Root End Research Articles

Comparison between Calcium Hydroxide with Mineral Trioxide Aggregate and Regenerative Endodontics in Inducing Root Apex Closure during Apexification – A Systematic Review and Meta-analysis

Abstract This study aimed to assess better effectiveness between regenerative endodontic procedures (REP) and apexification procedures (AP) with mineral trioxide aggregate (MTA) and calcium hydroxide for inducing root end apex closure. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and registered in PROSPERO-CRD42023398997. Electronic databases were searched for studies evaluating effectiveness of REP and AP in terms of survival rate, success rate, increase in root length, root width and decrease in apical diameter. Cochrane risk of bias (RoB) -2 tool was used for quality assesssment using RevMan 5.3. The risk ratio (RR) and standardized mean difference (SMD) was used as summary statistic measure with random effect model (P < 0.05). Nine studies were included in qualitative synthesis and eight studies for meta-analysis. Quality assessment revealed moderate to low risk of bias. The pooled estimate through RR and SMD favoured REP being superior to AP for better survival rate (RR = 1.01 (0.96 – 1.06)), success rate (RR = 1.09 (0.96 – 1.24)), increase in root length (SMD = 0.25 (-0.14 – 0.63)), root width (0.66 (0.22 – 1.10)) and decrease in apical diameter (SMD =0.66 (-0.51 – 1.83)). Funnel plot did not show any heterogeneity indicating absence of publication bias. REP significantly improved apical root end closure. AP are equally effective in forming calcific barrier, however it was concluded that regeneration procedures are comparably superior to apexification procedures with greater outcomes. Clinicians should consider employing the REP in cases when root development is severely deficient and where tooth’s prognosis is hopeless even with an apexification procedure.

Microsurgical Management of Nonsurgical Endodontically Treated Fiasco in Natural Permanent Upper Molar Tooth – A Clinical Case Report

Abstract The maxillary first permanent molar presents wide anatomical alterations for root number and their respective canal system. The medial root (mesiobuccal) specifically has been invariably associated to treatment failures when nonsurgical endodontic procedures have been solely carried out. In endodontic treatments, the decision to retreat the failed endodontic treatment with a surgical procedure depends on multiple factors. Evidence about the enduring prognosis of conventional retreatment (nonsurgical) comparative to invasive surgery (root end) remains questionable which requires additional scrutiny. The present case report presents a case of a patient (female, age 53 years) who presented with agony in relation to the maxillary first molar (left-sided) abutment of a four-unit fixed partial denture. Routine endodontic treatment was performed for the affected tooth which showed evidence of failure at 6-month follow-up intervals. Surgical intervention as part of the desired treatment was undertaken with the sealing of the canals done by Portland cement-based repair material. A pursual (6 months) after apicoectomy showed a complete rebuilding of the lateral apical region with freshly laid bone and a complete symptom-free patient. This clinical case report is directed to highlight the prospect of nonconservative clinical procedures once a noninvasive approach produces less anticipated results.

Residual dentin thickness of root canal transportation by various metallurgical rotary systems: An in vitro study

Introduction: Numerous nickel–titanium (NiTi) rotary systems have been released on the market with noncutting tips, various cross sections, and production techniques. This research was carried out to assess the quantity of remaining dentin thickness of mandibular first molar root canal at 3, 6, and 9 mm far from the anatomic peak that prepared through contemporary rotating systems with different metallurgical properties with a cone-beam computed tomography (CBCT). Materials and Methods: In this investigation, 45 human mandibular first molars that had been extracted were employed. Teeth were accordingly divided into three main groups through the NiTi rotary system that was utilized in canal instrumentation (15 teeth each), such that all ranges of curvatures were equally represented in each group – Group A: EdgeFile X3 rotating system, Group B: ProTaper Next (PTN) rotating system, and Group C: ProTaper (PT) rotating system. The samples were scanned before and after instrumentation using CBCT, and by deducing the instrumented canals from the uninstrumented counterpart, the remaining dentin thickness for each root canal is calculated at three levels of each root (3, 6, and 9 mm away from the root end). Data were statistically analyzed. Results: A significantly higher mean value was scored in PT, followed by PTN, and the lowest value was found in X3 of canal transportation at the level of 3 mm (P < 0.001), whereas at the 6- and 9-mm levels, there was no substantial difference statistically through the levels. Conclusion: The EdgeFile X3 showed the lowest canal transportation at a 3-mm level from the apex in comparison to the other tested files.

