In-vitro evaluation of apical microleakage of two obturation methods of immature permanent teeth: orthograde apical plug of Mineral Trioxide Aggregate and root canal filling combining custom gutta-percha cone with Calcium Silicate-based sealer

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Aim: The aim of this study was to assess whether an obturation, combining a custom guttapercha cone with the BIOROOTTM-RCS sealer, displays similar sealing quality to the orthograde apical plugs of MTA CAPS1 in immature teeth with irregular wide apices. Methodology: Thirty-four immature permanent premolars with apical diameter varying between (1-3 mm) were chosen for this study and were divided into two groups. They were imbedded in wet sponge, which simulated the periapex. In the first group; 5 mm orthograde plugs of MTAwere placed using an appropriate plugger. In the second group; a custom gutta-percha cone was fabricated and used for root canal filling with the BIOROOTTM-RCS sealer. The specimens were stored at 37 8C and 100% humidity during five weeks to allow the complete set of the filling materials. The apical leakage was evaluated using a dye penetration test with 50%-weight silver-nitrate. The teeth were then embedded in a transparent resin and sectioned transversally at 1 and 3 mm from the apex. The slices were examined under optical microscope and were given scores from (0) to (4). When scoring a slice was difficult, spectroscopy for energy dispersion using a scanning electron-microscope was used to confirm the score. The results were compared using the Fisher test with p < 0.05. Results: Silver-nitrate was found in both groups in all slices at 1 mm. At 3 mm, the difference of micro-leakage was not significant. Conclusions: The custom gutta-percha cone combined with BIOROOTtm-RCS sealer displays similar leakage resistance to the orthograde MTA plugs.