Comparative Evaluation of Sealing Ability and Pushout Strength of Four Different Furcation Repair Materials: An In Vitro Study

Abstract

Introduction:In endodontic practice, technical accidents are commonly encountered such as furcation perforation. For everlasting success, furcation perforations shall be corrected rapidly with an ideal perforation sealing material. For an ideal perforation sealing material, the desirable properties include an adequate seal, minimal microleakage, good biocompatibility, high pushout strength, stability in blood-contaminated areas, bactericidal, induction of mineralization, osteogenesis, and cementogenesis, radio-opacity and ease of clinical manipulation. Mineral trioxide aggregate (MTA) is the commonly used furcation repair material, but it presents sundry clinical shortfalls for instance prolonged setting time, difficulty in handling, and tooth discoloration. To remodel the attributions of MTA, new materials have been introduced which include Biodentine, calcium-enriched material (CEM) cement, and Cention N (CN). Biodentine is used as a dentin substitute because of its excellent sealing potential, high compressive strength, high pushout strength, less setting time, good biocompatibility, and biomineralization properties. Calcium-enriched material cement is a water-based tooth-colored material that yields a biological glue, is biocompatible, and ability to induce osteogenesis and cementogenesis. Cention N is an "alkasite" restorative material, like compomer or ormocer materials. It is radiopaque and releases ions such as fluoride, calcium, and hydroxyl. Objectives: To evaluate and equate the sealing capability and pushout strength of ProRoot MTA, CEM cement, CN, and Biodentine as furcation perforation repair materials. Materials and methods: A total of 60 extracted permanent mandibular molars were collected, and furcation perforations were made between the roots in a standardized manner. Based on kind of perforation repair material, samples were arbitrarily categorized into four discrete groups having 15 teeth each. In group I, samples were restored with ProRoot MTA. In group II, samples were restored with CEM Cement. In group III, samples were repaired with CN, and in group IV, samples were revived with Biodentine. After which, five samples from each group were selected for sealing ability testing using the dye extraction method by spectrophotometer, five samples from each group were selected for microleakage testing using the dye infiltration method followed by sectioning and evaluation of the sectioned samples by stereomicroscope, and five samples from each group were selected for Pushout strength evaluation by embedding them in acrylic using polyvinyl chloride (PVC) molds and subjecting them to universal testing machine. The data collected was statistically analyzed. Results: The mean spectrophotometric dye absorbance was significantly higher in CN followed by CEM cement and dye absorbance was least in ProRoot MTA and Biodentine. Infiltration loss was significantly higher among ProRoot MTA and Biodentine compared to CEM cement and CN. The mean pushout strength was significantly higher in Biodentine followed by ...