Root‐end resection with or without retrograde obturation after orthograde filling with two techniques: A <scp>micro‐CT</scp> study

Angerame, Daniele; Biasi, Matteo De; Lenhardt, Massimiliano; Porrelli, Davide; Bevilacqua, Lorenzo; Generali, Luigi; Rosa, Giusy Rita Maria La; Pedullà, Eugenio

doi:10.1111/aej.12634

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…In a previous study, the effectiveness of apicectomy alone was evaluated using micro-CT to quantify void volumes. The results showed fewer voids compared to the traditional method that utilizes MTA for retrograde filling, which is consistent with our own findings [37]. However, other research studies have indicated that obtaining a reliable apical seal is difficult without root end filling [38,39].…”

Section: Discussionsupporting

confidence: 91%

Apical Microleakage of Root End Resected Teeth After Orthograde Obturation Using a Bioceramic Sealer: An in Vitro Bacteriological Study

Mansour,

Moussa,

Meheissen

et al. 2024

Alexandria Dental Journal

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BACKGROUND: Endodontic surgery becomes a practical choice when non-surgical interventions are ineffective or are not expected to yield improved results. Limited access and technical challenges may prevent the implementation of controlled retrograde procedures in certain teeth . AIM OF THE STUDY:The objective was to compare bacterial microleakage of root end resected teeth after orthograde obturation using a single cone technique with a bioceramic sealer versus MTA retrofilling. MATERIALS AND METHODS: Thirty human extracted maxillary incisors were prepared and divided randomly into three groups. In group1, the canals were filled using the single cone technique with bioceramic sealer, followed by root resection 3 mm from the apex. Group 2 received standard retrograde ultrasonic preparation and retrograde obturation with mineral trioxide aggregate (MTA) and group 3 negative control. Subsequently, the roots were placed in a sterile experimental model and filled coronally with E. faecalis bacterial suspension for 30 days. Turbidity and the time taken for turbidity in the broth were analyzed to assess bacterial microleakage from the canal . RESULTS:The study revealed that there was no statistically significant difference in bacterial microleakage observed between the two test groups . CONCLUSION: Performing root end resection following a single cone technique obturation, along with a bioceramic sealer, may offer a favorable alternative approach when compared to the established gold standard MTA retrograde obturation.

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Section: Discussionsupporting

confidence: 91%

Apical Microleakage of Root End Resected Teeth After Orthograde Obturation Using a Bioceramic Sealer: An in Vitro Bacteriological Study

Mansour,

Moussa,

Meheissen

et al. 2024

Alexandria Dental Journal

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“…MTA is considered the gold standard for root end filling material. Thus, it was the reference technique in this study [ 37 , 38 ], . Despite this, MTA has several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…In certain surgical scenarios,, the location of the surgical site and the small size of the root-end preparation can pose challenges when attempting to deliver MTA as a retrograde filling due to its granular and loose nature [ 39 ]. This can lead to increased porosity, unexpected voids, and potential microbial leakage [ 3 , 37 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Bacterial sealing ability of calcium silicate-based sealer for endodontic surgery: an in-vitro study

