cálcio; Endodontia; inflamação; iodofórmio

ORIGINAL ARTICLE

Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats

Resposta inflamatória tecidual da implantação de hidróxido de cálcio e iodofórmio em dorso de ratos

Raul Capp Pallotta^I; Manoel Eduardo de Lima Machado^II; Norair Salviano dos Reis^III; Guilherme Henrique Rosa Martins^IV; Cleber Keiti Nabeshima^IV

^IGraduate Course in Endodontics, São Paulo General Hospital, São Paulo, SP, Brazil

^IIDepartment of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil

^IIIProfessor, Department of Biological Sciences, Pontifical Catholic University, Campinas, SP, Brazil

^IVGraduate Course in Endodontics, Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil

^{Correspondence} Correspondence: Raul Capp Pallotta R. Moreira de Godoi, 664 - 2 andar - cj.07 São Paulo, SP - Brasil 04266 - 060 E-mail: raulcapp@terra.com.br

ABSTRACT

PURPOSE: This study evaluated the inflammatory reaction caused by the implantation of iodoform and calcium hydroxide in the back of rats. These drugs may be used as intracanal dressings to eliminate residual bacteria of the root canal system.

METHODS: Twenty albinic rats (Rattus norvegicus, var Wistar) were divided into four groups: control group 1 (CG1) had normal skin; control group 2 (CG2) had wounded tissue without drugs; in groups 3 and 4, iodoform (IG) and calcium hydroxide (CHG) were inserted into the wounds, respectively. After 3, 5 and 11 days, slices of the implanted areas were macroscopically and microscopically observed regarding to their qualitative and quantitative aspects.

RESULTS: In the macroscopical analysis, the CHG showed a large area of necrosis and swelling, which progressively decreased; in the IG the presence of iodoform surrounded by normal tissue was observed. The qualitative and quantitative histological analysis showed that IG promoted a shorter delay in the inflammatory response than the CHG.

CONCLUSION: The inflammatory reaction for iodoform had a peak period five days after the drug insertion. By comparison, calcium hydroxide showed a very large area of necrosis that could only be partially eliminated after eleven days.

Key words: Calcium hydroxide; Endodontics; inflammation; iodoform

RESUMO

OBJETIVO: O objetivo deste estudo foi avaliar a resposta inflamatória causada pela implantação do iodofórmio ou hidróxido de cálcio em dorso de ratos. Estas drogas podem ser usadas como curativo intracanal para eliminar bactérias residuais do sistema de canal radicular.

METODOLOGIA: Foram utilizados 20 ratos albinos (Rattus norvegicus, var Wistar) e divididos em 4 grupos: grupo controle 1 (CG1) representado por tecido normal íntegro; grupo controle 2 (CG2) com ferida e sem medicação; nos grupos 3 e 4, Iodofórmio (IG) e hidróxido de cálcio (CHG) foram, respectivamente, inseridos nas feridas. Após três, cinco e onze dias, cortes microscópicos das áreas implantadas foram observados macroscópica e microscopicamente quanto a seus aspectos qualitativos e quantitativos.

RESULTADOS: Na análise macroscópica, o CHG mostrou uma grande área de necrose e edema, o que diminuiu progressivamente, no GI, a presença de iodofórmio rodeada por tecido normal foi observado. A análise qualitativa e quantitativa histológica mostrou que IG promoveu um prazo mais curto na resposta inflamatória do que o CHG.

CONCLUSÃO: A reação inflamatória de iodofórmio teve um período de pico de cinco dias após a inserção de drogas. Em comparação, o hidróxido de cálcio mostrou uma grande área de necrose que só poderia ser parcialmente eliminada após onze dias.

Palavras-chave: Hidróxido de cálcio; Endodontia; inflamação; iodofórmio

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Received: September 23, 2009

Accepted: December 30, 2009

1. Seltzer S, Farber PA. Microbiologic factors in Endodontology. Oral Surg Oral Med Oral Pathol 1994;78:634-45.
2. Sundquist G. Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol 1994;78:522-30.
3. Jontell M, Okiji T, Dahlgren U, Bergenholtz G. Immune defense mechanisms of the dental pulp. Crit Rev Oral Biol Med 1998;9:179-200.
4. Tronstad L, Barnett F, Riso K, Slots J. Extraradicular endodontic infections. Endod Dent Traumatol 1987;3:86-90.
5. Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J 2006;39:249-81.
6. Sakamoto M, Siqueira JR JF, Rocas IN, Benno Y. Bacterial reduction and persistence after endodontic treatment procedures. Oral Microbiol Immunol 2007;22:19-23.
7. Siqueira Jr JF, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999;32:361-9.
8. Dammaschke T, Schneider U, Stratmann U, Yoo JM, Schäfer E. Effect of root canal dressings on the regeneration of inflamed periapical tissue. Acta Odontol Scand 2005;63:143-52.
9. Tang G, Samaranayake LP, Yip HK. Molecular evaluation of residual endodontic microorganisms after instrumentation, irrigation and medication with either calcium hydroxide or Septomixine. Oral Dis 2004;10:389-97.
10. Pallotta RC, Ribeiro MS, Machado ME. Determination of the minimum inhibitory concentration of four medicaments used as intracanal medication. Aust Endod J 2007;33:107-11.
11. Cwikla SJ, Bélanger M, Giguère S, Progulske-Fox A, Vertucci FJ. Dentinal tubule disinfection using three calcium hydroxide formulations. J Endod 2005;31:50-2.
12. Manisali Y, Yücel T, Erisen R. Overfiling of the root. A case report. Oral Surg Oral Med Oral Pathol 1989;68:773-5.
13. Trusewqicz M, Buczkowska-Radlinska J, Giedrys-Kalemnba S. The effectiveness of some methods in eliminating bacteria from the root canal of a tooth with chronic apical periodontitis. Ann Acad Med Stetin 2005;51:43-8.
14. Ortega KL, Rezende NP, Araujo NS, Magalhaes MH. Effect of a topical antimicrobial paste on healing after extraction of molars in HIV positive patients: randomised controlled clinical trial. Br J Oral Maxillofac Surg 2007;45:27-9.
15. Abdullah M, NG YL, Gulabivala K, Moles DR, Spratt DA. Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications. J Endod 2005;31:30-6.
16. Distel, JW, Hatton JF, Gillespie MJ. Biofilm formation in medicated root canals. J Endod 2002;28:689-93.
17. Haapasalo HK, Sirén EK, Waltimo TM, Ørstavik D, Haapasalo MP. Inactivation of local root canal medicaments by dentine: an in vitro study. Int Endod J 2000;33:126-31.
18. De Moor RJG, De Witte MJ. Periapical lesions accidentally filled with calcium hydroxide. Int Endod J 2002;35:946-58.
19. Kaplan AE, Ormaechea MF, Picca M, Canzobre MC, Ubios AM. Rheological properties and biocompatibility of endodontic sealers. Int Endod J 2003;36:527-32.
20. Zmener O, Guglielmotti MB, Cabrini RL Biocompatibility of two calcium hydroxide-based endodontic sealers: a quantitative study in the subcutaneous connective tissue of the rat. J Endod 1988;14:229-35.

