Marginal gaps and internal voids after root-end filling using three calcium silicate-based materials: A Micro-CT analysis.

Alexander Pompermayer Jardine,Renata Grazziotin-Soares,Ketsia Fernanda Váz Rosa,Patricia Maria Poli Kopper,Felipe Barros Matoso,Ramiro Martins Quintana

doi:10.1590/0103-6440202104096

Alexander Pompermayer Jardine, Renata Grazziotin-Soares + Show 4 more

Open Access

https://doi.org/10.1590/0103-6440202104096

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Abstract

This study evaluated the 3D quality of root-end filling, assessing the presence (volume and percentage) of marginal gaps and internal voids formed after retro-filling with three calcium silicate-based materials: MTA Angelus (Angelus Soluçoes Odontologicas, Londrina, PR, Brazil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, France) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Florida, US). Thirty human, extracted, single rooted teeth were used. Orthograde root canal treatment, root resection (3mm shorter than the apex) and retrograde cavity preparation with ultrasonic tips were performed. Teeth were divided into 3 groups (n =10 each) following a stratified randomization according to the initial volume of the root-end cavity. After retrofilling, samples were stored for 7 days. Then, two rounds of micro-CT scans were performed: soon after root-end preparation (with the cavity still empty) and 7 days after root-end filling. Marginal gaps, internal voids volume (mm3 and %), as well as, the overall defects (sum of gaps and voids) were evaluated. Statistics compared the three groups in relation to those defects. There was not statistical difference between groups regarding the marginal gaps (P≥ 0.05), the internal voids (P≥ 0.05), and the overall defects (P≥ 0.05). Median (mm3) and % of overall air-entrapment defects (gaps and/or voids) was: 0.004mm3 and 1.749% for MTA Angelus, 0.018mm3 and 6.660% for Biodentine, and 0.012mm3 and 4.079% for Neo MTA Plus. All materials had gaps and/or voids. No differences were found between MTA Angelus, Biodentine and Neo MTA Plus.

Highlights

An appropriate root-end filling during apical surgery is important to reach a positive outcome when treating apical periodontitis that affects root-filled teeth (‘post-treatment disease’ or ‘non-healing cases’) [1]
Since the 90`s, previous studies that aimed to assess the appropriateness of the retro filling materials have used different techniques to show the sealing ability and marginal adaptation on the interface material-canal wall [4,5,6,7,8,9,10,11]
Other limitation of the past studies was the use of destructive techniques, which did not allow the use of the same sample for long time evaluations and did not provide a 3D viewing of the material [15]

Summary

Introduction

An appropriate root-end filling during apical surgery is important to reach a positive outcome when treating apical periodontitis that affects root-filled teeth (‘post-treatment disease’ or ‘non-healing cases’) [1]. In these cases, apical periodontitis is caused primarily by residual or subsequent infection after previous treatment [2]. Many materials were used (amalgam, IRM, super-EBA, composites and, calcium silicate-based cements) and primarily assessed by in vitro methods [4,5,6,7,8,9,10,11]. Other limitation of the past studies was the use of destructive techniques (tooth sectioning, photography, scanning electron microscopy, etc.), which did not allow the use of the same sample for long time evaluations and did not provide a 3D viewing of the material [15]

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Results

Conclusion