Hypertension Undermines Mineralization-inducing Capacity of and Tissue Response to Mineral Trioxide Aggregate Endodontic Cement

•Hypertension is an inflammatory disease that has systemic effects, including calcium loss from the body, and is associated with periodontal disease accompanied by abnormalities in mineralization.•Endodontic treatment using reparative cement such as mineral trioxide aggregate (MTA) can restore apical and periapical tissues because of its ability to induce mineralization in tissue at the site of application.•The inflammatory response to all materials was greater in hypertensive rates compared with normotensive rats.•Mineralization was observed for both gray and white MTA, but this was more pronounced in normotensive rats compared with hypertensive rats.•The results indicate that although hypertension can jeopardize tissue repair including mineralization and negatively impact endodontic treatment outcome, MTA still has satisfactory mineralization ability and is therefore the best choice among existing endodontic cements.

IntroductionThis study evaluated the effect of hypertension on tissue response to and mineralization capacity of white and gray mineral trioxide aggregate (MTA) (Angelus Industry Ontological Products, Londrina, Brazil), an endodontic reparative cement.MethodsPolyethylene tubes containing gray MTA, white MTA, or intermediate restorative material (positive control) or an empty tube (negative control) were implanted into the dorsal connective tissue of spontaneous hypertensive and Wistar rats (n = 12 each). Six rats in each group were sacrificed after 7 days, and the remainder after 30 days. Tubes with surrounding tissue were removed, and a histologic analysis was performed using hematoxylin-eosin and von Kossa staining and examination by polarized light microscopy.ResultsThe inflammatory response to all materials was greater in hypertensive compared with normotensive rats (P < .05). Positive von Kossa staining and birefringent structures in polarized light were observed for both gray and white MTA (P > .05), but these were more pronounced in normotensive rats (P < .05). Necrotic areas with positive von Kossa staining were observed for intermediate restorative material.ConclusionsHypertension undermines tissue repair and mineralization, which can negatively affect treatment outcome. Nonetheless, mineralization in response to MTA was observed even under hypertensive conditions.