Direct Effect of Endodontic Sealers on Trigeminal Neuronal Activity

By Nikita B. Ruparel, Shivani B. Ruparel, Paul B. Chen, Blake Ishikawa, Anibal Diogenes

Date: 09/2015
Journal: JOE


Purpose: to evaluate the effect of commonly used endodontic sealers on peripheral nociceptors


•Rat trigeminal sensory neurons were exposed in vitro to vehicle, zinc oxide-eugenol (ZOE)–based sealer, AH Plus, EndoSequence BC sealer, or RealSeal SE.

•Neuronal activation was measured by quantification of neuropeptide (CGRP) release.

•In addition, cultured neurons were also subjected to the set form of all 4 sealers.

•The concentration of CGRP released was quantified by using a radioimmunoassay.

•Data were analyzed by using one-way analysis of variance with Newman-Keuls multiple comparison post hoc test.

Most highlighted Results:

  • Both ZOE-based sealer and AH Plus in their fresh form evoked greater CGRP release than the control groups.
  • Conversely, EndoSequence BC and RealSeal sealers both reduced basal GCRP release at all concentrations tested.
  • Evaluation of the set sealers revealed that only ZOE-based sealer evoked significant CGRP release compared with its control group.

Clinical significance:

•Sealers can directly activate trigeminal nociceptors, leading to a robust release of CGRP, and may therefore lead to pain and neurogenic inflammation. This direct activation along with the immunologic response may underlie the symptoms and flare-up occurrences often seen with sealer extrusions.