Abstract
The application of biomaterials used in regenerative endodontics should be traceable. In this study, we checked some basic effects of rendering a fibrin hydrogel radiopaque using an iodine-based contrast agent (iodixanol) approved for systemic application. Fibrin hydrogels were prepared from a fibrin sealant (Tisseel) using either an isotonic iodixanol solution (Visipaque 320, test) or Tris buffer (control) as a diluent. Gelation kinetics, radiopacity, and swelling of lyophilized hydrogels were tested using standard methods. Hydrogel structure was evaluated using scanning electron microscopy (SEM). Furthermore, iodixanol release from the test gels was assessed using spectrophotometry, and tissue compatibility was compared between test and control hydrogels using the chick chorioallantoic membrane (CAM) assay. Results were compared using pairwise t-test, p < 0.05. Iodixanol caused a 70-fold delay in gelation to 26 min in the test compared to the control hydrogels (22 ± 1 s). Radiopacity of the test gels was 1.9 ± 0.2 mm Al/mm, compared to zero in the control hydrogels. Lyophilized hydrogel swelling was strongly reduced when iodixanol was added to the hydrogel (p < 0.05). Test hydrogels had an altered SEM appearance compared to controls, and exhibited a reduced porosity. Iodixanol release from the test hydrogels reached 14.5 ± 0.5% after 120 h and then ceased. This release did not have any apparent toxic effect and neither affected the viability, nor the physiology or vascularization of the CAM of fertilized chicken eggs. Iodixanol can render a fibrin hydrogel radiopaque and maintains its tissue compatibility, yet impacts gelation kinetics and hydrogel porosity.
Highlights
An exciting new field has emerged in endodontic research over the recent years: Regenerative Endodontics (Hargreaves, 2016)
In the current study we investigated the effects of a biocompatible iodinated X-ray contrast agent systemically used in angiography on some basic properties of a fibrin hydrogel intended for endodontic applications
This study showed that a radiopaque and tissue-compatible, yet slow setting and less porous fibrin hydrogel is obtained by diluting a commercially available fibrin sealant with an isotonic contrast agent containing iodixanol rather than Tris-buffered saline (TBS)
Summary
An exciting new field has emerged in endodontic research over the recent years: Regenerative Endodontics (Hargreaves, 2016). While attempts to attract soft tissues into the necrotic root canal space are not necessarily new (Nygaard Ostby, 1963), the systematic approach in the context of current tissue engineering concepts surely is. Different paths are followed that vary from pure basic science to translational medicine with the development and improvement of clinically applicable protocols. The passage to the clinics necessitates specific precautions for tissue engineering concepts and related products (Mao et al, 2012) These include issues such as treatment costs, safety, and the regulation of medical devices by local administrative bodies. Iodixanol in a Fibrin Hydrogel for Endodontic Applications
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