Sealer penetration and marginal permeability after apicoectomy varying retrocavity preparation and retrofilling material

Abstract

Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity, which allows percolation of microorganisms and their products from root canal system to periapex. This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr:YSGG laser and retrofilling with MTA or cyanoacrylate. Twenty-two singlerooted teeth were decoronated and endodontically treated, their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur. Twenty roots were randomly assigned to 4 groups (n=5): GI and GII -retrofilling with MTA and cyanoacrylate, respectively; GIII and GIV -retrocavity irradiation with Er;Cr:YSGG laser (2.78 μm, 4 W, 20 Hz, 70.8 J/cm 2 ) and retrofilling with MTA and cyanoacrylate, respectively. The remaining 2 roots served as positive and negative controls. The analysis of rhodamine B dye infiltration (p=0.05) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates (p<0.05). Retrofilling with cyanoacrylate showed significantly lower permeability, either when laser was used or not on retrocavity. SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA, suggesting a more efficient marginal sealing. Based on these results, it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method, suggesting a more favorable condition to the establishment of the periapical healing.

Cianoacrilato na colagem de Bráquetes ortodônticos em resina acrílica: há maior adesão?

“…Adesivos à base de cianoacrilato têm sido bastante utilizados nas diversas áreas da Medicina e da Odontologia [20]. Alguns estudos têm mostrado o uso do cianoacrilato como adesivos cirúrgicos [19,21,22], durante terapia endodôntica [23,24] e para estabilização do lençol de borracha durante isolamento absoluto [25]. Os resultados clínicos e histológicos destes estudos têm demonstrado a baixa toxicidade desse material.…”

Effect of Er,Cr:YSGG laser irradiation on apical sealing ability of calcium silicatecontaining endodontic materials in root-end cavities

“…Karlovic et al 7) and Kocak et al 21) showed that MTA-filled root-end cavities prepared by Er:YAG laser had significantly lower microleakage than those prepared using ultrasonic devices. However, in the absence of smear layers, there seemed to be no apparent advantages in the use of Er,Cr:YSGG laser over conventional root-end cavity preparation methods to address apical microleakage of root-end fillings 22,23) . In agreement with the results of these studies, Er,Cr:YSGG laser treatment did not influence the sealing ability of the root-end filling materials tested in this study when compared with EDTA application.…”

The use of the erbium yttrium aluminium garnet (2,940 nm) in a laser-assisted apicectomy procedure

“…36 Apicectomy failure is generally related to inappropri ate marginal sealing of the retro-cavity, which allows percolation of micro-organ isms and their products from the root canal system into the peri-apical tissue. 37 The majority of periapical lesions har bour a variety of flora which cannot be eradicated despite a thorough apicec tomy procedure. 38 Surgical re-treatment of teeth previously treated with surgery is a valid alternative to extraction.…”