Comparison of the sealing ability amongst orthograde apical plugs of mineral trioxide aggregate plus, mineral trioxide aggregate repair HP, and Biodentine after root resection : a bacterial leakage study

• Published in: Odontology 2024-04, Vol.112 (2), p.364-371
• Main Authors: Harinkhere, Chhaya, Patni, Pallav Mahesh, Jain, Pradeep, Raghuwanshi, Swadhin, Pandey, Sanket Hans, Bilaiya, Sakshi
• Format: Article
• Language: English
• Subjects: Bacteria; Dentistry; Medicine; Microleakage; Oral and Maxillofacial Surgery; Original Article; Root canals; Statistical analysis; Survival analysis; Turbidity
• ISSN: 1618-1247; 1618-1255
• DOI: 10.1007/s10266-023-00847-4

[Abstract] This study aimed to analyse the effect of root-end resection on the sealing ability of orthograde apical plugs of three root-end filling materials (MTA Repair HP, Biodentine, MTA Plus) using the bacterial leakage method and compare it with the retrograde root-end filling technique. Eighty-four extracted mandibular premolar teeth with single root and single straight canals were selected and randomly divided into two main experimental groups (n=36) depending on the apical plug placement technique and a control : Group I : orthograde technique, followed by root-end resection ; Group II : retrograde root-end filling technique ; one control Group III (n=12) : obturation with gutta-percha, followed by root-end resection. Experimental groups were further subdivided into three subgroups A, B, and C (n=12) depending on the three different root-end filling materials used. An apical plug of 3 mm thickness was obtained in both the experimental groups. The apical sealing ability was evaluated with the dual-chamber bacterial leakage method. Statistical analysis was performed using the Kaplan-Meier survival analysis test. By the end of 30 days, the occurrence of turbidity indicating bacterial leakage was 75% in MTA Repair HP, 83.3% in Biodentine, and 91.7% in MTA Plus samples. This trend of turbidity was similar in both orthograde and retrograde technique. The control group showed turbidity in all the samples (100%). More MTA Repair HP samples (25%) survived the 30 days observation period with no bacterial leakage compared to Biodentine (16.7%) and MTA Plus (8.3%). The sealing ability of already set root-end filling materials placed through the orthograde technique did not deteriorate after root-end resection. Also among three root-end filling materials, MTA Repair HP presented the lowest bacterial microleakage followed by Biodentine and MTA Plus, respectively.