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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 1-4

A study to evaluate and compare the apical sealing ability of MTA, Biodentine, and TotalFill BC RRM Putty in simulated immature teeth


1 Consultant Endodontist, Trivandrum, Kerala, India
2 Consultant Endodontist, Department of Conservative Dentistry, Sri Siddhartha Dental College, Tumkur, Karnataka, India

Date of Submission23-Feb-2022
Date of Acceptance03-Mar-2022
Date of Web Publication24-Mar-2022

Correspondence Address:
Dr. Neetha Raju
Consultant Endodontist, Trivandrum, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpcdr.ijpcdr_4_22

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  Abstract 


Background: Adequate seal of the root canal is necessary to prevent recontamination and ensure long-term clinical success. The aim of this study was to evaluate the sealing ability of ProRoot mineral trioxide aggregate (MTA), Biodentine, and Total Fill Bioceramic Root Repair Material Putty as the root canal obturation materials using the dye penetration test.
Materials and Methods: In this in vitro study, a total of All 68 human teeth were mounted on an experimental setup. Teeth were randomly divided into four groups: Group 1 – A 4 mm apical plug of premixed TotalFill BC RRM Putty; Group 2 – A 4 mm apical plug of hand-mixed MTA; Group 3 – A 4 mm apical plug of mechanically mixed MTA was placed; and Group 4 – A 4 mm apical plug of mechanically mixed Biodentine was placed.
Results: There is a statistically significant difference between Group II and Group III along the root canal wall (P < 0.05). There is no significant difference between Group I and Group IV along the root canal walls (P > 0.05). The lowest mean value of microleakage was recorded by Group I, whereas the highest mean value of microleakage was shown by Group II.
Conclusion: Within the limitation of this study, none of the root-end filling materials were free from microleakage. Among these materials, TotalFill BC RRM Putty showed the least microleakage along the root canal walls. However, the validity of this in vitro study could be appreciated only through further clinical trials.

Keywords: Dental leakage, filtration, mineral trioxide aggregate, root canal filling materials


How to cite this article:
Raju N, Kumar PS, Jayashankara C M, Girish S A. A study to evaluate and compare the apical sealing ability of MTA, Biodentine, and TotalFill BC RRM Putty in simulated immature teeth. Int J Prev Clin Dent Res 2022;9:1-4

How to cite this URL:
Raju N, Kumar PS, Jayashankara C M, Girish S A. A study to evaluate and compare the apical sealing ability of MTA, Biodentine, and TotalFill BC RRM Putty in simulated immature teeth. Int J Prev Clin Dent Res [serial online] 2022 [cited 2022 May 19];9:1-4. Available from: https://www.ijpcdr.org/text.asp?2022/9/1/1/340843




  Introduction Top


Pulpal necrosis in a young, immature permanent tooth can occur due to trauma or caries. This leads to the cessation of root development resulting in thin, fragile root canal walls with an open apex.[1] The management of such cases possesses treatment challenges due to difficulty in cleaning, disinfecting, and obturating of the canal space. Furthermore, poses the risk of root fracture due to fragile dentinal walls.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10] With the advent of mineral trioxide aggregate (MTA), the apexification procedure could be completed predictably in one appointment as there is increasing acceptance with one visit apexification technique. Biodentine, novel calcium silicate-based cement with similar properties to dentine introduced recently, has been considered as a promising option in the management of open apex cases due to its excellent sealing ability. TotalFill BC RRM Putty, a premixed bioceramic-based material, is one such novel material introduced recently to offset the poor handling characteristics of MTA and Biodentine. The purpose of this in vitro study is to compare the apical sealing ability of MTA, Biodentine, and TotalFill BC RRM Putty in simulated immature teeth.


  Materials and Methods Top


The present study was conducted in the Department of Conservative Dentistry and Endodontics, Sri Siddhartha Dental College and Hospital, Agalakote, Tumkur. Ethical clearance was obtained from Institutional Ethical Committee to conduct the study. The study was conducted on extracted human maxillary central incisor teeth, which fulfill the inclusion criteria, and the extracted teeth were stored immediately at room temperature in deionized water to which 1% thymol was added, taking care not to let them dry. The stored teeth were cleaned with an ultrasonic scaler to remove the surface deposits. All 68 teeth were mounted on an experimental setup using Abgel (Aegis Lifesciences) at the bottom of the GP glass vial used to prevent apical extrusion while condensing the filling material.

