Repair of root canal perforation by different materials

Abstract

Background: The aim of this in vitro study was to compare sealing ability of Mineral Trioxide Aggregate (MTA), Glass ionomer cement (GIC) and Epiphany obturation system in repairing the iatrogenic lateral root canal perforation. Materials and Methods: Thirty freshly extracted human teeth with single and straight canals were used in this study. These teeth were cleaned and their crowns were removed at the cemento-enamel junction. The roots were instrumented using the step-back technique. A perforation was created on the mesial root surface at about 45- degree angle to the long axis of each root apico-coronally at the middle third by small round bur #1/2 with copious irrigation of 2.5% NaOCL and 17% buffered solution of EDTA was used as the final rinse to remove the smear layer and to prevent the blockage of perforation. The 30 roots were divided randomly in to three groups (10 roots for each group):- Group A: The root canal perforation was repaired by MTA then obturated by lateral condensation technique with gutta-percha and zinc oxide eugenol sealer. Group B: The root canal perforation was repaired by GIC then obturated by lateral condensation technique with gutta-percha and zinc oxide eugenol sealer. Group C: the roots were obturated with Epiphany obturation system by lateral condensation technique. The external surfaces of all roots were coated by two layers of sticky wax except the perforation site then immersed in 2% methylene blue dye for 48 hrs in incubator at 37C°. After that all roots were longitudinally sectioned for linear measurement of dye penetration through the perforation using a stereomicroscope at X40 magnification with calibrated scale ocular grid. Results: The result showed that group A showed the lowest mean of dye leakage (0.77mm) while group C showed the highest mean of dye leakage (4.45mm). Conclusion: Significantly less dye leakage in roots which perforations repaired by MTA than those repaired by GIC and highly significant less dye leakage than those repaired by Epiphany obturation system.