Comparison of the sealing ability of mineral trioxide aggregate and Portland cement used as root-end filling materials

Inadequate apical seal is the major cause of surgical endodontic failure. The root-end filling material used should prevent egress of potential contaminants into periapical tissue. The purpose of this study was to compare the sealing ability of four root-end filling materials: white mineral trioxide aggregate (MTA), gray MTA, white Portland cement (PC) and gray PC by dye leakage test. Ninety-six human single-rooted teeth were instrumented, and obturated with gutta-percha. After resecting the apex, an apical cavity was prepared. The teeth were randomly divided into four experimental groups (A: white MTA, B: gray MTA, C: white PC and D: gray PC; n = 20) and two control groups (positive and negative control groups; n = 8). Root-end cavities in the experimental groups were filled with the experimental materials. The teeth were exposed to Indian ink for 72 hours. The extent of dye penetration was measured with a stereomicroscope at 16× magnification. The negative controls showed no dye penetration and dye penetration was seen in the entire root-end cavity of positive controls. However, there was no statistically significant difference among the four experimental groups (P > 0.05). All retrograde filling materials tested in this study showed the same microleakage in vitro. Given the low cost and apparently similar sealing ability of PC, PC could be considered as a substitute for MTA as a root-end filling material.     

Sealing ability of MTA and radiopaque Portland cement with or without calcium chloride for root-end filling

The aim of this study was to evaluate the influence of calcium chloride (CaCl(2)) on the sealing ability of three Mineral Trioxide Aggregate (MTA) cements, ProRoot MTA, MTA-Angelus, and radiopaque White Portland cement (WPC), for retrograde root filling. Seventy roots of extracted single-rooted teeth were instrumented and obturated. After sectioning the samples at 2 mm from the apex, they received one layer of Araldite and two coats of nail enamel, except for the apical dentinal surface submitted to apicectomy. Standardized retrograde cavities were prepared, filled with one of the materials, and immersed in 0.2% Rhodamine B solution for 72 hours. Dye leakage was analyzed on a light microscope with ocular micrometer. Kruskal-Wallis and Miller tests were used to compare groups arranged in increasing order of leakage, according to mean rank of scores: WPC+CaCl(2), MTA-Angelus+CaCl(2), ProRoot MTA+CaCl(2), MTA-Angelus, ProRoot MTA, and WPC. CaCl(2) improved the sealing ability of all three MTA cements.     

Effect of different dye solutions on the evaluation of the sealing ability of Mineral Trioxide Aggregate

Alkaline materials have shown incompatibility with methylene blue dye in leakage experiments. The goal of the present study was to analyze the effect of different dyes on the evaluation of the apical sealing ability of Mineral Trioxide Aggregate root-end fillings. Fifty-six extracted human canines were submitted to root canal instrumentation and obturation. After apical resection, retrograde cavities were prepared and teeth were randomly divided into four experimental (n = 13) and two control groups (n = 2). The following root-end filling materials were used: groups 1 and 2--Pro Root MTA (Dentsply), groups 3 and 4--zinc oxide-eugenol cement (ZOE). Teeth in groups 1 and 3 were immersed in 2% methylene blue solution, while teeth in groups 2 and 4 were immersed in 0.2% rhodamine B in a reduced pressure environment for 48 hours. Teeth were then longitudinally sectioned and leakage was evaluated. Results were submitted to statistical analysis (ANOVA and Tukey's test). Group 1 presented the least leakage (p < 0.05). It was concluded that the evaluation of the sealing ability of MTA is influenced by the dye used, since this material presented better sealing ability when evaluated with Methylene Blue, but was similar to ZOE when evaluated with rhodamine B.     

SEALING ABILITY OF CASTOR OIL POLYMER AS A ROOT-END FILLING MATERIAL

Objective: The purpose of this study was to evaluate the sealing ability of castor oil polymer (COP), mineral trioxide aggregate (MTA) and glass ionomer cement (GIC) as root-end filling materials. Forty-five single-rooted human teeth were cleaned and prepared using a step-back technique. The apical third of each root was resected perpendicularly to the long axis direction. All teeth were obturated with gutta-percha and an endodontic sealer. After, a root-end cavity with 1.25-mm depth was prepared using a diamond bur. The specimens were randomly divided into three experimental groups (n=15), according to the root-end filling material used: G1) COP; G2) MTA; G3) GIC. The external surfaces of the specimens were covered with epoxy adhesive, except the root-end filling. The teeth were immersed in rhodamine B dye for 24 hours. Then, the roots were sectioned longitudinally and the linear dye penetration at the dentin/material interface was determined using a stereomicroscope. ANOVA and Tukey''s tests were used to compare the three groups. The G1 group (COP) presented smaller dye penetration, statistically different than the G2 (MTA) and G3 (GIC) groups (p<0.05). No statistically significant difference in microleakage was observed between G2 and G3 groups (p>0.05). The results of this study indicate that the COP presented efficient sealing ability when used as a root-end filling material showing results significantly better than MTA and GIC.     