Teeth were randomly divided into four groups:

  • Group 1 – A 4 mm apical plug of premixed TotalFill BC RRM Putty (FKG Dentaire Brasseler USA) will be placed
  • Group 2 – A 4 mm apical plug of hand-mixed MTA (Angelus Soluções Odontológicas, Londrina, Brazil) will be placed
  • Group 3 – A 4 mm apical plug of mechanically mixed MTA (Angelus Soluções Odontológicas, Londrina, Brazil) will be placed
  • Group 4 – A 4 mm apical plug of mechanically mixed Biodentine (Septodont, Saint-Maur-des-Fosses, France) will be placed.


The canals were filled with a single tapered gutta-percha cone (Dentsply Maillefer, Ballaigues, Switzerland) after an appropriate setting time suggested by the manufacturer. Coronal access was sealed with Type II Glass Ionomer Cement (GIC). Fingernail polish was applied to the external tooth surface to prevent leakage. The coated teeth were immersed in 0.5% methylene blue dye for 48 h. The teeth were then rinsed with tap water, dried, and will be sectioned buccolingually through the center using a sectioning disc (3M, St Paul, USA). The statistical calculation was performed using the software SPSS Inc., 233, South Warker Drive, 11th floor, Chicago. The following statistical methods were employed in the present study. The data were tabulated and analyzed using one-way ANOVA followed by post hoc test., The power of the study was 90% and P < 0.05.


  Results Top


The present in vitro study was undertaken to assess, evaluate, and compare the apical sealing ability of MTA, Biodentine, and TotalFill BC RRM Putty. It was measured along the root canal walls under a stereomicroscope at 40 X magnification. [Table 1] shows descriptive data showing the dye penetration scores [Figure 1] of various groups along the root canal wall using Chi-square test. Group II exhibited the highest dye penetration, followed by Group III and Group I. Group 1V showed the least dye penetration. [Table 2] shows an intergroup comparison of microleakage along the root canal wall. There is a significant difference between the groups. [Table 3] shows a pairwise comparison with statistically significant differences between the groups. There is a significant difference between Group II and Group III, with Group II exhibiting more microleakage than Group III. Group II had significantly high microleakage along the root canal wall compared to other groups. There is a statistically significant difference between Group II and Group III along the root canal wall (P < 0.05). There is no significant difference between Group I and Group IV along the root canal walls (P > 0.05). The lowest mean value of microleakage was recorded by Group I, whereas the high mean value of microleakage was shown by Group II.
Figure 1: Dye penetration under stereomicroscope

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Table 1: Descriptive data showing the dye penetration scores along root canal walls

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Table 2: Intergroup comparison of microleakage along root canal walls

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Table 3: Pairwise comparison of study groups

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  Discussion Top


The present in vitro experimental study was conducted to assess and compare the microleakage of MTA, Biodentine, and TotalFILL BC RRM Putty used as a root-end filling material in simulated immature teeth. The favorable properties of MTA include biocompatibility, good sealing ability, and promoting periradicular tissue regeneration.[11],[12] MTA contains tricalcium silicate, tricalcium aluminate, tricalcium oxides, and other material oxides forming a hydrophilic powder that sets in the presence of water. Hydration of the powder results in a colloidal gel which solidifies to a hard structure. It has a long setting time of 2 h and 45 min. The compressive strength of the material increases with time.[13] Appetite-like interfacial deposits formed during the maturation of MTA result in filling the gap induced during the material shrinkage phase and improves the frictional resistance to MTA to root canal walls. In addition, the presence of calcium and phosphate ions in its formation results in the capacity to attract blastic cells and a favorable environment for cementum deposition. Biodentine has improved physical properties, which can be used as a root-end filling material. It is a calcium silicate-based cement. The presence of zirconium oxide in the powder of Biodentine reduces the setting time and increases the compressive strength. Biodentine has increased physicochemical properties such as short setting time high mechanical strength, which allows to handle it with ease. The novel material TotalFill BC RRM Putty is available in the premixed form and has advantages such as fast setting and premixed syringe delivery system. It is extremely resistant to wash out. Composition of TotalFill BC RRM Putty consists of calcium phosphate monobasic as an additional agent that enhances hydroxyapatite formation. It possesses excellent chemical durability, wear resistance, biocompatibility, and esthetics, which can be contributed to their nano-sized particles. In the present study, the null hypothesis was rejected as there is a difference in microleakage in TotalFill BC RRM Putty with MTA and Biodentine. In this study, the dye leakage method was used because it is a simple, inexpensive, fast technique and does not require the use of complex laboratory equipment. The pairwise comparison shows there is a statistically significant difference between TotalFill BC RRM Putty, MTA, and Biodentine. There is no significant difference between TotalFill BC RRM Putty (Group I) and Biodentine (Group IV) along the root canal walls. The lowest mean value of microleakage was recorded by TotalFill BC RRM Putty (Group I), whereas the high mean value of microleakage was shown by hand-manipulated MTA (Group II). Biodentine (Group IV) has less microleakage than hand-manipulated.


