Balancing Disinfection and Regenerative Potential: Effects of Irrigation and Intracanal Medicaments on TGF-β1 Release in Immature Teeth
23rd World Congress on Dental Traumatology , Warszawa, Poland, 3 - 05 September 2026, pp.66, (Summary Text)
- Publication Type: Conference Paper / Summary Text
- City: Warszawa
- Country: Poland
- Page Numbers: pp.66
- Kütahya Health Sciences University Affiliated: Yes
Abstract
Background: In immature permanent teeth, pulp necrosis resulting from trauma or bacterial infection may affect root development. Regenerative endodontic procedures aim to support root maturation; however, achieving effective disinfection while preserving dentin-derived growth factors remains challenging. Irrigation protocols and intracanal medicaments may influence both bacterial elimination and the release of bioactive molecules such as transforming growth factor beta-1 (TGF-β1).
Objective: To evaluate the effects of different irrigation protocols (sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), etidronic acid (HEDP), glycolic acid (GA)) and intracanal medicaments (calcium hydroxide (Ca(OH)2), triple antibiotic paste (TAP), N-acetylcysteine (NAC)) on bacterial reduction and TGF-β1 release.
Methods: One hundred extracted human teeth were prepared as simulated open apex models and infected with Enterococcus faecalis. The specimens were randomly assigned to irrigation (NaOCl+EDTA, NaOCl+HEDP, NaOCl+GA, control) and intracanal medicament groups (Ca(OH)2, TAP, NAC, control). Bacterial load was quantified as log10 CFU. TGF-β1 levels were measured using ELISA. Canal volumes were determined using cone-beam computed tomography, and TGF-β1 values were evaluated in relation to canal volume. Data were analyzed using one-way and two-way ANOVA (p<0.05).
Results: All irrigation protocols significantly reduced bacterial load compared to control (p<0.001), with no significant differences among EDTA, HEDP, and GA. TAP demonstrated the greatest antibacterial effect among medicaments (p<0.05). Irrigants significantly increased TGF-β1 release in both sterile and infected samples (p<0.05), whereas intracanal medicaments reduced TGF-β1 release in sterile samples and did not significantly affect TGF-β1 release in infected samples. Two-way ANOVA showed significant effects of infection status and treatment (p<0.001), with no significant interaction between the two factors. A significant negative correlation was observed between bacterial load and TGF-β1 release after irrigation (r=−0.574, p=0.003).
Conclusion: Irrigation enhances both disinfection and growth factor release, whereas intracanal medicaments may compromise the biological environment. Optimizing this balance is essential for maintaining regenerative potential in immature teeth. This work has been supported by the Kütahya Health Sciences University Scientific Research Projects Coordination Unit under Grant No. TDH-2025-263.