Efficacy of Mineral Trioxide Aggregate and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study

Abstract

Aim To compare the bacterial leakage of mineral trioxide aggregate (MTA) and biodentine when used as an apical plug in immature permanent teeth. Materials and methods It was a randomized double-blind in vitro study. A total of 60 teeth were divided into 2 groups of MTA and biodentine, which were further divided into 2 subgroups ( n = 30) each based on the apical plug thickness of 2 and 4 mm. The teeth were cleaned and shaped; root-end resection and canal preparation were done. Mineral trioxide aggregate and biodentine were mixed and filled as apical plugs of 2 or 4 mm thickness. Enterococcus faecalis was used to assess the bacterial leakage of the filled samples. Statistical analysis The comparison between the two groups was done by Chi-square test for categorical data. All p values <0.05 were considered as statistically significant. Results A 4 mm apical plug of biodentine showed the least amount of bacterial leakage followed by 2 mm MTA and 4 mm MTA. A 2 mm apical plug of biodentine showed the maximum bacterial leakage. But this was not statistically significant over a period of 3 months. There was a statistically significant difference ( p value = 0.042) among the total number of samples that leaked in the 2 and 4 mm biodentine group. Conclusion Mineral trioxide aggregate and biodentine had a similar apical sealing ability. The apical sealing ability of biodentine at 4 mm thickness was greater than 2 mm thickness. Clinical significance The apical leakage of the materials used in apexification is one of the main causes of endodontic failures in immature necrotic teeth. Materials like MTA and biodentine have overcome various drawbacks of calcium hydroxide as apexification material. The thickness of the apical plug plays an important role in preventing any microorganism from entering the periapical area, hence maintaining an adequate seal. How to cite this article Abbas A, Kethineni B, Puppala R, et al. Efficacy of MTA and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study. Int J Clin Pediatr Dent 2020;13(6):656–662.

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Bioceramics in Endodontics: Updates and Future Perspectives

“…The application of other bioceramics as apical barriers has also been reported. Biodentine as an apical barrier is better at preventing bacterial leakage than MTA in vitro [ 78 , 79 ]. Apical barrier techniques using MTA, Biodentine, and CEM increase the fracture resistance of immature teeth [ 80 , 81 ].…”

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“…The major disadvantage of using calcium hydroxide for apexification is that it requires a long term followup, in contrast Biodentine allows for a single visit apexification procedures and this barrier will prevent the penetration of toxins and bacteria from the root canal as well as this barrier allows for compaction of root filling material [20] . Abbas A et al, evaluated the efficacy of MTA and Biodentine as apical barriers in immature permanent Teeth and they found that the sealing capabilities was similar for both MTA and Biodentine irrespective of its thickness and better seal was created when Biodentine was used in increased thickness [21] .…”