Microleakage of resected MTA

Forty-six single rooted extracted human teeth were used in this study. After cleaning and shaping, twenty canals were randomly selected for obturation with MTA placed in an orthograde manor (Group 1). Another twenty roots were obturated with gutta-percha and Kerr EWT sealer, using warm vertical compaction (Group 2). The apical 3 mm of each root in both groups were resected at approximately 45 degrees to its long axis. The teeth were aged for 48 h in a humidor. The root-ends of the teeth in Group 2 were then prepared and received MTA as a root-end filling material to a depth of 3 mm. Six roots were used as positive and negative controls. The roots of all teeth were placed in contact with India ink for 48 h. The roots were split and examined for dye leakage. There was no discernible leakage in teeth with resected MTA or those with MTA placed as a retrograde root-end filling material. We found no significant difference in dye leakage between resected MTA (Group 1) and non-resected MTA (Group 2). Based on these results it appears that the resection of set MTA does not affect its sealing ability.     

Effect of an acid environment on leakage of root-end filling materials

One hundred fifty-six single-rooted human extracted teeth received root canal treatment, apicoectomy, and ultrasonic root-end preparations. The roots were divided into six groups of 24 teeth. The groups were filled with Amalgam, Geristore, Super-EBA, Mineral Trioxide Aggregate (MTA), Calcium Phosphate Cement (CPC), or MTA with CPC matrix, respectively. Immediately after root-end filling, 12 teeth from each group were exposed to a pH of 5.0 for 24 h, and 12 teeth were exposed to a pH of 7.4 for 24 h. Twelve teeth served as controls. All teeth were exposed to Pelikan Ink for 5 days and cleared. Linear dye leakage was recorded. Data were statistically analyzed. An acid pH significantly reduced dye leakage of Geristore (0.67 vs. 3.93 mm) and MTA with CPC matrix (0.54 vs. 2.41 mm), whereas leakage of all other materials was not affected by pH. In conclusion an acid environment did not hinder the sealing ability of any of the materials tested, and enhanced the sealing ability of Geristore and MTA with CPC matrix.     

Properties of a new root-end filling material

The purposes of this investigation were 2-fold: to study the physical properties and sealing ability of Viscosity Enhanced Root Repair Material (VERRM); and, to compare them with Mineral Trioxide Aggregate (MTA). VERRM has a composition similar to mineral trioxide aggregate, with handling characteristics and consistency similar to commercially available materials such as IRM and Super EBA. The pH, setting times, solubility, radiopacity, dimensional change upon setting, and apical sealing ability of VERRM were evaluated and compared to that of ProRoot MTA (GMTA) and ProRoot MTA (Tooth Colored Formula) (WMTA). The results showed that VERRM had physical properties similar to WMTA. VERRM and WMTA showed significantly greater dye penetration than GMTA (p < 0.05) when used as a root-end filling material. There was no significant difference in depth of dye penetration between VERRM and WMTA. Further development of VERRM is indicated to produce a biocompatible root-end filling material with superior handling characteristics.     

IN VITRO SEALING ABILITY OF WHITE AND GRAY MINERAL TRIOXIDE AGGREGATE (MTA) AND WHITE PORTLAND CEMENT USED AS APICAL PLUGS

This study evaluated the sealing ability of apical plugs made of white and gray MTA-Angelus® and white Portland cement placed via the root canal and having different thicknesses (2, 5 and 7 mm). Ninety extracted human single-rooted teeth were instrumented using a size 40 K-file to standardize the foraminal opening by the stepback technique. The teeth were assigned to 3 groups (n=30), according to the material used for fabrication of the apical plugs: A = gray MTA; B = white MTA; C = white Portland cement. The groups were subdivided into groups of 10 teeth each according to the apical plug thickness (2, 5 and 7 mm). Marginal apical dye leakage was assessed using 0.2% Rhodamine B solution in which the specimens were immersed for 72 hours at 37°C. The roots were sectioned longitudinally in a buccolingual direction for apical plug exposure, and digital photographs were taken and analyzed by Image Tool image-analysis software. Data were analyzed statistically by Kruskal-Wallis and Dunn''s tests. Significance level was set at 5%. The least percent leakage was observed for 5- and 7-mm-thick plugs (p<0.05). No significant difference (p>0.05) was found between gray MTA and white Portland cement. Among the three materials analyzed, white MTA presented the highest marginal leakage (p<0.05). The findings of the present study showed that gray MTA and Portland cement had better sealing ability than white MTA when used as apical plugs. Dye leakage was smaller for 5- and 7-mm-thick plugs compared to 2-mm-thick plugs.     