Comparative in-Vitro Evaluation of Material Properties of Commonly Used Root-End Filling Materials

Background: Standard guidelines for performing conventional endodontic procedures have undergone a number of modifications recently. An ideal characteristics of a root end filling materials include dimensional stability; radio-opacity; non-resorbability; compressibility, adequate working and quick setting time; biocompatibility especially in peri-radicular area; bioactivity and easy handling properties. Objectives: This study evaluated and compared different root-end filling materials by determining their solubility, sorption and fluid uptake after immersion in deionized water over a period of 28 days. Methods: Materials were mixed a per manufacturer’s instructions and disc-shaped specimens were made (15mm×1mm). After 24h curing, discs were immersed in deionized water and incubated at 37±1◦C. At specified time intervals, measurements for mass and volume of discs were taken to calculate fluid sorption, solubility and uptake. Results: Fluid uptake of MTA was 0.029±0.0025g at day 1 and 0.066±0.004g at day 28 whereas, for Acroseal it was 0.0006±0.0001g at day 1 and 0.006±0.001g at day 28. Fluid uptake of MTA and Acroseal increased with passage of time but for Biodentine fluid uptake decreased from day 1 (0.017±0.005g) to day 28 (0.008±0.005g). Acroseal exhibited lowest values of fluid sorption (0.006±0.0005%) and solubility (0.0006±0.00005%) whereas bio-dentine exhibited maximum values of fluid sorption (0.06±0.007%) and solubility (0.04±0.03%). Conclusions: Percent water solubility and sorption of Biodentine is higher than MTA and Acroseal, whereas its fluid uptake decreases over a period of 28 days in comparison to MTA and Acroseal, indicating its stability and thus making Biodentine a better root-end filling material.

Case series on two-stage disinfection in regenerative endodontics on permanent mandibular molar with blunderbuss canal

Background: Revascularization is a promising approach as it promotes root end closure forming healthy, thick root dentin at the apex which provides clinical and radiographic success due to the elimination of bacteria and disinfection of the canal which gives a 100% sterile environment to receive SCAP. Aim: To examine the effect of a regenerative endodontic procedure on immature necrotic teeth with apical periodontitis Method: An 8-year-old medically fit boy was referred to the department with a lingering type of pain in the immature permanent mandibular first right molar. Bleeding was induced in the root canals at the third appointment. The blood clots (scaffolds) were covered with MTA, and the tooth was restored with a composite filling. Recall sessions were scheduled after one month and 3 months, when the tooth appeared asymptomatic clinically and radiographically, with considerable periapical healing. Conclusion: An immature multirooted tooth with necrotic pulps and periapical radiolucency was managed with evident clinical and radiographic success, wherein non-setting calcium hydroxide paste and triple antibiotic paste were used sequentially to guarantee complete canal disinfection.

An in-vitro comparison of bond strength of three different root end filling materials with Universal testing machine

Bacterial infection is widely known cause of apical periodontitis. Failure of conventional root canal treatment indicates the periapical surgery, this procedure requires root end resection. For the long term success of periapical surgery, root end filling materials are used. To compare the push-out bond strength of Portland cement, ProRoot MTA and Biodentine used as root-end filling materials using Universal Testing Machine. From the middle part of each root, three dentinal slices were made to produce 93 slices which were divided into 3 groups. In Group A: ProRoot MTA, In Group B: Biodentine and In group C: Portland cement were used and were further divided in subgroups based on soaking time in PBS solution i.e. 24hrs and 7 days before assessing the push out bond strength using Universal Testing Machine. The mode of bond failure of material to root dentin was analyzed using microscope. Data was analyzed using ANOVA and post-hoc tukey’s test. After 24hrs, there was statistically non-significant difference but After 7 days, ProRoot MTA showed significantly higher bond strength as compared to other tested groups. While analyzing the mode of bond failure, ProRoot MTA had adhesive failure, Biodentine had cohesive failure and Portland cement had mixed type of bond failure. All the tested materials showed comparable bond strength but ProRoot MTA had highest bond strength to root dentin among the other tested materials.

