Evaluation of Sealing Ability of Five Different Root End Filling Material: An In Vitro Study

Background: Aim of the study was to evaluate sealing ability of five different root end filling materials by dye penetration method. Materials and Methods: About 100 extracted maxillary central incisors were sectioned at Cementoenamel junction. Access cavities were prepared, instrumented chemo-mechanically, and obturated with laterally condensed gutta-percha and AH Plus sealer. Access cavities were sealed with composite resin. After 3 mm of root resection a 3 mm deep root-end cavity was prepared in each tooth. The teeth were retrofilled with glass ionomer cement (GIC), super-ethoxy benzonic acid (EBA), gray-mineral trioxide aggregate (MTA), white-MTA and biodentine. Three coats of nail varnish were then applied to the whole surface of total length of each root except tip of the root where retrograde filling was applied. All roots were stored in 1% solution of methylene blue for 72 h; after which roots were rinsed under tap water. The teeth were sectioned buccolingually, depth of dye penetration was evaluated under stereomicroscope. Results: The overall results showed no statistically significant difference between two types of MTA and biodentine, but all the three materials are superior to GIC, super-EBA. Conclusion: Both forms of MTA, biodentine provide a better seal than GIC, super-EBA. Key Words: Biodentine, glass ionomer cement, micro-leakage, mineral trioxide aggregate, root-end filling and super-ethoxy benzonic acid Introduction Complete obliteration of the root canal system and development of a fluid tight seal are among the most important factors of successful endodontic treatment. Although non-surgical endodontic procedures have been shown to be successful, failures in treatment sometimes occur. Apicoectomy and retrograde root filling are common surgical procedures performed in an attempt to seal the root canal. Adequacy of the apical seal is the single most important factor for successful apicoectomy.1 Root end filling is the procedure by which an inert non-toxic material is packed into the root canal through an apical cavity.2 The characteristics of an ideal apical root end filling material include adherence to dentinal walls of the retrograde preparation, periradicular tissue tolerance and bioactive promotion of healing. The filling material should not corrode or be electrochemically active nor should it stain the periradicular tissues. It should be easy to manipulate and radiopaque. In addition, it should be dimensionally stable, non-absorbable, not penetrable by bacteria, and unaffected by moisture.3 Several root-end filling materials have been used like gutta-percha, amalgam, cavit, intermediate restorative material, super-ethoxy benzonic acid (EBA), glass ionomers, composite resins, carboxylate cements, zinc phosphate cements, zinc-oxide eugenol cements, and mineral trioxide aggregate (MTA).3 Some potentially, available materials like bioactive glass, biodentine, bioaggregate, bioceramics, CER (Cemento Endodontico Rapido/ Fast endodontic cement), endosequence root repair material and Endocem (MTAderived pozzolan cement) have been introduced with the aim of overcoming some of the disadvantages of the MTA.4 MTA was introduced by Dr. Torabinajed in 1993 as grey MTA. Because of discoloration potential of gray-MTA, whiteMTA was developed in 2002. This version improved esthetics because the original gray-colored MTA was proved to darken overlying tissues. The principal components of MTA are tricalcium aluminate, tricalcium silicate, bismuth oxide, dicalcium silicate, tetracalcium aluminoferrite. White-MTA differs from gray-MTA in that it has a significant reduction in the proportion of tetracalcium aluminoferrite content. MTA has all the properties of retrograde filling material except its poor handling properties, long setting time (165 ± 5 min) and requirement of additional moisture for setting reaction.5-7 Biodentine,8 a calcium silicate based material was introduced as dentin substitute by Septodont in 2010. Biodentine is available in capsule containing dicalcium silicate, tricalcium silicate, calcium carbonate and iron oxide, and zirconium oxide filler. Liquid consists of calcium chloride which acts as