Comparative SEM study of the marginal adaptation of white and grey MTA and Portland cement

The use of a suitable substance that prevents egress of potential contaminants into the periapical tissues is important in endodontic surgery. The aim of the present study was to compare the marginal adaptation of three root-end filling materials (white mineral trioxide aggregate (MTA), grey MTA and Portland cement), using scanning electron microscopy. Seventy-five single-rooted extracted human teeth were used. The canals were instrumented and filled with gutta-percha. Following root-end resection and cavity preparation, root-end cavities were filled with white MTA, grey MTA or Portland cement. Using a diamond saw, roots were longitudinally sectioned into two halves. Under scanning electron microscopy, the gaps between the material and dentinal wall were measured. The data were analysed using Kruskal-Wallis test. The mean of the gap in grey MTA, white MTA and Portland cement was 211.6, 349 and 326.3 microm, respectively. The results indicate that the gap between grey MTA and the dentinal wall is less than other materials, but there was no significant difference between the materials tested in this study (P > 0.05).     

Characteristics of novel root-end filling material using epoxy resin and Portland cement

Objectives

The aim of this study was to evaluate the physical properties and cytotoxicity of a novel root-end filling material (EPC) which is made from epoxy resin and Portland cement as a mineral trioxide aggregate (MTA) substitute.

Materials and methods

EPC, developed as a root-end filling material, was compared with MTA and a mixture of AH Plus sealer and MTA (AMTA) with regard to the setting time, radio-opacity, and microleakage. Setting times were evaluated using Vicat apparatus. Digital radiographs were taken to evaluate the aluminium equivalent radio-opacity using an aluminium step wedge. Extracted single-rooted teeth were used for leakage test using methylene blue dye. After canal shaping and obturation, the apical 3-mm root was resected, and a root-end cavity with a depth of 3 mm was prepared. The root-end cavities were filled with MTA, AMTA, and EPC for 15 specimens in each of three groups. After setting in humid conditions for 24 h, the specimens were tested for apical leakage. For evaluation of the biocompatibility of EPC, cell (human gingival fibroblast) viability was compared for MTA and Portland cement by MTT assay, and cell morphological changes were compared for MTA and AH Plus by fluorescence microscopy using DAPI and F-actin staining. The setting time, radio-opacity, and microleakage were compared using one-way ANOVA and Scheffe’s post hoc comparison, and the cytotoxicity was compared using the nonparametric Kruskal–Wallis rank sum test. Statistical significance was set at 95 %.

Results

EPC had a shorter setting time and less microleakage compared with MTA (p?<?0.05). EPC showed 5-mm aluminium thickness radio-opacity and similar biocompatibility to MTA.

Conclusions

Under the conditions of this study, EPC, a novel composite made from a mixture of epoxy resin and Portland cement, was found to be a useful material for root-end filling, with favourable radio-opacity, short setting time, low microleakage, and clinically acceptable low cytotoxicity.

Clinical relevance

The novel root-end filling material would be a potentially useful material for a surgical endodontic procedure with favourable properties.     

iRoot FS���������о�

??Objective    To examine the apical sealing ability of iRoot FS through micro-CT and 3D reconstruction software Mimics??as well as the dye leakage study. Methods    A total of 34 extracted permanent teeth were retrofilled by iRoot FS??MTA??then scanned by micro-CT??3D models were reconstructed by software Mimics. The volume between the mater and the root was calculated. Then the teeth were placed in India ink for the day leakage study??Robertson's technology was used to make specimens transparent. The apical leakage was measured under the microscope. Results    Micro-CT scanning found that there was no significant difference in voids between iRoot FS group and MTA group??P??0.05??. There was no significant difference in microleakage between iRoot FS group and MTA group??P??0.05??. Conclusion    ??    iRoot FS has similar apical sealing ability to MTA and might be considered as a promising root-end filling material.     

