Elsevier

Journal of Endodontics

Volume 42, Issue 4, April 2016, Pages 654-658
Journal of Endodontics

Basic Research
Comparative Analysis of Calcium Silicate–based Root Filling Materials Using an Open Apex Model

https://doi.org/10.1016/j.joen.2016.01.015Get rights and content

Highlights

  • Calcium silicate–based materials including ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), NeoMTA Plus (Avalon Biomed Inc, Bradenton, FL), and Endosequence BC RRM-Fast Set Putty (BC RRM-FS; Brasseler USA, Savannah, GA) were compared for marginal adaptation after orthograde placement in roots with open apices.

  • As evaluated by a scanning electron microscope, all materials showed good marginal adaptation at the anatomic apex when used for orthograde obturation of open apices.

  • The application of BC Sealer before delivery of BC RRM-FS Putty enhanced the quality of adaptation coronal to the apex.

Abstract

Introduction

Many new calcium silicate–based root filling materials have emerged in the market; however, their performance in the orthograde obturation of an open apex has not been evaluated. The purpose of this study was to compare the marginal adaptation of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), NeoMTA Plus (Avalon Biomed Inc, Bradenton, FL), and Endosequence BC RRM-Fast Set Putty (BC RRM-FS; Brasseler USA, Savannah, GA) after orthograde placement in roots with open apices.

Methods

Palatal roots of maxillary molars were instrumented to create divergent open apices and divided into 4 groups for orthograde obturation: ProRoot MTA, NeoMTA Plus, BC RRM-FS, and BC RRM-FS + BC Sealer. Using a scanning electron microscope, the quality of material adaptation at the anatomic apex was evaluated by 5 blinded examiners; 3 mm of the root end was sectioned, and gap distance was measured at the material-dentin interface. Statistical analyses were performed using the Kruskal-Wallis test.

Results

There were no significant differences in marginal adaptation among the 4 groups at the level of the anatomic apex (P = .175). BC RRM-FS + BC Sealer had a significantly smaller gap size after 3-mm root end resection compared with the other 3 groups (P < .01). No differences were observed among the other 3 materials.

Conclusions

All materials showed comparable marginal adaptation at the anatomic apex when used for orthograde obturation of open apices. Application of BC Sealer before the delivery of BC RRM-FS Putty enhanced the quality of adaptation coronal to the apex.

Section snippets

Sample Preparation

Sixty freshly extracted human maxillary molars were used under a protocol approved by the Institutional Review Board of Texas A&M University Baylor College of Dentistry, Dallas, TX. Teeth were analyzed under 4× magnification (Zeiss, Oberkochen, Germany), and those containing root fractures or missing root tips were excluded. The palatal root was obtained by sectioning each tooth at the level of furcation. Each root was wrapped in moist gauze to prevent desiccation. Cleaning and shaping of the

Qualitative Evaluation of the Marginal Adaption of Root Filling Materials

Representative scanning electron microscopic photomicrographs of the root end after orthograde obturation with different materials, and root sections 3 mm from the apex are shown in Figure 3. The distribution of scores for each group is shown in Table 1. There were no significant differences (P = .175) between the 4 experimental groups in the quality of marginal adaptation of the root filling material at the level of the anatomic apex. The interclass correlation coefficient yielded a weighted

Discussion

Nonsurgical endodontic treatment of necrotic immature permanent teeth is challenging for the clinician because of the lack of resistance and retention form associated with a blunderbuss apex. Recent studies have reported successful long-term clinical outcomes associated with MTA apexification procedures 1, 2, 3. Although the quality of marginal adaptation does not necessarily correlate with clinical success, it has been established as an appropriate proxy to evaluate sealability and resistance

Conclusion

Within the parameters of this in vitro study, it can be concluded that for treatment of teeth with open apices requiring orthograde delivery of an apical barrier, there is no statistically significant difference in the quality of marginal adaptation at the level of the anatomic apex between the 3 materials evaluated. At a level 3 mm coronal to the apex, the application of BC Sealer to the canal walls before orthograde delivery of BC RRM-Fast Set Putty significantly enhanced its adaptation to

Acknowledgments

Supported by a resident research grant from the American Association of Endodontists Foundation.

The authors deny any conflicts of interest related to this study.

References (29)

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