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      In vitro comparison of apical microleakage by spectrophotometry in simulated apexification using White Mineral Trioxide Aggregate, TotalFill Bioceramic Root Repair material, and BioDentine

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          Abstract

          Aim:

          The purpose of this study was to compare the sealing ability of various calcium silicate-based root-filling materials with a glucose leakage model after orthograde obturation using an open apex model.

          Materials and Methods:

          Thirty-two recently extracted human maxillary anterior teeth with single, straight root canals were selected and divided into four groups: Group 1 (G1), White Mineral Trioxide Aggregate; the material was delivered into the canal using the MAP system and further compacted with a specific plugger. Group 2 (G2), TotalFill bioceramic Root Repair material: the material was injected directly into the middle half of the root canal. Group 3 (G3), BioDentine; the material was delivered into the canal using the Hawe composite gun and prefitted pluggers.

          Statistical Analysis:

          Statistical analysis was performed using the SPSS 23.0 statistical software package. The Kruskal–Wallis nonparametric test was applied to compare the differences in glucose microleakage.

          Results:

          There were no significant differences among the three experimental groups. The results showed a tendency for leakage to increase from the 1 st day to the end of experimental period.

          Conclusions:

          Within the parameters of this in vitro study, it may be concluded that the three materials evaluated present similar apical microleakage when treating teeth with open apices requiring orthograde delivery of an apical barrier.

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          Most cited references22

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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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              The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification.

              Treatment of the immature pulpless tooth presents both an endodontic and restorative challenge. A more favorable long-term prognosis may be achieved with a mineral trioxide aggregate (MTA) apexification procedure followed by an internal bonding technique. We investigated the efficacy of this treatment option by testing the sealing ability and retention characteristics of MTA when placed as an apical barrier in a standardized in vitro open apex model. MTA was placed as an apical barrier at a thickness of 1 mm or 4 mm, with and without prior calcium hydroxide medication. The barriers were challenged with bacteria exposure within a leakage model and displacement forces on an Instron machine. In the leakage study, 100% of the MTA apical barriers showed bacterial penetration by day 70, compared with 20% of MTA root-end fillings used as controls. The displacement study demonstrated a statistically significant greater resistance to force with a 4-mm thickness of MTA, regardless of calcium hydroxide use. We concluded that it was the intracanal delivery technique and not the MTA that contributed to the leakage observed. MTA shows promise in our proposed treatment option of immature pulpless teeth if the sealing ability can be enhanced by improving the delivery technique.

                Author and article information

                Journal
                J Conserv Dent
                J Conserv Dent
                JCD
                Journal of Conservative Dentistry : JCD
                Wolters Kluwer - Medknow (India )
                0972-0707
                0974-5203
                May-Jun 2019
                : 22
                : 3
                : 237-240
                Affiliations
                [1]Department of Endodontics, University of Barcelona, Barcelona, IDIBELL Institute, Barcelona, Spain
                Author notes
                Address for correspondence: Prof. Berástegui E, Department of Endodontics, School of Dentistry, University of Barcelona, Feixa Llarga S/N, Hospitalet del llobregat 08907, Barcelona, Spain. E-mail: eberastegui@ 123456gmail.com
                Article
                JCD-22-237
                10.4103/JCD.JCD_19_19
                6632622
                31367105
                c6435b00-7857-402e-983b-b85219e1e000
                Copyright: © 2019 Journal of Conservative Dentistry

                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
                : 08 February 2019
                : 25 April 2019
                : 03 June 2019
                Categories
                Original Article

                Dentistry
                apexification,apical microleakage,bioceramic cements,mineral trioxide aggregate
                Dentistry
                apexification, apical microleakage, bioceramic cements, mineral trioxide aggregate

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