Morphometric and microscopic evaluation of the effect of solution of acetazolamide as an intracanal therapeutic agent in late reimplanted rat teeth

Abstract

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of acetazolamide, a resorption inhibitor, as an intracanal therapeutic agent for late reimplanted teeth. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided into two groups according to the intracanal dressing: Group I, solution of acetazolamide and Group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30, and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results showed that calcium hydroxide paste limited root resorption, even though not avoiding it. In contrast, no root resorption was observed after 60 days in the acetazolamide group, confirming the efficacy of the substance in inhibiting root resorption.

Effect of zoledronic acid used in the root surface treatment of late replanted teeth: a study in rats

“…Due to the similarity among the morphology, enzymatic properties and function of the cells that reabsorbs bone, dentin, and cementum, both root and bone resorption processes can be considered similar (2). Therefore, drugs and other substances used for inhibiting bone resorption may also be effective for the root resorption treatment.…”

“…The vascular-nervous bundle that supplies dental pulp is also disrupted, leading to its necrosis (1). These aspects have characterized dental avulsion as a complex traumatic lesion of difficult treatment (2).…”

“…Thus, instead of accomplishing either immediate replantation or storing the tooth in an appropriate media, people usually keep an avulsed tooth exposed to the dry environment, either wrapping it in plastic or paper, or storing it in solutions incompatible with the survival of the cells on root surface. This may lead to the development of ankylosis and root resorption, which can be undesirable consequences of tooth replantation (1,2).…”

“…During tooth avulsion, several tissues may be affected or damaged, including: periodontal ligament, alveolar bone, gingiva, lips, and dental pulp (1). The periodontal ligament is disrupted, disorganizing its orientation and compromising its viability (1,2). The vascular-nervous bundle that supplies dental pulp is also disrupted, leading to its necrosis (1).…”

“…In addition to being more resistant to resorption, cementum does not allow bacterial toxins to penetrate deeply (9), thus the cleanness should be superficial. After this initial cleanness, the tooth should be immersed in sodium fluoride solution because this, in addition to strengthening the dental structure by forming fluorapatite, is still toxic for the resorptive cells of the hard tissue (2,6,10,11). The intracanal dressing of choice is calcium hydroxide (9,12), due to its antimicrobial and anti-resorptive characteristics.…”