Correspondence:

Raul Capp Pallotta

R. Moreira de Godoi, 664 - 2 andar - cj.07

São Paulo, SP - Brasil 04266 - 060

E-mail:

raulcapp@terra.com.br

Publication Dates

Publication in this collection
26 Aug 2011
Date of issue
2010

History

Received
23 Sept 2009
Accepted
30 Dec 2009

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Seltzer S, Farber PA. Microbiologic factors in Endodontology. Oral Surg Oral Med Oral Pathol 1994;78:634-45.

[2] 2. Sundquist G. Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol 1994;78:522-30.

[3] 3. Jontell M, Okiji T, Dahlgren U, Bergenholtz G. Immune defense mechanisms of the dental pulp. Crit Rev Oral Biol Med 1998;9:179-200.

[4] 4. Tronstad L, Barnett F, Riso K, Slots J. Extraradicular endodontic infections. Endod Dent Traumatol 1987;3:86-90.

[5] 5. Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J 2006;39:249-81.

[6] 6. Sakamoto M, Siqueira JR JF, Rocas IN, Benno Y. Bacterial reduction and persistence after endodontic treatment procedures. Oral Microbiol Immunol 2007;22:19-23.

[7] 7. Siqueira Jr JF, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999;32:361-9.

[8] 8. Dammaschke T, Schneider U, Stratmann U, Yoo JM, Schäfer E. Effect of root canal dressings on the regeneration of inflamed periapical tissue. Acta Odontol Scand 2005;63:143-52.

[9] 9. Tang G, Samaranayake LP, Yip HK. Molecular evaluation of residual endodontic microorganisms after instrumentation, irrigation and medication with either calcium hydroxide or Septomixine. Oral Dis 2004;10:389-97.

[10] 10. Pallotta RC, Ribeiro MS, Machado ME. Determination of the minimum inhibitory concentration of four medicaments used as intracanal medication. Aust Endod J 2007;33:107-11.

[11] 11. Cwikla SJ, Bélanger M, Giguère S, Progulske-Fox A, Vertucci FJ. Dentinal tubule disinfection using three calcium hydroxide formulations. J Endod 2005;31:50-2.

[12] 12. Manisali Y, Yücel T, Erisen R. Overfiling of the root. A case report. Oral Surg Oral Med Oral Pathol 1989;68:773-5.

[13] 13. Trusewqicz M, Buczkowska-Radlinska J, Giedrys-Kalemnba S. The effectiveness of some methods in eliminating bacteria from the root canal of a tooth with chronic apical periodontitis. Ann Acad Med Stetin 2005;51:43-8.

[14] 14. Ortega KL, Rezende NP, Araujo NS, Magalhaes MH. Effect of a topical antimicrobial paste on healing after extraction of molars in HIV positive patients: randomised controlled clinical trial. Br J Oral Maxillofac Surg 2007;45:27-9.

[15] 15. Abdullah M, NG YL, Gulabivala K, Moles DR, Spratt DA. Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications. J Endod 2005;31:30-6.

[16] 16. Distel, JW, Hatton JF, Gillespie MJ. Biofilm formation in medicated root canals. J Endod 2002;28:689-93.

[17] 17. Haapasalo HK, Sirén EK, Waltimo TM, Ørstavik D, Haapasalo MP. Inactivation of local root canal medicaments by dentine: an in vitro study. Int Endod J 2000;33:126-31.

[18] 18. De Moor RJG, De Witte MJ. Periapical lesions accidentally filled with calcium hydroxide. Int Endod J 2002;35:946-58.

[19] 19. Kaplan AE, Ormaechea MF, Picca M, Canzobre MC, Ubios AM. Rheological properties and biocompatibility of endodontic sealers. Int Endod J 2003;36:527-32.

[20] 20. Zmener O, Guglielmotti MB, Cabrini RL Biocompatibility of two calcium hydroxide-based endodontic sealers: a quantitative study in the subcutaneous connective tissue of the rat. J Endod 1988;14:229-35.