Usage test of four endodontic sealers in Macaca fascicularis monkeys.

Root canals with vital pulps in four Macaca fascicularis monkeys were subjected to pulp extirpation and root filling with gutta-percha and sealer, either AH26, Endomethasone, Kloroperka N-phi, or ProcoSol. Observation periods were 1 and 6 months. The results of treatment were evaluated by radiographic analysis (periapical index scores) and by histopathologic assessment of the remaining pulp and periapical tissues. Sixty roots with acceptable termination (between 0.5 and 3 mm from apex) of the root fillings and adequate histopathologic specimens were available for analysis. These roots were equally distributed in each observation period group and among the four material groups. Radiography indicated periapical pathosis in 6 of the 60 roots--4 at 1 month and 2 at 6 months. Periapical inflammation was observed on histopathologic examination in 17 roots--11 after 1 month and 6 after 6 months. Histologic and radiographic assessment of periapical inflammation was significantly correlated (p less than 0.01, chi 2) at the 6-month observation period. No granuloma or cyst formation was evident on histologic examination. The magnitude of the inflammatory response appeared unrelated to the endodontic sealer used, and several inflammatory foci were not related to foreign bodies in the tissues. Bacteriologic sampling showed growth in thioglycollate broth cultures in 9 of the 60 roots, but the presence of cultivable bacteria by this technique was unrelated to inflammatory changes. Histologic demonstration of bacteria was positive in 4 roots, all of which were associated with inflammatory periapical reactions. The method applied in the present study did not provide a sensitive discrimination among endodontic materials of widely different chemical composition.