Sealing capacity produced by some materials when utilized under furcation perforations of extract human molars

It has been evaluated in vitro the sealing capacity of MTA-Angelus, ProRoot-MTA, Super-EBA and MBP-c when sealing furcal perforations of extracted human molars. The experiment took place with materials both isolated as well as in association with a plaster of Paris matrix applied at the bottom of the perfuration path. The materials sealing capacity was analyzed by dye leakage of rhodamine B 0,2%.The statistical analysis revealed that when isolated and tested (without the matrix), the cement MBP-c presented the smallest coefficient of marginal leakage, followed by the Super-EBA. There was a statistical significance between those and the cements ProRoot - MTA e MTA - Angelus (p<0,001). In the presence of the matrix, the cement MBP-c also had a superior performance having statistical significance between those and the cements ProRoot - MTA e MTA - Angelus (p<0,05); The Plaster of Paris matrix had a negative impact with statistical significance regarding the sealing capacity of the cements Super-EBA and the MBP-c (p<0,05). Nevertheless, it avoided the leakage of the respective sealing materials.     

Sealing ability of Biodentine versus ProRoot mineral trioxide aggregate as root-end filling materials

Aim

This study evaluated the sealing ability of ProRoot MTA and Biodentine as root-end filling materials.

Cell and tissue reactions to mineral trioxide aggregate and Portland cement

OBJECTIVE: Mineral trioxide aggregate (MTA) is being widely used for root-end fillings, pulp capping, perforation repairs, and other endodontic procedures. MTA and Portland cement (PC) have many similar physical, chemical, and biologic properties. PC cement has shown promising potential as an endodontic material in several studies in vitro and in vivo. The purpose of this study was to compare the cytotoxic effect in vitro and the tissue reaction of MTA and Portland cement in bone implantation in the mandibles of guinea pigs. STUDY DESIGN: Millipore culture plate inserts with freshly mixed or set material were placed into the culture plates with already attached L929 cells. After an incubation period of 3 days, the cell morphology and cell counts were studied. Adult male guinea pigs under strict asepsis were anesthetized, during which a submandibular incision was made to expose the symphysis of the mandible. Bilateral bone cavities were prepared and Teflon applicators with freshly mixed materials were inserted into the bone cavities. Each animal received 2 implants, one filled with ProRoot and 1 with PC. The animals were killed after 2 or 12 weeks, and the tissues were processed for histologic evaluation by means of light microscopy. RESULTS: There was no difference in cell reactions in vitro. Bone healing and minimal inflammatory response adjacent to ProRoot and PC implants were observed in both experimental periods, suggesting that both materials are well tolerated. CONCLUSIONS: MTA and PC show comparative biocompatibility when evaluated in vitro and in vivo. The results suggest that PC has the potential to be used as a less expensive root-end filling material.     

Apical leakage of root-end placed SuperEBA, MTA, and Geristore restorations in human teeth previously stored in 10% formalin

The purpose of this study was to determine if storage of extracted teeth in 10% formalin affects microleakage of MTA, Geristore, or SuperEBA root-end fillings. There were 130 freshly extracted single-rooted teeth collected, immediately placed in phosphate buffered saline (PBS) and stored for less than 24 hours. Teeth were divided and either placed in 10% formalin for a 4-weeks immersion or immediately prepared. Preparation for all teeth consisted of canal instrumentation, obturation, apical resection, retrograde preparation, and placement of a root-end filling material. After 72 hours, the apical portions were immersed in India ink under vacuum pressure for 30 minutes, and then stored in ink for 1 week. Negative controls and positive controls performed as expected. In general, there was significantly less dye leakage of root-end restorations in teeth stored in 10% formalin when compared to the freshly extracted teeth (p < 0.0001). No difference in dye leakage was observed between Geristore restorations placed in teeth stored in formalin as compared to fresh teeth (p = 0.892). Less dye leakage was noted in teeth restored with Geristore as compared to MTA and SuperEBA, regardless of storage medium (p < 0.0001). No difference was observed between MTA and SuperEBA root-end restorations (p = 0.157). The results of this study provide evidence that storage of teeth in 10% formalin over a 4-week period may significantly influence dye leakage as compared to leakage in freshly extracted teeth.     