Proposal of Brotulella n. gen. for Monogeneans from the Gills of the Pacific Bearded Brotula Brotula clarkae Hubbs, 1944 (Ophidiiformes: Ophidiidae) Based on Morphological and Molecular Evidence

Based on morphological and molecular data, Brotulella n. gen. is proposed to accommodate the dactylogyrid monogeneans Brotulella laurafernandae n. sp. (type species) and Brotulella luisahelenae n. sp. on the gill filaments of the Pacific bearded brotula Brotula clarkae Hubbs, 1944 (Ophidiiformes: Ophidiidae) from Puerto Pizarro in the Tumbes region (northern Peru). Species of the new genus are distinguished from all other dactylogyrids by the combination of the following features: (1) anchors with a stocking-shaped sheath associated with the distal end of superficial and deep roots, (2) tandem gonads, (3) a vas deferens looping left intestinal caecum, (4) a distally twisted male copulatory organ (MCO) with a delicate membranous accessory piece articulated to the shaft of the MCO, (5) a U-shaped ovary, (6) an almost sigmoid seminal vesicle, and (7) two prostatic reservoirs with thick muscular walls. A 28S ribosomal DNA-based phylogenetic analysis (Maximum likelihood and Bayesian inference) of sequences of two new species of Brotulella n. gen. from the Southeastern Pacific Ocean, along with sequences from closely related genera of the marine Dactylogyridae, supports the establishment of the new genus for the dactylogyrid parasites on the gills of the Pacific bearded brotula.

Morphological diversity of onion genetic resources at the Agricultural Institute of Slovenia

Onion is an important vegetable crop grown for its pungent bulbs and aromatic leaves. Onion genetic resources collected in the Slovenian Plant Gene Bank at the Agricultural Institute of Slovenia were evaluated for the first time using various morphometric traits. Using the prescribed descriptors (UPOV, CPVO) for Allium cepa spp., a collection of 61 onion accessions and varieties grown in the experimental fields of the Infrastructure Centre Jablje in 2022 was described. For each onion genetic resource, a total of thirteen quantitative (numerical) and qualitative descriptors were evaluated on the bulbs: bulb size, bulb height, bulb diameter, ratio height/diameter, position of maximum diameter, width of the neck, shape in longitudinal section, shape of stem end, shape of root end, base colour of dry skin, intensity of base colour of dry skin, coloration of epidermis of fleshy scales, and dry matter content. The results showed significant differences between onions in the collection in terms of bulb size (73.7 ± 26.0 g), bulb height (46.3 ± 14.2 mm), bulb diameter (36.7 ± 6.8 mm), bulb shape (predominant transverse medium elliptic), and colour of dry skin (brown, pink, red, purple). The highest coefficients of variation were observed for bulb size (35.3%) and height/ diameter ratio (32.6%) and the lowest for dry matter content (8.6%). The data obtained and the variability of the traits studied indicate that these onion accessions require further genetic analysis to identify the best candidates for future breeding programmes.

Assessment of Quality and Readability of Online Patient-Centered Arabic Web-Based Knowledge About Apicoectomy.

Background Endodontic microsurgery (apicectomy) can be considered in cases of persistent infection that is resistant to conventional root canal treatment. The aim of this study was to evaluate the quality and readability of the available online information regarding the apicectomy procedure in Arabic. Methods Online search on the three most commonly used websites (Google, Yahoo, and Bing) using one keyword. The first 100 websites from each search were analyzed for quality and readability using DISCERN instrument scores, the Journal of the American Medical Association (JAMA) benchmarks, the Health On the Net (HON) seal, Flesch Reading Ease Scores (FRES), Flesch-Kincaid Grade Level (FKGL), and the Simplified Measure of Gobbledygook (SMOG) Index. Results Searching using the Arabic translation for "root end resection surgery" revealed 349,900 websites. Following the inclusion criteria, 31 websites were selected and evaluated in this study. The selected websites belonged to either non-profit organizations or commercial websites. The quality of most of the selected websites received a moderate score (83.9%) using the DISCERN tool. None of the selected websites obtained the HON seal. Quality evaluation using the JAMA benchmarks revealed that currency was the most achieved item (45.2%), followed by authorship (22.6%). Evaluation of the readability of the selected websites using the FRES, FKGL, and SMOG showed that the included websites were considered readable. Conclusion Although the included websites were readable, the quality of the websites was moderate. There is an urgent need to create more trustworthy and readable websites explaining the different endodontic treatments.

BIODENTINE V/S BIOSTRUCTURE MTA- THE BETTER ROOT END FILLING MATERIAL- CLINICAL CASE REPORT

An ideal root end filling material is the one which is biocompatible, easy to handle, dimensionally stable ,radio opaque, set in the presence of wet environment, have good compressive strength, non staining, have adequate working time and must be antibacterial in nature. Newer materials have been introduced over the years and two such materials are Biostructure MTA and Biodentine. Both of them fulfil the criteria of an ideal root end filling material. So this case report compares the two materials and the post operative healing following the placement of the material.

