Quality and leakage of perforation repair-materials: A comparison of intracoronal and retrograde techniquesBackground: The objective of this in vitro study was to evaluate the quality and leakage of repair materials when perforation sites were challenged from an orthograde or retrograde direction.
Methods:Intentional perforations were created on the mesial and distal root surfaces of the extracted human molar teeth (below the CEJ) using a diamond bur at a 45 degree angle to the long axis. Mesial perforations were repaired intracoronally using the following materials (n=15): IRM (Dentsply), amalgam (Dentsply), Dyract (Dentsply), SuperBond C&B (Sun Medical) and MTA (Dentsply). After filling the access cavities with cement, distal perforations were repaired retrogradely using the same materials. The teeth were kept at humid conditions (100%, 24hrs), the perforation sites were stained with 2%methylene blue (24hrs), sectioned and examined under a stereomicroscope at 20x and 40x magnifications and scored as extruded, insufficient or adequate in combination with the dye penetration.
Results:The data was statistically analyzed (Kruskal-Wallis and Mann-Whitney U-tests). A significant difference was found among the restoration techniques (p<0.05). All the materials showed less leakage when used retrogradely (p<0.05). Repair of the perforation through the access cavity resulted in 86% extruded or insufficient restorations with leakage. IRM restoration showed 80% and MTA showed 60% adequate restoration without leakage when applied retrogradely.
Conclusion:Repair of the perforations using the retrograde technique has significantly increased the number of the adequate restorations regardless the effect of the material factor. IRM showed the best sealing followed by MTA when applied retrogradely.
KEY WORDSLeakage, MTA, perforation.Root perforation is a procedural error that can occur during endodontic or restorative treatments (Thesis and Fuss 2006). Apical, furcal and lateral root perforations can cause a chronic inflammatory reaction of the periodontium and may result in irreversible attachment loss (Seltzer et al 1970, Jew et al 1982. The prognosis of treatment involving a root perforation is questionable and depends on the accessibility of the perforation, the elapsed time after the perforation and the degree of contamination (Seltzer et al 1970, Sinai et al 1989, Fuss and Trope 1996. The success rate for treatment after a lateral root perforation is lower than treatment for other type of perforations because lateral root perforations occur close to the gingival attachment site and they can be repaired by an internal or external approach (Jew et al 1982, Martin et al 1982. Another important factor is the characteristics of the materials that are used for treatment (Lee et al 1993 2006, Fuss andTrope 1996). Several studies investigating these materials have reported that MTA has the optimal properties to manage perforations.
93The main component of MTA is calcium oxide and silicon dioxide (70% to 95% of the cement) . In ad...