Bioatividade dos cimentos endodônticos biocerâmicos obturadores: uma revisão de escopo

Abstract

Bioactivity is an important feature of root canal filling cements based on MTA and calcium silicate to promote bone repair of periradicular tissues after endodontic treatment. However, the concept of bioactivity is related to results from several methodologies used in studies. The objective of this scope review was to compile the studies that evaluated the bioactivity of sealers, group and evaluate evidence to better characterize the use of this concept in future studies. For this, the research question was asked: What are the main methodologies evaluated to assess the bioactivity of bioceramic filling cements? In vitro and in vivo studies that evaluated the bioactivity of filling cements containing MTA and calcium silicate were included. Of the 3013 studies screened, 49 were included. For data analysis, the following information was tabulated: author's name, study country, year of publication, journal, material used, cement dilution, control group, bioactivity analysis method, sample number, evaluation duration and main results. In general, the bioactivity in the studies was evaluated in vitro through the mineralization potential, formation of carbonated apatite on the surface, as well as the gene expression related to proteins involved in the mineralization process. Furthermore, in vivo studies assess biocompatibility through mineralization and bone implantation. It was observed in the selected studies the denomination of acellular bioactivity potential, evaluated through the immersion of the hardened material in solutions that simulate body fluids and observation of the hardened material surface with Scanning Electron Microscope followed by Energy Dispersive X-Ray. When evaluated in cells, it was called cellular bioactive potential, with the most frequent use of Alizarin red, followed by alkaline phosphatase activity and molecular biology (RT-PCR). In animal studies, in studies of subcutaneous implantation, the use of the von Kossa technique to detect mineralization was frequent, being associated in some studies with immunohistochemical tests to detect protein markers involved in the mineralization process. In cases of bone implantation, the hematoxylin-eosin staining technique was used for tissue observation.