Quartz Nonadherent and Clean Exfoliation of the Heteroatom-Doped Bulk Carbon Nanotubes Array.

Vertically aligned carbon nanotubes array offers unique properties for various applications. Detaching them from the growth substrate, while preserving their vertical structure, is essential. Quartz, a cost-effective alternative to silicon wafers and metal-based substrates, can serve as both a reaction chamber and a growth substrate. However, the strong adhesive interaction with the quartz substrate remains an obstacle for further applications. Herein, we presented a simple and well-controlled exfoliation strategy assisted by the introduction of heteroatoms at root ends of a carbon nanotubes array. This strategy forms lower surface polarity of the carbon fragment to significantly reduce adhesion to the quartz substrate, which contributes to the effortless exfoliation. Furthermore, this scalable approach enables potential mass production on recyclable quartz substrates, enhancing the cost-effectiveness and efficiency. This work can establish a solid foundation for cost-competitive carbon nanotube-based technologies, offering a promising avenue for their widespread applications.

An in vitro assessment of cytotoxicity and genotoxicity of root repair materials.

The success of the root-end procedure depends on the regeneration of the functional periodontal attachment system, including the cementum on the resected root-end surface, periodontal ligament (PDL), and alveolar bone. As root end filling materials remain in close contact with live periapical tissues, they may influence the endodontic treatment outcome. To assess and compare the cytotoxicity and genotoxicity of three root repair materials, mineral trioxide aggregate (MTA), endosequence, and geristore in human-cultured periodontal ligament fibroblasts. Cultured human periodontal ligament fibroblasts of the third passage were used in the study. They were placed in contact with the root repair materials. The cytotoxic effect on PDL fibroblasts was determined by (3-(4,5-dimethylthiazol-2-yl)-2,5-tetrazolium bromide) assay after 24 hours and 48 hours intervals. Cell viability was determined using an inverted phase contrast microscope. The genotoxic effect on the periodontal fibroblast cells was determined by comet assay using imaging software. Data were analyzed using Tukey's multiple comparison test and Dunnett's multiple test. All the test materials showed higher cytotoxicity and genotoxicity at the 48th hour interval with a statistically significant difference from the control group (P < 0.05). MTA was shown to be least cytotoxic and genotoxic to PDL fibroblasts, followed by endosequence root repair material and geristore at 24 hour and 48 hour intervals. The cytotoxicity and genotoxicity of MTA were the least compared to endosequence and geristore on human-cultured PDL fibroblasts.

Evaluation the Marginal Adaptation for the Bio C Repair and Other Root end Filling Material by Using Scanning Electron Microscope (A Comparative In Vitro Study)

АBSTRАCT:‏‏‏‏‏‏ Background: The ability of the retrograde filling material to adhere to dentin has a substantial impact on the success of endodontic procedures. the marginal adaptation of the rᴏᴏt end filling materials considered important factor, since it demonstrates the materials adaptation to the dentinal walls. Objective: Assess the marginal adaptation of Biᴏ-C reparative materials in contrast to MTA (АNGELUS) and Amalgam. Material and method: A total of thirty human maxillary central incisors teeth that each had a single root were chosen. To keep the root canal length at 15mm, the crown was resected. The teeth underwent endodontic treatment, along with the resection of their root ends and preparation of root-end cavities. On the basis of the type of filling, the teeth were categorized into one of three groups, as follows: (А) Bio-C repair (Bioceramic reparative material), (B) MTА АNGELUS, (C) Amalgam. teeth were sectioned in longitudinal manner, marginal gabs measured by the use of a scanning electron microscope. Data was statically analyzed using АNOVА and Tukey Honestly Significant Difference (Tukey's HSD). Results: Bio-C Repair material and MTA show better marginal adaptation with significant difference between them and amalgam, no significant different between Bio-C repair group and MTA group. Conclusion: marginal adaptation better for Bio-C repair in comparison to Amalgam and MTА АNGELUS

The impact of pulpotomy on the long-term prognosis and survival of young permanent teeth

This review explores the impact of pulpotomies on the long-term prognosis and survival of primary and young permanent teeth. Pulpotomy is a vital pulp therapy procedure aiming to preserve pulp health and functions. The review covers various vital pulp therapy techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and full pulpotomy. Apexogenesis, a procedure promoting root end formation, is also discussed. Long-term success in endodontic therapy requires an effective coronal seal to prevent microleakage and bacterial ingress into root canals. The study's methodology involved a comprehensive literature search to gather information on pulpotomy's effects on tooth prognosis and survival. Factors influencing the success of vital pulp therapy, such as the size of the exposure, the state of the pulp, and the choice of capping material, are analyzed. Bacterial contamination is identified as a crucial factor affecting the therapy's prognosis. Strategies to improve pulp healing and treatment outcomes are explored, offering insights into clinical decision-making for pulpotomy procedures.