  Conclusion Top


Within the limitation of this study, none of the root-end filling materials were free from microleakage. Among these materials, TotalFill BC RRM Putty showed the least microleakage along the root canal walls. However, the validity of this in vitro study could be appreciated only through further clinical trials.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bani M, Sungurtekin-Ekçi E, Odabaş ME. Efficacy of biodentine as an apical plug in nonvital permanent teeth with open apices: An in vitro study. Biomed Res Int 2015;2015:359275.  Back to cited text no. 1
    
2.
El-Meligy OA, Avery DR. Comparison of apexification with mineral trioxide aggregate and calcium hydroxide. Pediatr Dent 2006;28:248-53.  Back to cited text no. 2
    
3.
Soundappan S, Sundaramurthy JL, Raghu S, Natanasabapathy V. Biodentine versus mineral trioxide aggregate versus intermediate restorative material for retrograde root end filling: An invitro study. J Dent (Tehran) 2014;11:143-9.  Back to cited text no. 3
    
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Gupta PK, Garg G, Kalita C, Saikia A. Microleakage of biodentine using different manipulation methods. J Int Oral Health 2015;7:111-4.  Back to cited text no. 4
    
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Solanki NP, Venkappa KK, Shah NC. Biocompatibility and sealing ability of mineral trioxide aggregate and biodentine as root-end filling material: A systematic review. J Conserv Dent 2018;21:10-5.  Back to cited text no. 6
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Kokate SR, Pawar AM. Evaluation of marginal seal between mineral trioxide aggregate, glass ionomer cement and biodentine as root end filling materials. Endod Dent Traumatol2014;11:264-9.  Back to cited text no. 7
    
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Butt N, Talwar S, Chaudhry S, Nawal RR, Yadav S, Bali A. Comparison of physical and mechanical properties of mineral trioxide aggregate and biodentine. Indian J Dent Res 2014;25:692-7.  Back to cited text no. 8
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Shahi S, Bashirzadeh A, Yavari HR, Jafari F, Salem Milani A, Ghasemi N, et al. Effect of different mixing methods on the bacterial microleakage of white Portland cement and white mineral trioxide aggregate. J Dent Res Dent Clin Dent Prospects 2017;11:84-9.  Back to cited text no. 9
    
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Nikhil V, Jha P, Suri NK. Effect of methods of evaluation on sealing ability of mineral trioxide aggregate apical plug. J Conserv Dent 2016;19:231-4.  Back to cited text no. 10
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Reyhani MF, Yavari H, Ghasemi N, Rahimi S, Barhaghi MH, Mokhtari H, et al. Comparing the coronal seal of different thicknesses of MTA with gutta-percha after post space preparation. ScientificWorldJournal 2015;2015:708639.  Back to cited text no. 11
    
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Asgary S, Eghbal MJ, Parirokh M, Torabzadeh H. Sealing ability of three commercial mineral trioxide aggregates and an experimental root-end filling material. Iran Endod J 2006;1:101-5.  Back to cited text no. 12
    
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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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