Objectives: The aim of this study was to compare the neurotoxicity of various root canal sealers on rat sciatic nerve by electrophysiologic and histopathologic analyses.
Materials and methods: A total of 40 male rats were randomly divided into five groups: Control, AH Plus, GuttaFlow, Sealapex and Smartpastebio. Sciatic nerves of the rats were uncovered using the surgical procedures, and the prepared sealers were then applied on nerves with a polyethylene tube vehicle for 15 days. Nerve potentials were recorded at initial exposure, 5, 30 and 120 min (early phase), and 15 days (late phase) by an electrophysiologic analysis system for all groups. The obtained measurements were then used to calculate the nerve conduction velocities (NCV). Subsequently, all rats were sacrificed, and their sciatic nerves were removed for histopathologic analysis. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests for intergroup variables and the Friedman and Wilcoxon test for intragroup variables. Statistical significance was set at P < 0.05.
Results: There was no significant difference between early and late phase results in the control group. This group showed little or no lasting damage to nerve tissue. All sealers decreased the NCV in the early phase time periods, but this decrease was only statistically significant in the AH Plus group at 120-min time period (P < 0.0125). During the late phase, the AH Plus and GuttaFlow groups almost reached initial NCV values, and it was lower than the initial values in the Sealapex and Smartpastebio groups. However, this decrease was not statistically significant. When intergroup comparisons were performed, statistically significant differences occurred at 30 min in the Sealapex group and 120 min in the AH Plus group compared with the control group (P < 0.0125). All sealers induced neurotoxicity as a result of degenerative and inflammatory responses of nerve tissue in histologic analysis. Histologic analysis revealed Sealapex and GuttaFlow to be the most and least neurotoxic, respectively.
Conclusions: All tested root canal sealers exhibited a variable degree of neurotoxicity depending on their chemical compositions.
Clinical relevance: Apical extrusion of endodontic filling materials may cause undesired consequences, such as inflammation and severe neurotoxic damage; therefore, extrusion factor plays an important role during the root canal treatment.
Keywords: AH Plus; Animal study; GuttaFlow; Neurotoxicity; Rat sciatic nerve; Root canal sealer; Sealapex; Smartpastebio.