Comparison of root end sealing ability of three retrograde filling materials in teeth with root apices resected at 900 using dye penetration method under fluorescent microscope

Background: The main factor contributing to surgical endodontic dissatisfaction is an inadequate seal at the apex. The material used for retrograde filling should prevent contaminants from penetrating periradicular tissue. So the objective of this study was to evaluate and compare the ability of Mineral Trioxide Aggregate (MTA), Zirconomer and bioactive bone cement to seal the root end as retrograde filling material with apices resected at 900 angles using dye penetration method under fluorescent microscope. Methods: 36 extracted teeth samples were cut at Cementoenamel junction horizontally. Following the customary protocols of, cleaning, shaping and obturation with gutta percha and AH Plus sealer, resection of samples was done 3mm at the apical end at 90 degree angle along the long axis of the tooth with the help of diamond disc. A depth of 3mm of root end cavity was made with diamond coated ultrasonic surgical tip. The samples were randomly allocated in 3 groups: Group I: MTA ; Group II : Zirconomer; Group III: Bioactive Bone Cement . Coating of nail varnish was done with the roots except at the tip. Each material was compacted in the retrocavity using small pluggers. All the retrofilled samples were kept in acridine orange for 24 hours, following which cleaning &amp; bucco-lingual sectioning (vertical) was carried out. Confocal laser scanning fluorescent microscope was used for checking the dye penetration in these samples thereby evaluating sealing ability. Results: Group III (Bioactive Bone Cement) had the highest root end sealing ability with mean (1.4 ± 0.51) followed by Group I (MTA) (2.3 ± 0.65) and lastly Group II (Zirconomer) (4.1 ± 0.57) as root end filling material with apices resected at 900 angle using dye penetration method under fluorescent microscopy which were statistically significant. Conclusions: Bioactive Bone cement can be recommended as an acceptable retrograde filling material.

The Washout Resistance of Bioactive Root-End Filling Materials.

Fast-setting bioactive cements were developed for the convenience of retrograde fillings during endodontic microsurgery. This in vitro study aimed to investigate the effect of irrigation on the washout of relatively fast-setting materials (Biodentine, EndoCem Zr, and MTA HP) in comparison with MTA Angelus White and IRM in an apicectomy model. Washout resistance was assessed using artificial root ends. A total of 150 samples (30 for each material) were tested. All samples were photographed using a microscope, and half of them were also scanned. The samples were irrigated and immersed in saline for 15 min. Then the models were evaluated. Rinsing and immersing the samples immediately after root-end filling and after 3 min did not disintegrate the fillings made of all tested materials except Biodentine. Root-end fillings made of Biodentine suffered significant damage both when rinsing was performed immediately and 3 min after the filling. Quantitative assessment of washed material resulted in a slight loss of IRM, EndoCem MTA Zr, and MTA HP. MTA Angelus White showed a slightly greater washout. Rinsing and immersion of Biodentine restorations resulted in their significant destruction. Under the conditions of the current study, the evaluated materials, excluding Biodentine, showed good or relatively good washout resistance.

Ultrasonic SH guided wave detection of the defects of switch rails with 3D finite element method

A switch rail is an important part of the high-speed railway system, but it is highly susceptible to defects during service, which threat traffic safety. A switch rail has an asymmetric variable cross-section structure, which makes it challenging to detect its defects with ultrasonic testing. In this study, the finite element model of switch rails and the ultrasonic SH guided wave detection of groove defects were explored. The three-dimensional finite element model of switch rails with the same sizes used under working conditions was established. Furthermore, the influences of grid division method, switch mechanism setting method, and root end variable cross-section grid type on guided wave propagation in the model were analyzed in detail. The switch rail model was experimentally validated. The ultrasonic SH guided wave detection of the defects at the rail head and rail bottom was successfully realized and the echo signals from other special structures of switch rail were also obtained. The finite element model calibrated with experimental results could be used to simulate guided wave detection at any location with any defect. The calibrated model could optimize the switch rail guided wave detection scheme and guide signal identification. The study provides an important basis for the inspection and monitoring of switch rails.

