Abstract
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.
Highlights
In some clinical situations, such as root canal overinstrumentation, apical resorption and teeth with open apices, there may be extrusion of the filling material, either gutta-percha, root canal sealer or both, due to the difficulty or impossibility to lock the master gutta-percha cone
mineral trioxide aggregate (MTA) was introduced in the early 1990’s as an experimental material developed by Dr Mahmoud Torabinejad at Loma Linda University, USA
It has been used in different clinical situations, such as communicating internal and external resorptions, as capping material in mechanically exposed pulps, as intracoronal barrier during internal bleaching of endodontically treated teeth, and as apical plug in case of difficulty to lock the master gutta-percha cone[4]
Summary
In some clinical situations, such as root canal overinstrumentation, apical resorption and teeth with open apices, there may be extrusion of the filling material, either gutta-percha, root canal sealer or both, due to the difficulty or impossibility to lock the master gutta-percha cone. MTA was introduced in the early 1990’s as an experimental material developed by Dr Mahmoud Torabinejad at Loma Linda University, USA This material was originally indicated as a retrograde filling material for use in endodontic surgery and cases of intraradicular and furcal perforations[18]. Since it has been used in different clinical situations, such as communicating internal and external resorptions, as capping material in mechanically exposed pulps, as intracoronal barrier during internal bleaching of endodontically treated teeth, and as apical plug in case of difficulty to lock the master gutta-percha cone[4]. These indications of MTA are related to the possibility of use in moist environments, as in most aforementioned indications, and mainly to its biocompatibility[4,26]
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