A micro-computed tomography evaluation of voids using calcium silicate-based materials in teeth with simulated internal root resorption

Abstract

Objectives:The obturation quality of MTA, Biodentine, Total Fill BC root canal sealer (RCS), and warm gutta-percha (WGP) in teeth with simulated internal root resorption (IRR) was evaluated by using micro-computed tomography. Materials and Methods: Standardized IRR cavities were created using 40 extracted maxillary central incisor teeth and randomly assigned into 4 groups (n = 10). IRR cavities were filled with MTA, Biodentine, Total Fill BC RCS (bulk-fill form) and WGP + Total Fill BC RCS. Percentage of voids between resorptive cavity walls and obturation material (external void), and inside the filling materials (internal voids) were measured. Results: Total Fill BC sealer in the bulk-fill form presented significantly highest values of external and internal void percentages (p < 0.05). Biodentine showed a significantly lowest external void percentage (p < 0.05). WGP + Total Fill BC RCS presented significantly lower values of internal void percentages than all groups (p < 0.05), except Biodentine (p > 0.05). Conclusion:None of the filling materials were created void-free obturation in resorption cavities. Biodentine may favor its application in teeth with IRR over Angelus MTA and bulkfill form of Total Fill BC.

Clinical applications of calcium silicate‐based materials: a narrative review

“…51 According to a microcomputed tomography (micro-CT) study, Biodentine presented better obturation quality in internal resorption cavities compared with MTA and a bulk-fill form of a CSS. 52 Another micro-CT study reported that MTA and Biodentine presented similar and good obturation quality in filling internal resorption cavities. 21 It is well known that intracanal placement of Ca (OH) 2 can arrest external inflammatory root resorption owing to its high pH and diffusion of hydroxyl ions through dentinal tubules.…”

“…Clinically, it has been reported that void‐free root filling is an important factor in improving the outcome of root canal treatment, 50 and the quality of root canal filling plays a significant role in the success of root canal treatment 51 . According to a micro‐computed tomography (micro‐CT) study, Biodentine presented better obturation quality in internal resorption cavities compared with MTA and a bulk‐fill form of a CSS 52 . Another micro‐CT study reported that MTA and Biodentine presented similar and good obturation quality in filling internal resorption cavities 21 …”

A critical analysis of research methods and experimental models to study root canal fillings

“…Jung et al (2005) reported a good correlation between sectioned slices of root filled maxillary teeth and their respective micro‐CT cross‐section images, and showed that micro‐CT enabled to evaluate any level of the root and to visualize and calculate the volume of filling materials and voids as a 3D single object or in separate. Since this study, micro‐CT has been used to evaluate different materials and techniques regarding their ability to fill lateral canals (Fragachan et al, 2018) and experimental internal resorption cavities (Keleş et al, 2014a; Tek & Turker, 2020) but, mostly, to calculate the percentage volume of the sealer and gutta‐percha, as well as, the amount of voids and interfacial gaps (Figures 35 and 36) in permanent teeth (Table 1) or printed replicas (Figures 7, 8 and 9; Holmes et al, 2021). Overall, it has been reported that no filling technique produced void‐free fillings and the presence of voids was associated with spreader tracts, quality of canal preparation, operator expertise, filling technique, and consistency, volume, and polymerization shrinkage of sealers (Hammad et al, 2009; Keleş et al, 2014c; Zogheib et al, 2012; Figures 37 and 38).…”

An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy

“…Considering void formation following obturation of internal root resorptions, a comparison was performed between Biodentine, MTA, TotalFill BC root canal sealer (bulk-fill form), and warm gutta-percha with TotalFill BC sealer. None of these obturation materials were detected without void formation; however, Biodentine demonstrated the least void formation in comparison to the other experimental groups [ 174 ]. Another report stated that obturation of artificial internal root resorptions resulted in an optimum outcome using EndoSeal MTA with a warm vertical technique and a single-cone technique rather than a single-cone technique using GuttaFlow 2 and EndoSequence [ 175 ].…”