Healing after Root-end Microsurgery by Using Mineral Trioxide Aggregate and a New Calcium Silicate–based Bioceramic Material as Root-end Filling Materials in Dogs

Abstract

Introduction The purpose of this study was to compare healing after root-end surgery by using grey mineral trioxide aggregate (MTA) and EndoSequence Root Repair Material (RRM) as root-end filling material in an animal model. Methods Apical periodontitis was induced in 55 mandibular premolars of 4 healthy beagle dogs. After 6 weeks, root-end surgeries were performed by using modern microsurgical techniques. Two different root-end filling materials were used, grey MTA and RRM. Six months after surgery, healing of the periapical area was assessed by periapical radiographs, cone-beam computed tomography (CBCT), micro computed tomography (CT), and histology. Results Minimal or no inflammatory response was observed in the majority of periapical areas regardless of the material. The degree of inflammatory infiltration and cortical plate healing were not significantly different between the 2 materials. However, a significantly greater root-end surface area was covered by cementum-like, periodontal ligament–like tissue, and bone in RRM group than in MTA group. When evaluating with periapical radiographs, complete healing rate in RRM and MTA groups was 92.6% and 75%, respectively, and the difference was not statistically significant (P = .073). However, on CBCT and micro CT images, RRM group demonstrated significantly superior healing on the resected root-end surface and in the periapical area (P = .000 to .027). Conclusions Like MTA, RRM is a biocompatible material with good sealing ability. However, in this animal model RRM achieved a better tissue healing response adjacent to the resected root-end surface histologically. The superior healing tendency associated with RRM could be detected by CBCT and micro CT but not periapical radiography.

Cimentos biocerâmicos em endodontia: revisão de literatura

“…Assim, a avaliação da formação de apatita na superfície de um material, quando exposta a um fluido corporal simulado, é um método aprovado para examinar a bioatividade in vivo dos tecidos duros 40 . A bioatividade de materiais biocerâmicos endodônticos foi confirmada no Bioagregado 12 , EndoSequence Root Repair Material 12,18 , ProRoo tMTA 12 , iRoot SP 17 . Com relação à adaptação marginal, essa propriedade foi considerada aceitável para materiais biocerâmicos 21,22 , com elevada resistência adesiva nas paredes do canal radicular 24,25 , as quais sofrem pouca influência dos métodos de irrigação 16 .…”

Novel Bioceramic Root Repair Materials: Review of the Literature

“…According to this research, there is no significant difference in inflammatory response, epithelial proliferation and new hard tissue formation between BioAggregate and MTA. As far as EndoSequence is concerned, studies conducted by Chen et al [34] revealed a superior healing after root-end surgery in dogs associated with EndoSequence rather than MTA. Nevertheless, this could have been detected only by CBCT or micro CT. One of the most valuable studies available is the one by Shinbori et al [35].…”

Endodontologie in beweging: nieuwe concepten, materialen en technieken 1. Hydraulische calciumsilicaatcementen

“…Het is aangetoond dat EndoSequence ® RRM™ in een zure omgeving zal leiden tot meer poreuze en minder kristallijne microstructuren. Aangezien MTA minder beïnvloed wordt door de zure pH van het milieu (bijvoorbeeld in geval van inflammatie), lijkt dit het meest geschikte materiaal om in zo een situatie te gebruiken (Wang et al, 2015).…”