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      Comparison of the microleakage of mineral trioxide aggregate, calcium-enriched mixture cement, and Biodentine orthograde apical plug

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          Abstract

          Background:

          One-visit apexification is a treatment of choice in necrotic immature open apex teeth. Calcium silicate base materials are suitable for this method. The purpose of this study was to investigate and compare the sealing efficiency of Biodentine, mineral trioxide aggregate (MTA) ProRoot, and calcium-enriched mixture (CEM) cement orthograde apical plug using bacterial leakage method.

          Materials and Methods:

          In this in vitro study a total of 70 extracted maxillary incisors were cleaned and shaped. A 1.1-mm standardized artificially open apex was created in all samples. The teeth were randomly divided into three experimental groups of 20, and two negative and positive control groups of 5. In experimental groups, 4-mm thick apical plugs of ProRoot MTA, CEM cement, or Biodentine were placed in an orthograde manner. Negative control samples were completely filled with MTA while positive control samples were left unfilled. Sealing efficiency was measured by bacterial leakage method, and results were analyzed by Kaplan–Meier and Chi-square tests. The level of significance was set at 0.05.

          Results:

          The highest number of turbidity was recorded for ProRoot MTA samples, while the lowest for Biodentine. There was a significant difference in the number of turbidity between ProRoot MTA and Biodentine groups ( P < 0.001), but there was no significant difference between CEM cement and Biodentine ( P = 0.133) and ProRoot MTA ( P = 0.055).

          Conclusion:

          Within the limitation of this in vitro study, Biodentine showed promising results as a substance with good-sealing efficiency.

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          Most cited references35

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          Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action.

          Mineral trioxide aggregate (MTA) has been recommended for various uses in endodontics. Two previous publications provided a comprehensive list of articles from November 1993-September 2009 regarding the chemical and physical properties, sealing ability, antibacterial activity, leakage, and biocompatibility of MTA. The purpose of Part III of this literature review is to present a comprehensive list of articles regarding animal studies, clinical applications, drawbacks, and mechanism of action of MTA. A review of the literature was performed by using electronic and hand-searching methods for the clinical applications of MTA in experimental animals and humans as well as its drawbacks and mechanism of action from November 1993-September 2009. MTA is a promising material for root-end filling, perforation repair, vital pulp therapy, and apical barrier formation for teeth with necrotic pulps and open apexes. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies regarding clinical applications of this material. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. Hydroxyapatite crystals form over MTA when it comes in contact with tissue synthetic fluid. This can act as a nidus for the formation of calcified structures after the use of this material in endodontic treatments. On the basis of available information, it appears that MTA is the material of choice for some clinical applications. More clinical studies are needed to confirm its efficacy compared with other materials. Copyright (c) 2010. Published by Elsevier Inc.
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            Mineral trioxide aggregate: a comprehensive literature review--part II: leakage and biocompatibility investigations.

            Mineral trioxide aggregate (MTA) was developed because existing materials did not have the ideal characteristics for orthograde or retrograde root-end fillings. MTA has been recommended primarily as a root-end filling material, but it has also been used in pulp capping, pulpotomy, apical barrier formation in teeth with open apexes, repair of root perforations, and root canal filling. Part I of this literature review presented a comprehensive list of articles regarding the chemical and physical properties as well as the antibacterial activity of MTA. The purpose of part II of this review is to present a comprehensive list of articles regarding the sealing ability and biocompatibility of this material. A review of the literature was performed by using electronic and hand-searching methods for the sealing ability and biocompatibility of MTA from November 1993-September 2009. Numerous studies have investigated the sealing ability and biocompatibility of MTA. On the basis of available evidence it appears that MTA seals well and is a biocompatible material. Copyright 2010. Published by Elsevier Inc.
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              Apexification: a review.

              This paper reviews the rationale and techniques for treatment of the non-vital immature tooth. The importance of careful case assessment and accurate pulpal diagnosis in the treatment of immature teeth with pulpal injury cannot be overemphasized. The treatment of choice for necrotic teeth is apexification, which is induction of apical closure to produce more favorable conditions for conventional root canal filling. The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has been expressed in the use of mineral trioxide aggregate. Introduction of techniques for one-visit apexification provide an alternative treatment option in these cases. Success rates for calcium hydroxide apexification are high although risks such as reinfection and tooth fracture exist. Prospective clinical trials comparing this and one-visit apexification techniques are required.
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                Author and article information

                Journal
                Dent Res J (Isfahan)
                Dent Res J (Isfahan)
                DRJ
                Dental Research Journal
                Wolters Kluwer - Medknow (India )
                1735-3327
                2008-0255
                Jan-Feb 2020
                21 January 2020
                : 17
                : 1
                : 66-72
                Affiliations
                [1 ]Department of Endodontics, Faculty of Dentistry, Islamic Azad University of Isfahan (Khorasgan) Branch, Isfahan, Iran
                [2 ]Dental Research Center, Department of Endodontics, Dental Research Institute/Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Address for correspondence: Dr. Maryam Zare Jahromi, Department of Endodontics, Faculty of Dentistry, Islamic Azad University of Isfahan (Khorasgan) Branch, Isfahan, Iran. E-mail: maryam.zare.j@ 123456gmail.com
                Article
                DRJ-17-66
                10.4103/1735-3327.276238
                7001563
                32055296
                35a2a804-5c86-4b3e-a90e-b3fa16c0896c
                Copyright: © 2020 Dental Research Journal

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : October 2018
                : June 2019
                Categories
                Original Article

                Dentistry
                apexification,biocompatible materials,calcium-enriched mixture cement,dental leakage,mineral trioxide aggregate

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