formocresol and Necrosis

Accidental injection or leakages of various chemical disinfectants used during root canal preparation into adjacent tissues have been shown to have deleterious effects on surrounding tissue. Formocresol (FC) is an effective intracanal disinfectant used in endodontic procedures. However, it is known to have harmful effects into adjacent tissues. The aim of this article is to present an unusual case in which a 28-year-old male patient developed gingival and bone necrosis after the accidental injection of FC instead of local anesthetic solution for tooth extraction and to review cases in the literature where complications have occurred due to the use of FC.

Topics: Adult; Anesthesia, Dental; Anesthesia, Local; Anesthetics; Formocresols; Gingiva; Humans; Injections; Male; Maxilla; Medication Errors; Necrosis; Osteonecrosis; Reoperation; Root Canal Preparation; Tooth Extraction; Turkey

The present study was conducted to investigate the role of Formocresol (FC)-induced apoptosis and necrotic cell death in murine peritoneal macrophages (pMø). Macrophages were cultured with 1:100 FC for 2 to 24 h. The viability (trypan blue assay), cell morphology (scanning electronic microscope), and apoptotic and necrotic indexes (light and fluorescent microscopy) were determined at different scheduled times. Simultaneously, the expressions of proteins related to stress, survival, and cell death were measured by western blotting. FC-exposed macrophages exhibited maximal apoptosis from 2 to 6 h, coincident with Bax overexpression (P < 0.001). Additionally, Bcl-x(L) showed maximal expression between 12 and 24 h suggesting its survival effect in pMø. The lowest pMø viability and the increment of the necrotic rate from 4 to 12 h were observed in accordance to Fas and Hsp60 overexpressions. In summary, all the experimental data suggest that two different pathways emerge in pMø exposed to FC, one leading Bax-dependent apoptosis (2-6 h) and the other one favoring necrosis (4-18 h), related to Fas-receptor and Hsp60 stress signal.

Topics: Animals; Apoptosis; bcl-X Protein; Blotting, Western; Cell Shape; Cell Survival; Chaperonin 60; Formocresols; Gene Expression; Macrophages, Peritoneal; Mice; Microscopy, Electron, Scanning; Microscopy, Fluorescence; Necrosis; Signal Transduction

This study performed a histological analysis of the effect of formocresol associated to endotoxin (LPS) in the subcutaneous connective tissue of mice. Ninety mice were randomly assigned to 3 groups (n=30). Each animal received one plastic tube implant containing endotoxin solution (10 mg/mL), formocresol (original formula) or a mixture of endotoxin and formocresol. The endotoxin and formocresol groups served as controls. The periods of analysis were 7, 15 and 30 days. At each experimental period, tissue samples were collected and submitted to routine processing for histological analysis. Endotoxin and formocresol produced necrosis and chronic inflammation at 7 and 15 days. At 30 days, the endotoxin group showed no necrosis, while in the formocresol group necrosis persisted. The formocresol-endotoxin association produced necrosis and chronic inflammation in the same way as observed with formocresol at all experimental periods. In conclusion, formocresol seems not to be able to inactive the toxic effects of endotoxin in connective tissues.

Topics: Animals; Connective Tissue; Endotoxins; Escherichia coli; Fibrosis; Formocresols; Giant Cells, Foreign-Body; Granulation Tissue; Inflammation; Leukocytes; Lipopolysaccharides; Lymphocytes; Macrophages; Mice; Necrosis; Neutrophils; Plasma Cells; Random Allocation; Root Canal Irrigants; Subcutaneous Tissue; Time Factors; Vasodilation

The purpose of this study was to compare pulpal and periapical tissue reactions to electrosurgery versus formocresol pulpotomy techniques in the primary teeth of dogs. The study was conducted on 33 primary teeth of three mongrel dogs between the ages of one to three months. Each dog had three teeth treated by Formocresol Pulpotomy with Mechanical Coronal Pulp Removal (FC), three teeth treated by Electrosurgery Pulpotomy with Mechanical Coronal Pulp Removal (ES/MCPR), three teeth treated by Electrosurgery Pulpotomy with Electrosurgical Coronal Pulp Removal (ES/ECPR), and two teeth serving as untreated Controls. Dogs one, two and three were sacrificed performing the pulpotomies at two, four and six weeks, respectively. The pulp, periapical tissue and after surrounding bone were submitted to histological examination and the histological reaction was recorded. The results were fourteen out of 18 unfavorable and zero out of three favorable histological reactions occurred in the FC treated teeth. Six out of 18 unfavorable and one out of three favorable histological reactions occurred in the ES/MCPR treated teeth. Nine out of 18 unfavorable and two out of three favorable histological reactions occurred in the ES/ECPR treated teeth. One out of 18 unfavorable and zero out of three favorable histological reactions occurred in the untreated Control teeth. The conclusion of this study is that of the three experimental groups, the teeth treated by Electrosurgery Pulpotomy with either Mechanical or Electrosurgical Coronal Pulp Removal exhibited less histopathological reaction than the teeth treated by Formocresol Pulpotomy.

Topics: Animals; Dental Pulp; Dental Pulp Cavity; Dental Pulp Necrosis; Dental Restoration, Permanent; Dentin, Secondary; Dogs; Electrosurgery; Fibrosis; Formocresols; Homeostasis; Necrosis; Periapical Abscess; Periapical Periodontitis; Periapical Tissue; Pulpotomy; Root Resorption; Tooth Crown; Tooth, Deciduous; Zinc Oxide-Eugenol Cement