Mansour,

Moussa,

Meheissen

et al. 2024

BMC Oral Health

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Background Apical surgery with standard retrograde maneuvers may be challenging in certain cases. Simplifying apical surgery to reduce operating time and streamline retrograde manipulation is an emerging need in clinical endodontics. Aim of the study The aim of the study was to compare the bacterial sealing ability of a calcium silicate-based sealer with the single cone technique combined with root end resection only, and calcium silicate-based sealer as a retrograde filling versus MTA retrofilling, and to analyze bacterial viability using confocal laser scanning microscope (CLSM). Materials and methods In this in vitro experimental study, 50 extracted human maxillary incisor teeth were instrumented and randomly divided into five groups: three experimental groups, a positive control group, and a negative control group (n = 10/group). In the experimental groups, the roots were obturated using the single cone technique (SCT) and a calcium silicate-based sealer. In group 1, the roots were resected 3 mm from the apex with no further retrograde preparation or filling. In groups 2 and 3, the roots were resected, retroprepared, and retrofilled with either a calcium silicate-based sealer or MTA, respectively. Group 4 (positive control) was filled with a single gutta-percha cone without any sealer. In group 5 (negative control), the canals were left empty, and the roots were sealed with wax and nail varnish. A bacterial leakage model using Enterococcus faecalis was employed to assess the sealing ability over a 30-day period, checking for turbidity and analyzing colony forming units (CFUs) per milliliter. Five specimens from each group were examined using CLSM for bacterial viability. Data for the bacterial sealing ability were statistically analyzed using chi-squared and Kruskal-Wallis tests. Results The three experimental groups did not show significant differences in terms of bacterial leakage, or bacterial counts (CFUs) (P > 0.05). However, significant differences were observed when comparing the experimental groups to the positive control group. Notably, the calcium silicate-based sealer, when used as a retrofilling, yielded the best sealing ability. CLSM imaging revealed viable bacterial penetration in all the positive control group specimens while for the experimental groups, dead bacteria was the prominent feature seen. Conclusion Within the limitations of this study, it could be concluded that the bacterial sealing ability of calcium silicate-based sealer with the single cone technique combined with root end resection only and calcium silicate-based sealer as a retrograde filling were comparable with MTA retrofilling during endodontic surgical procedures.

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“…It has been found that Enterococcus faecalis [ 24 ], one of the commonly-seen bacteria in the reinfection, is approximately 2.0 μm-diameter [ 25 ], much smaller than the voids ranging from 0.004 to 0.018 mm 3 , making it possible for Enterococcus faecalis to migrate through the voids in the gap volume [ 26 ]. A previous study found that the orthograde technique and apical resection without retro-filling can achieve a similar number of voids compared to methods containing retrograde obturation in single-rooted permanent teeth [ 27 ]. Micro-CT and µCT techniques enable analysis of voids in filling materials without damaging the samples, which have been applied in a lot of studies [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

A novel simplified approach for endodontic retrograde surgery in short single-rooted teeth

Zheng,

Wu,

Zhang

et al. 2024

BMC Oral Health

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Background High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many developing countries. This study aimed to compare the effects of a simplified, cost-effective, and time-efficient surgical approach involving orthograde obturation using biological ceramic material greater than 6 mm combined with apicoectomy for single-rooted teeth with short lengths with those of the conventional and current standard methods. Materials and methods Forty-five premolars equally categorized into three groups: conventional surgery group, standard surgery group, and modified surgery group. A µCT scan was used to calculate the volume of voids. A micro-leakage test and scanning electron microscope (SEM) were performed to assess the sealing effect. Additionally, four cases of chronic periapical periodontitis in the anterior region were selected, and the patients received either the modified approach or the standard surgery for endodontic microsurgery. Results The volumes of voids in the apical 0–3 mm of the modified group and the standard group were comparable. The micro-leakage test and SEM examination demonstrated closely bonded fillings in the dentinal walls in both the modified surgery group and standard surgery group. The outcomes of the preliminary application of this modified procedure on patients were successful at the time of the follow-up cutoff. Conclusions The modified surgery group exhibited similar root canal filling and apical sealing abilities with the standard procedure for single-rooted teeth with short lengths (< 20 mm). The preliminary application of this modified surgical procedure achieved favorable results.

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Root‐end resection with or without retrograde obturation after orthograde filling with two techniques: A micro‐CT study

Cited by 4 publications

References 31 publications

Apical Microleakage of Root End Resected Teeth After Orthograde Obturation Using a Bioceramic Sealer: An in Vitro Bacteriological Study

Apical Microleakage of Root End Resected Teeth After Orthograde Obturation Using a Bioceramic Sealer: An in Vitro Bacteriological Study

Bacterial sealing ability of calcium silicate-based sealer for endodontic surgery: an in-vitro study

A novel simplified approach for endodontic retrograde surgery in short single-rooted teeth

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