Integrative oral medicine: Dentistry's role in improving health outcomes.

This article describes the importance of identifying inflammation-inducing conditions in the dental office that are prevalent in the population and have significant systemic health risks for the patient. The role of the dental biofilm will be presented, as will the clinical protocols for treating an unhealthy biofilm. Methods for testing and maintaining a healthy biofilm are also presented. Periodontal disease, dental caries, and periapical infections are inflammation-inducing diseases that can be identified in the dental office. Additionally, sleep apnea has been linked to chronic systemic inflammation. Dentists can identify risk factors and provide treatments that lower the risk of serious systemic outcomes, such as atherosclerosis, cardiac arrest, and stroke. A thorough dental examination, including a comprehensive periodontal evaluation, can provide important information that can be used to improve or maintain a patient's systemic health. Treatments provided to improve oral health have been shown to improve systemic indicators of cardiovascular health. This is the basis of integrative oral medicine, a collaboration between the medical and dental providers, which can offer patients the best opportunity for improved health outcomes. Periodontal disease, caries, periapical infections, and sleep apnea all have negative systemic health consequences for the patient (DiMatteo, Inside Dent, 2017, 13, 30; Nakano, Oral Microbiol Immunol, 2009, 24, 64; El Ouarti, BMC Oral Health, 2021, 21, 124; Lamberg, Steve). Periodontal disease, caries, and root end infections influence the health of the oral biofilm. If the biofilm becomes pathogenic the host inflammatory response can be stimulated, resulting in a cascade of inflammatory processes that damage the supporting structures of the teeth and harm the patient's overall health. A thorough dental exam that includes a comprehensive periodontal evaluation will identify patients with active inflammation or oral conditions that contribute to chronic inflammation. Dentists can integrate this information into treatment strategies that reduce the inflammatory burden and assist in better overall health outcomes.

Guiding Groove: A New Hypothetical Strategy for Ostectomy and Fenestration in Endodontic Microsurgery

Introduction: How to save more bone for the teeth of patients with chronic periapical periodontitis with intact or small defects of the labiobuccal cortical plate in the periapical surgeries is a problem that many dentists are concerned about. The Hypothesis: We came up with a new strategy for periapical surgery by designing a modified osteotomy and fenestration method, which we named the “guiding groove” method. There are two ways to achieve this, one is to perform guided groove positioning under CBCT dynamic navigation, and the other is to design a guide plate that marks the position and direction of the guided groove based on CBCT data before surgery. Evaluation of the Hypothesis: The existence of the “guiding groove” locks in the angle and direction of the ultrasonic root end preparation and retrofilling apparatus, which not only minimizes the deviation of the root canal but also preserves more cortical plate on the labial and buccal sides of the teeth and thus improves the efficiency of treatment. This hypothesis has certain limitations. Firstly, the technical sensitivity of the operation is high, and proficiency in CBCT dynamic navigation technology is required. The accuracy requirements for navigation equipment are also relatively high. It will also increase the patient’s exposure to X-rays. For the guide plate designed before surgery that has already marked the position of the guide groove, it can only accurately avoid the deviation of the operating instrument in the proximal and distal directions, and it is difficult to avoid the deviation of the instrument in the buccal and lingual directions.

Comparative Evaluation of Setting Time and Sealing Ability of Two Root End Filling Materials: An In vitro Study

Purpose: Incomplete root formation caused due to trauma can lead to problems in future. Treating such open apices teeth pose a challenge. Apexification is one of the treatment options for such teeth with open apex. Thus, this in vitro study intended to assess and compare two commercially available root-end filling materials mineral trioxide aggregate (MTA)-Angelus and Biodentine™ for their setting time and sealing ability. Materials and Methods: This in vitro study assessed the setting time and sealing ability of the two materials; MTA-Angelus and Biodentine™. For setting time evaluation, 30 rings were made and divided into two groups. The evaluation was done using Vicat apparatus. For sealing ability, sixty single rooted teeth were used and were divided into four groups (two experimental and two control). The assessment was done using the linear dye penetration method. Results: Mean setting time of Biodentine and MTA was 29.2 ± 3.84 min and 15.2 ± 2.11 min, respectively. The mean linear dye penetration in MTA group was found to be 0.808 ± 1.094 mm, 3.76 ± 1.05 mm in Biodentine group, 5.28 ± 1.73 mm and 0.05 mm in positive control group. Conclusion: MTA-Angelus demonstrated a faster setting time when compared to biodentine, while biodentine showed to have a superior sealing ability.