Animal models used in furcation perforation studies: A systematic review and comprehensive synthesis of model characteristics

Cardoso, Miguel; Catré, Dora; Noites, Rita; Paulo, Manuel; Viegas, Carlos

doi:10.1111/aej.12221

Cited by 4 publications

(6 citation statements)

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“…Several promising materials have emerged for the repair of furcation perforations (Cardoso et al ). The ideal material should provide an adequate seal, be biocompatible, not be affected by blood contamination, be radiopaque, induce mineralization and be easily handled and inserted (Aggarwal et al ).…”

Section: Introductionmentioning

confidence: 99%

Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation

et al. 2019

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Aim To evaluate in vivo tissue responses after sealing furcation perforations in dog's teeth with either Biodentine™, mineral trioxide aggregate (MTA) or gutta‐percha, by means of histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis. Methodology After root canal treatment, perforations were created in the central region of the pulp chamber floor using a round diamond bur and filled with one or other of the materials. The animals were euthanized after 120 days, and the teeth (n = 30) were processed for histopathological analysis of new mineralized tissue formation and collagen fibre reinsertion, immunohistochemical analysis of osteopontin (OPN) and alkaline phosphatase (ALP) and immunofluorescence analysis for bone morphogenetic protein (BMP‐2), cementum attachment protein (CAP), bone sialoprotein (BSP), osteocalcin (OCN) and cementum protein1 (CEMP1). Histoenzymology was performed for TRAP activity and osteoclast count. Data were analysed statistically (α = 0.05) using chi‐square and Kruskal–Wallis tests. Results Gutta‐percha did not induce mineralized tissue formation. MTA and BiodentineTM formed mineralized tissue in 88% and 92% of specimens, respectively, with no significant difference (P > 0.05). Gutta‐percha was associated with scattered collagen fibres parallel to the perforations. Groups treated with MTA or BiodentineTM had partial fibre reinsertion perpendicular to the newly formed mineralized tissue. All materials induced OPN and ALP expression, weakest for gutta‐percha and strongest for MTA (P < 0.05). Only MTA induced BMP‐2, BSP, OCN, CAP and CEMP1 expression. Osteoclast counts were similar in all groups (P = 0.97). Conclusions Mineral trioxide aggregate and BiodentineTM were biocompatible, with formation of mineralized tissue and partial reinsertion of collagen fibres. In addition, the participation of several molecules by which calcium silicate‐based materials induce the formation of mineralized tissue were noted, with expression of ALP and OPN mineralization markers, without interference in the number of osteoclasts. Only MTA stimulated the expression of proteins associated with the formation of a cementum‐like mineralized tissue.

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Section: Introductionmentioning

confidence: 99%

Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation

et al. 2019

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“…The material used in direct contact with living tissue should meet certain standards of tissue compatibility, in addition to any therapeutic or mechanical benefit that it may provide. Therefore, this study was conducted to investigate the tissue response to different repairing materials and techniques used in repairing furcation perforations and dogs appear to possess the most suitable model characteristic to furcation perforation studies ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Histologic evaluation of artificial floors under MTA and Nano-filled resin-modified glass ionomer used to repair furcation perforation in dogs

et al. 2020

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Objective: This study aimed to compare the tissue reaction of two repair materials for furcation perforations, nano-filled resin modified glass ionomer (Nano-FRMGI) and mineral trioxide aggregate (MTA), used with or without an artificial floor. Methods: A total of 96 teeth in 6 dogs were used for this study. After access cavities, root canals were prepared and obturated with gutta percha using cold lateral condensation technique. Perforations were then created on the floors of the pulp chambers. The perforations divided into four groups n=24/group that were sealed with MTA alone, MTA with calcium sulphate artificial floor (CSAF), FRMGI alone and Nano-FRMGI with CSAF. All access cavities were filled with composite resin. Two dogs were sacrificed at 1, 3, and 6 month. The experimental tooth along with the surrounding alveolar bone were cut in block sections and histologically evaluated for tissue response. Data were analyzed by Chi-square (P≤0.05). Results: MTA and MTA with CSAF showed more bone and cementum apposition when compared to Nano-FRMGI at 6-month interval. MTA and MTA with CSAF showed less bone resorption, epithelium proliferation and inflammation compared to Nano-FRMGI at 6-month interval. Conclusion: MTA with CSAF or MTA-alone show better outcomes in the repair of pulp chamber floor perforation.

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“…A furcal perforation is defined as a pathologic or mechanical communication between the root canal system and the external tooth surface in the interradicular region of multirooted teeth (American Association of Endodontists, 2020; Cardoso et al, 2018a). Accidental perforations have been reported to account for up to 29% of all iatrogenic errors during root canal treatment (Vehkalahti & Swanljung, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Although randomized clinical trials are the reference standard for the comparison of materials and methods, few observational studies (de Chevigny et al, 2008; Farzaneh et al, 2004; Gorni et al, 2016; Gorni & Gagliani, 2004; Mente et al, 2010; Ng et al, 2011) and no randomized clinical trials have investigated root canal perforations, because of ethical issues and difficulties in standardizing procedural accidents. Therefore, experimental in vivo models, which may simulate the periradicular tissues and clinical conditions, are widely used to evaluate the biocompatibility and bioactivity of repair materials (Cardoso et al, 2018a). These studies use standardized methods (Hooijmans & Ritskes‐Hoitinga, 2013), which favours comparison between materials and reduces the risk of bias (RoB).…”

Section: Introductionmentioning

confidence: 99%

Does MTA provide a more favourable histological response than other materials in the repair of furcal perforations? A systematic review

et al. 2021

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Background There is no consensus on which furcal perforation repair material induces a more favourable histological response. This systematic review of laboratory studies provides an overview of the studies comparing repair materials in animal models. Objectives To evaluate whether mineral trioxide aggregate (MTA) yields a more favourable histological response than other materials when used to repair furcal perforations in animal experimental models. Methods This review followed the PRISMA checklist. The studies included various materials used to repair furcal perforations and compared the histological responses with MTA. An electronic search was conducted in EMBASE, PubMed, Scopus and Web of Science up to 2 September 2020, with no language or publication date restrictions. Studies whose full text was unavailable were excluded. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. Results The studies included in the qualitative synthesis were conducted in rat (n = 3) and dog (n = 17) models. They were classified as having a low quality, high methodological heterogeneity and high RoB. MTA and Biodentine, the materials most often compared, reduced the inflammatory reaction to mild over time. In addition, a mineralized tissue was formed in all studies. The response yielded by MTA was better than or equivalent to that of the other tested materials. Discussion This review confirmed that MTA is the reference standard material for furcal perforation repair. However, research using animal models has inherent limitations, and the substantial methodological heterogeneity across the studies included should be considered. Therefore, the knowledge generated by this systematic review should be translated into clinical practice cautiously. Conclusions Features described in the report and quality assessment guidelines, such as PRIASE, ARRIVE and SYRCLE, should guide researchers. Despite the high RoB and the low methodological quality of the studies included, findings indicated that MTA yields a more favourable histological response than other materials in the repair of furcal perforations. Registration PROSPERO (CRD42020181297).

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Animal models used in furcation perforation studies: A systematic review and comprehensive synthesis of model characteristics

Cited by 4 publications

References 31 publications

Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation

Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation

Histologic evaluation of artificial floors under MTA and Nano-filled resin-modified glass ionomer used to repair furcation perforation in dogs

Does MTA provide a more favourable histological response than other materials in the repair of furcal perforations? A systematic review

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