Root perforations treatment using mineral trioxide aggregate and Portland cements

Abstract

Purpose: Clinical, radiological and histological evaluation of root perforations treated with mineral trioxide aggregate (MTA) or Portland cements, and calcium sulfate barrier. Methods: One molar and 11 premolar teeth of a male mongrel dog received endodontic treatment and furcations were perforated with a high-speed round bur and treated with a calcium sulfate barrier. MTA, Portland cement type II (PCII) and type V (PCV), and white Portland cement (WPC) were used as obturation materials. The teeth were restored with composite resin and periapical radiographs were taken. The animal was euthanized 120 days post-surgery for treatment evaluation. RESUMOObjetivo: Avaliar clínica, radiológica e histologicamente perfurações radiculares tratadas com MTA e cimentos Portland, com barreira de sulfato de cálcio. Métodos: A amostra foi constituída por 11 dentes pré-molares e um molar de cão macho, sem raça definida. Após tratamento endodôntico realizaram-se perfurações nas furcas com broca esférica de alta rotação e barreira de sulfato de cálcio. Foram utiliados os cimentos MTA, Portland tipo II (CPII), Portland tipo V (CPV) e Portland branco estrutural (CPB). Os dentes foram restaurados com resina composta e submetidos a radiografias periapicais. O animal foi confinado por 120 dias e submetido à eutanásia para avaliações. Resultados: Primeiro pré-molar inferior direito (MTA), terceiro pré-molar inferior direito (CPV), segundo pré-molar inferior esquerdo (MTA) e segundo pré-molar inferior direito (CPB): clinicamente normal; leve área radiotransparente na furca; pequeno infiltrado inflamatório e neoformação óssea. Terceiro pré-molar inferior esquerdo (CPII), primeiro pré-molar superior direito (CPB), terceiro pré-molar superior direito (CPII) e primeiro molar superior esquerdo (CPV): clinicamente normal; área radiopaca na furca; neoformação óssea. Segundo pré-molar superior direito (MTA), segundo pré-molar superior esquerdo (CPB) e terceiro pré-molar superior esquerdo (CPII): clinicamente com lesão na furca; intensa área radiolucida; infiltrado inflamatório intenso. Conclusão: Todos os cimentos induziram a neoformação óssea.

Analysis of Metal Contents in Portland Type V and MTA-Based Cements

“…Usually, Type I PC is the main material of MTA-based cements [8–10, 14], but when new material is proposed for this end, the investigations should be conducted again. Type V PC can be used as alternative material to substitute MTA-based cements for clinical practice [3, 4]. However, more than understanding the behavior of these materials in the organism, for safe clinical use, it is necessary to study their compositions.…”

“…In 1993, at the University of Loma Linda in the United States, a new MTA- (Mineral Trioxide Aggregate-) based cement, indicated for sealing perforating areas in human teeth, was developed. The results showed excellent physical [6–8], chemical [9, 10], and biological properties [3, 4]. …”

“…Based on the biocompatibility [3, 4] and similar compositions of MTA-based cements [11], pure PC has been proposed to be potential substitute to MTA in endodontic procedures [5–8]. It is known that the main compound of MTA-based cements is the ordinary Type I PC [5, 8].…”

“…The biocompatibility of Type V PC had been proved in animal studies by the observation of biomineralization areas [3, 4]. On the other hand, studies have shown the presence of contaminant metals, which were aggregated during the production process as a result of the substitution of the primary fuel by alternative fuels [16–18].…”

Comparative analysis of physicochemical properties of root perforation sealer materials

“…Additional dental applications of MTA have been subsequently proposed, including direct pulp capping, external root resorption repair, and its use in the apexification therapy 3,4. This material has excellent physical, chemical, and biological properties 4,5,6,7,8,9,10,11,12,13. However, MTA presents one of the longest setting time among the root canal perforation sealer materials, forming a colloidal gel that solidifies in 2 hours and 30 minutes 14,15.…”