An endodontic sealer induces a pathological condition when associated with persistent tissue toxicity and presence of myofibroblasts.

The aims of this study were to evaluate the ratio between inflammatory reactions induced by four endodontic sealers and the occurrence of fibrosis and the number of myofibroblasts with positivity to α-smooth-actin muscle (α-SMA). Polyethylene tubes were filled with a root canal sealer (Endofill, AH Plus, Acroseal and Epiphany) and inserted into 4 site at the dorsal region of 24 Wistar rats; 2 empty tubes (control) were grafted in 6 rats. After 7, 21, and 45 days, 8 animals were euthanized, providing 6 specimens per test group and 2 specimens from the control group. The fragments were subjected to histological processing and immunohistochemical analysis for anti α-SMA protein. All specimens, except those from the control group, presented severe inflammatory reaction on the 7th postoperative day, which also coincided with a large number of myofibroblasts. On the 21st and 45th days post-surgery, the inflammatory reaction induced by Endofill, AH Plus and Acroseal decreased significantly, which coincided with reduced presence of myofibroblasts and usual collagen deposition. In contrast, in the group filled with Epiphany, significant inflammatory cell infiltrate was present in all analyzed periods. The persistence of an inflammatory reaction induced by endodontic sealer may also induce the development of fibrosis in combination with presence of myofibroblasts.