Effect of intracanal medicaments on matrix metalloproteinase 9 and vasoactive intestinal peptide secretion in periapical lesions: randomized controlled clinical study

Aim: The aim of the present study was to evaluate the effect of the use of calcium hydroxide paste [Ca(OH)2] and % 2 chlorhexidine gel (CHX) as intracanal medication on matrix metalloproteinase 9 (MMP 9) and vasoactive intestinal peptide (VIP) secretion in periapical lesions. Material and method: Sixty patients were randomly divided into two groups according to the medication selected using a web program: Ca(OH)2 and % 2 CHX. Root canal samples were taken from the interstitial fluid of the apical tissues in teeth by using paper points before and after root canal medication. The levels of VIP and MMP 9 before and after medication were measured by enzyme-linked immunosorbent assay. Results: Intragroup analyses revealed that in the Ca(OH)2 medication group postmedication VIP secretion level was significantly higher than the level of premedication VIP secretion. However, in the CHX group there was no statistically significant difference between the premedication and postmedication level of VIP secretion. Moreover, intragroup analyses revealed that in the CHX medication group, the postmedication level of MMP 9 expression were higher than the premedication level, whereas in the Ca(OH)2 medication group there was no statistically significant difference between the premedication and postmedication level of MMP 9 secretion. Conclusion: The use of Ca(OH)2 paste as an intracanal medication increased the level of VIP secretion. With in the limitation of the present study it can be concluded that the use of Ca(OH)2 paste as an intracanal medication might be beneficial in healing process of periapical lesions.