Restor Dent Endod.  2021 Aug;46(3):e35. 10.5395/rde.2021.46.e35.

Comparison of the sealing ability of various bioceramic materials for endodontic surgery

• Rencher B
• Chang AM
• Fong H
• Johnson JD
• Paranjpe A

• KMID: 2548079
• DOI: http://doi.org/10.5395/rde.2021.46.e35

Abstract

Objectives
Endosequence Bioceramic Root Repair Material (BC-RRM) is used in endodontic microsurgery. It is available as a paste and a putty. However, no studies to date have examined the sealing ability of these forms alone or in combination as root-end filling materials. Hence, this study aimed to compare the sealing properties of these 2 forms of BC-RRM.
Materials and Methods
Forty-two extracted upper anterior teeth were divided into 3 experimental groups, a positive and negative control. After the root canal treatment, the root ends were resected, retroprepared and retrofilled with either putty, paste + putty or mineral trioxide aggregate (MTA). The teeth were mounted in tubes so the apical 3 mm was submerged in Brain Heart Infusion (BHI) broth. The coronal portions of the canals were inoculated with Enterococcus faecalis and BHI broth and incubated for 30 days. The broth in the tubes was analyzed for colony forming units to check for leakage of bacteria from the canal. The teeth from the groups were sectioned and analyzed using scanning electron microscopy (SEM). The Kruskal-Wallis test and analysis of variance were used to analyze the data with a significance level p < 0.05.
Results
The BC-RRM and MTA groups showed similar sealing ability. The positive control showed leakage in all samples. The SEM imaging showed the presence of bacteria in all experimental groups at the material-tooth interface.
Conclusions
No significant differences were noted in the experimental groups, providing sufficient evidence that any combination could be effectively used during endodontic microsurgery.

Keyword

Bacteria; Bioceramic Paste; Bioceramic Putty; Mineral trioxide aggregate; Sealability

Figure

• 

  Figure 1 Schematic representation of the methodology used in this study.BHI, Brain Heart Infusion.

• 

  Figure 2 Bacterial counts were determined with the optical density of 600 nm (OD600) readings. There were statistically significant differences between the gutta-percha (positive control) and experimental groups. Analysis of variance with a post hoc Tukey test was used to test for differences in the OD readings between the different groups.MTA, mineral trioxide aggregate.*The significance level was set at p < 0.05.

• 

  Figure 3 Colony forming units (CFUs) were calculated for all the groups. CFU data corroborated optical density of 600 nm readings. Gutta-percha (positive control) had statistically higher numbers as compared to the other experimental groups. The negative control had no colonies. The Kruskal-Wallis test was used to test for differences in CFUs across groups.MTA, mineral trioxide aggregate.*The significance level was set at p < 0.05.

• 

  Figure 4 Scanning electron microscopic (SEM) images demonstrated the surface canal interface for the positive control and the experimental groups. The gutta-percha from the canals for all groups was displaced during specimen preparation. (A) Bacteria present in the canal (red box); the resected root surface in the gutta-percha (positive control) group (red arrow). (B) Root-end filling material in the bioceramic putty (group 1) group (20×). The marginal adaptation of the material to the root surface (black arrow). (C) Material and canal interface in the bioceramic putty group (group 1). This SEM image further demonstrates the marginal adaptation of the material to the root surface (250×). (D) Root-end filling material in the bioceramic paste + putty group (group 2) (20×). The marginal adaptation of the material to the root surface (black arrow). (E) Material and canal interface in the bioceramic paste + putty group (group 2) (250×). This SEM image demonstrates the marginal adaptation of the material to the root surface. (F) Presence of bacteria (red box) in the tooth canal space in group 2 (5,000×). (G) Root-end filling material in the Grey mineral trioxide aggregate (MTA) (group 3) (20×). The marginal adaptation of the material to the root surface (black arrow). (H) Material and canal interface in the Grey MTA (group 3) (250×). This SEM image demonstrates the marginal adaptation of the material to the root surface. (I) Presence of bacteria (red box) in the canal space in the tooth in group 3 (5,000×).SEI, scanning electron imaging; WD, working distance.

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