Porosity Distribution in Apically Perforated Curved Root Canals Filled with Two Different Calcium Silicate Based Materials and Techniques: A Micro-Computed Tomography Study

Abstract

The present study evaluated the porosity distribution of BioRoot RCS/single gutta-percha point (BR/SC) and MTA flow (MF) fillings, which were used as plugs for the apical perforation repair in curved canals of extracted mandibular molars using micro-computed tomography (μCT). Forty mesial root canals of mandibular first molars were shaped with ProTaper NEXT X1–X5 files 2 mm beyond the apex to simulate apical perforations that were randomly divided into two groups (n = 20) according to the material and technique used for the apical plug: BR/SC or MF. The specimens were scanned before and after canal filling at an isotropic resolution of 9.9 μm. The volumetric analysis of voids in the apical 5 mm of the fillings was performed. Data were analyzed using one-way ANOVA with Bonferroni correction (p < 0.05). Micro-computed tomography (µCT) evaluation revealed significant differences between the groups in terms of porosity: the total volume and percentage volume of voids was lower in the BR/SC group in comparison with the MF group (p < 0.05), with the predominance of open pores in both groups. Neither of the materials and/or application techniques were able to produce void-free root fillings in the apical region of artificially perforated curved roots of mandibular molars.

Physicochemical and Antibacterial Properties of Novel, Premixed Calcium Silicate-Based Sealer Compared to Powder–Liquid Bioceramic Sealer

“…At WL-2 mm, BioRoot had more interfacial void percentages or “open pores” than the Ceraseal sealer ( Table 2 ). However, it was reported that interfacial voids (open pores or gaps) allowed leakage, whilst internal voids (inside filling material) have no impact on the overall obturation [ 37 ]. Indeed, interfacial gaps have been advocated to serve as a pathway for microorganisms for the reinfection the root canal system from the coronal, as well as from the apical side [ 38 , 39 ].…”

“…The pH change of distilled water in contact with BR and CS sealers was evaluated. Alkaline pH plays a key role as it may enhance the antibacterial activity of a material [ 37 ], improve the healing process, neutralize the lactic acid from the osteoclast [ 46 , 47 ], and increases the deposition of mineralized components [ 48 ]. The current study showed that both BR and CS increased the pH of the storage media ( Figure 4 ).…”

The Effect of Ultrasonic Agitation on the Porosity Distribution in Apically Perforated Root Canals Filled with Different Bioceramic Materials and Techniques: A Micro-CT Assessment

“…However, MTA is generally assumed to be a benchmark for sealing various types of root perforations [ 32 ]. MF is one of the newest MTA-based repair materials, which surpasses traditional MTA in terms of clinical applicability due to its superior handling and delivery characteristics as well as faster setting time and thus increased washout resistance [ 10 , 19 ]. Moreover, MF retains all desirable biological properties of the original MTA, such as biocompatibility and bioactivity, which are the crucial requirements for perforation repair material exposed to periodontal tissues [ 41 ].…”

“…The biocompatibility and bioactivity are attributed mainly to the continuous calcium ion release and the formation of calcium phosphate apatite crystals, which induce the regeneration and remineralization of adjacent hard tissues while also reducing the porosity of filling material [ 28 , 41 ]. Nevertheless, a previous study has shown that, despite all the improvements and advantageous characteristics, MF results in highly porous apical plugs [ 19 ]. These results are in accordance with the present study, in which both MF groups (with/without ultrasonic agitation) exhibited a high porosity.…”

“…However, the available data on the performance of the BR/SC technique used for an apical plug in apically perforated roots are still limited. There is only one study demonstrating the sealability of apical perforations using the BR/SC technique and porosity distribution in these fillings [ 19 ].…”