Sealing Ability of ProRoot MTA and MTA-Angelus Simulating a One-Step Apical Barrier Technique- An in vitro Study

Abstract

Endodontic treatment of the pulpless tooth with an immature root apex poses a special challenge for the clinician due to lack of an apical stop against which to compact an interim dressing of calcium hydroxide, or the final obturation material. A one-visit apexification protocol with MTA (Mineral Trioxide Aggregate) has be seen as an alternative to the traditional treatment practices with calcium hydroxide [Ca(OH)2]. The aim of this study was to investigate the use of MTA as a 5mm apical barrier by comparing sealing ability of ProRoot MTA to that of MTA-Angelus. 50 freshly extracted Maxillary and Mandibular single canal sound human incisor teeth were used in this study, which were decoronated to standardized 10mm root lengths. The root segments were prepared to simulate the clinical situation of an open apex with Gates Glidden burs # 5-1 and randomly assigned into 2 experimental groups of 20 samples each (Group A: ProRoot MTA, Group B: MTA-Angelus) and 10 root segments were used as control (Group C) where no apical barrier was used. After obturation the coronal portion of all samples were sealed with Glass Ionomer and stored at 37°C and 100% humidity for 4 weeks. The root segments were then double coated with nail varnish except for the apical 1mm and apical ends of all root segments were suspended vertically in methylene blue dye for 48 hours at room temperature. After removal from the dye, the samples were sectioned longitudinally and linear dye penetration was measured using a Grid and stereomicroscope. The measurements were tabulated and statistically analyzed. The mean percentage of dye leakage for Group A was 55.5% and for Group B was 53.25%. The results showed no statistically significant difference in the sealing ability of ProRoot MTA and MTA-Angelus when used as apical barriers.

Mineral Trioxide Aggregate: A Comprehensive Literature Review—Part II: Leakage and Biocompatibility Investigations

“…Results showed no significant difference in dye penetration (109). However, the major drawback for this study was use of methylene blue dye for assessing leakage of the materials (20,82).…”

Evaluation of Bacterial Infiltration in Teeth with Apical Barrier of MTA: An ex-vivo Study

“…Regarding the apical barrier of MTA, the literature shows that several thicknesses have been employed. One study [19] have tested 1-mm-thick barriers, although most of the studies and clinical case reports have used 3-to 5-mm-thick barriers [9,[17][18][19]21]. In the present study, the authors used 3-and 5-mm barriers of MTA, taking into account that the remaining root would be filled with conventional filling material in two groups.…”

In Vitro Evaluation of the Effects of MTA, CEM and Biodentine on Apical Leakage in Open Apex Teeth

“…11,14,36 İn vitro koşullarda materyallerin apikal örtü-cülük özelliklerinin değerlendirmesinde elekrokimyasal analiz, radyoizotop yöntemi, kimyasal ajanların kullanımı, basınçlı hava kullanımı, bakteri sızıntı yöntemi ve boyama yöntemi gibi pek çok sızıntı testi kullanılmaktadır. [37][38][39][40] Bu test yön-temleri içerisinde uygulanması kolay ve daha ekonomik olması nedeni ile en çok tercih edilen yöntem, boya sızıntı testidir. 38,39 Metilen mavisinin molekül hacmi bakteriyel ürünlere benzer biçimde düşük molekül hacmine sahip olduğu için, diğer boyalara göre kanal boyunca daha derin bölgelere penetre olabilme yeteneğine sahiptir.…”