Long-term durability of root-end sealing with 4-MEtA/MMA-TBB resin

The purpose of this study was to compare root-end sealing using 4-META/MMA-TBB resin with that using conventional retrograde root filling technique, and thereby determine if 4-META/MMA-TBB resin offers long-term prevention against dye leakage from the root canal of human teeth. Thirty-five teeth had the apical 2.5 mm of the root resected. In the Sealing (SB) group, 4-META/MMA-TBB resin was applied to the resected surface. In the Filling (Am and EBA) groups, a root-end cavity was prepared and retrofilled with high copper amalgam alloy or reinforced zinc oxide-eugenol cement. Root canals were filled with methylene blue dye solution. Then, dye leakage outside the root canal was measured for 50 weeks. The integrated amount of leakage in SB group was significantly lower than those in Am group (p < 0.05) and EBA group (p < 0.05). Therefore, it can be concluded that root-end sealing using 4-META/MMA-TBB resin resulted in better, long-term sealing than conventional retrograde root filling.     

Sealing ability of MTA, Super EBA, Vitremer and amalgam as root-end filling materials

This study evaluated the root-end sealing ability of mineral trioxide aggregate (MTA Angelus), reinforced zinc oxide-eugenol cement (Super EBA), resin-modified glass ionomer (Vitremer) and zinc-free amalgam (GS-80) (control). The root canals of eighty human lower molars were accessed, cleansed, shaped and obturated. Apexes were resected and cavities were prepared. Teeth were divided into 4 groups of 40 cavities, root-end filled with the materials, and immersed in methylene blue for 72 h at 37 degrees C. Roots were then sectioned transversally at each millimeter and evaluated under magnification, observing the dye penetration in each section. Data were evaluated using Kruskal-Wallis test at a 5% level of significance, showing the differences among all materials (p < 0.001). The crescent order of microleakage was MTA < Vitremer < Super EBA < amalgam. Higher leakage levels were observed in the first millimeter sections of amalgam, Vitremer and MTA, when compared with the third millimeter section (p < 0.05).     

Comparison of the sealing of Resilon, Pro Root MTA, and Super-EBA as root-end filling materials: a bacterial leakage study

The purpose of this in vitro study was to compare the root-end sealing of the Resilon/Epiphany system (RES) to Pro Root MTA and Super-EBA using a bacterial leakage system. Fifty-five extracted teeth were instrumented and root-ends were resected and ultrasonically prepared. Test materials were placed in the root-end preparations; Streptococcus salivarius was introduced coronally and the apical 4 mm were immersed in BHI culture medium with phenol red indicator. Bacterial leakage was monitored every 24 h for 4 wk. All positive controls leaked within 24 h; none of the negative controls leaked. Based on chi2 analysis (p < 0.05), RES and MTA leaked significantly less than Super-EBA. There was no statistical difference between RES and MTA. RES may be a viable option as a root-end filling material with good surgical isolation.     

牙本质黏结剂增强根管倒充填材料密闭性能的实验研究

目的观察在使用MTA进行根尖倒封闭术时,牙本质粘结剂对其密闭抗微渗漏的影响.方法取40颗离体单根恒牙,分别用MTA、MTA 牙本质粘结剂进行根尖倒封闭术,用染料渗透法检测根尖微渗漏的情况.结果MTA 牙本质粘结剂组的根尖密闭效果明显优于单纯使用MTA组,其差别具有统计意义(P<0.05).结论在使用MTA进行根尖倒封闭术时,使用牙本质粘结剂可提高充填体的密闭效果.     

Sealing ability of retrograde obturation materials containing calcium hydroxide or MTA

Newly available materials for retrograde obturation should have their sealing properties evaluated. The goal of this study was to evaluate the sealing ability of Endo CPM sealer, an MTA-based endodontic cement. Single-rooted extracted human teeth were endodontically treated. After apical sectioning, retrograde cavities were prepared. Teeth were divided into five experimental groups (n=12), in which the following materials were used: Sealer 26 (S26), white Mineral Trioxide Aggregate (MTA), Endo CPM Sealer (CPM1), Endo CPM Sealer in thicker consistency (CPM 2), and zinc oxide and eugenol cement (ZOE), and two control groups (n=3). After retrograde obturation, the teeth were immersed in 0.2% rhodamine B dye for 48 hours in a vacuum chamber Marginal leakage data were subjected to ANOVA and Tukey tests at 5% significance level. S26 presented greater sealing ability (p<0.05) than ZOE, MTA, CPM1, and CPM2, all of which had similar results (p>0.05). We concluded that Sealer 26 has the greatest sealing ability. Endo CPM Sealer, with sealing ability similar to MTA, could be used as a retrograde obturation material.