Comparison of the Sealing Ability of Biodentine, iRoot BP Plus and Mineral Trioxide Aggregate

Cumhuriyet Dental Journal Volume 19 Issue 2 doi: Doi: 10.7126/cdj.58140.5000144905 available at http://dergipark.ulakbim.gov.tr/cumudj/ RESEARCH ARTICLE Comparison of the Sealing Ability of Biodentine, iRoot BP Plus and Mineral Trioxide Aggregate Seda Aydemir1, Hale Cimilli2, Parla Meva Gerni3, Alperen Bozkurt4, Hasan Orucoglu5, Nicholas Chandler6, Nevin Kartal7 1 Department of Endodontics, Faculty of Dentistry, Kocaeli University, Yuvacik-Basiskele, Kocaeli, Turkey. e-mail: 2 Department of Restorative Dentistry, Faculty of Dentistry, Marmara University, Nisantasi, Istanbul, Turkey. e-mail: 3 Department of Endodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey. e-mail: 4 Department of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey. e-mail: 5 Department of Endodontics, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey. e-mail: 6 Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand. e-mail: 7 Department of Restorative Dentistry, Faculty of Dentistry, Marmara University, Nisantasi, Istanbul, Turkey e-mail: ARTICLE INFO ABSTR ACT Article history: Received 2015-Sept-29 Accepted 2016-Feb-10 Objective: The aim of this study was to compare the sealing ability of two new root repair materials, Biodentine and iRoot BP Plus against ProRoot MTA when used as root-end fillings. Keywords: Endodontics; calcium silicate-based cement; bioceramic root repair material; MTA; root-end filling Methods: The root canals of 45 extracted maxillary anterior teeth were prepared with ProTaper instruments. After apical resection and ultrasonic root-end cavity preparation, the teeth were divided into three groups. The cavities in the first group of 15 were filled with Biodentine, the second with iRoot BP Plus and the third with ProRoot MTA. A computerized fluid filtration method assessed the seal at 2, 10 and 28 days. Results: Significant differences were found between Groups 1-2, Groups 1-3 and between Groups 2-3 at all-time intervals (P < 0.05). Leakage was not significantly different at 10 and 28 days for Biodentine and iRoot BP Plus (P > 0.05). Conclusion: The two new root repair materials showed good performance and both offered improved handling properties compared to MTA. Correspondence author at: Seda Aydemir, Kocaeli Üniversitesi - Diş Hekimliği Fakültesi, Yuvacık Yerleşkesi, Paşadağı Mahallesi, Akçakesme Sokak, No:5 41190, Başiskele/Kocaeli. e-mail: , Tel: 00905065053880 Fax: 00902623442109 166 Aydemir, et al.: Comparison of the Sealing Ability of Biodentine INTRODUCTION its workability. This material is presented as a powder and liquid, is prepared in an amalgamator and has a setting time of 10 minutes.13 Despite the success of root canal treatment being high1 failed cases arise where teeth cannot be retreated conservatively and endodontic surgery is required. The root tip of the tooth is resected perpendicular to its long axis with 3 mm commonly removed, and then a root-end cavity 3 mm deep is prepared and filled. Resection allows accessory canals and ledged and altered root morphology to be addressed, and the root-end filling aims to prevent the passage of any residual microbial products from the root canal to the periapical tissues2. Many materials have been proposed for root-end fillings, including amalgam, gutta-percha, zinc oxide–eugenol, polycarboxylate, glass ionomer and composite resin cements, IRM, Super-EBA and more recently mineral trioxide aggregate (MTA)3-8. MTA demonstrates superior sealing ability and biocompatibility compared to many other materials7-11, however its handling characteristics and slow setting time make it challenging to use12. To reduce or eliminate these problems new materials have been introduced. According to the manufacturer, iRoot BP Plus Root Repair Material (Innovative BioCeramix, Vancouver, Canada) is a convenient and ready-to-use white hydraulic bioceramic putty developed for permanent root canal repair and surgical applications. It is an insoluble, radiopaque and aluminium-free material based on a calcium silicate composition, requiring the presence of water to set. It claims to not shrink during setting and to have excellent physical properties. It is packaged premixed in a container. Biodentine (Septodont, Maidstone, UK) is a calcium silicate-based material intended as a dentine substitute, developed to circumvent the shortcomings of traditional filling materials. It is composed of Ca3SiO5, CaCO3, ZrO2, water and a superplasticizing admixture to reduce the water content of the mix and to retain In this study we compared the sealing properties of these new materials with ProRoot MTA when used as root-end fillings. MATERIALS AND METHODS Forty-five extracted maxillary anterior human teeth were used. The teeth had been extracted following appropriate consent procedures, and were from hospital dental department collections. Their crowns were removed at the cemento- enamel junction. A size of 15 K-file (Mani Inc., Tochigi-Ken, Japan) was placed passively until it reached the apical foramen under magnification 2.5X (Heine USA Ltd, Dover, USA). The working lenth was established as 0.5 mm shorter than the meausered length. Their canals prepared with ProTaper instruments SX, S1, S2, F1, F2 to finishing file F3 (Dentsply/Maillefer, Ballaigues, Switzerland). Irrigation was copious throughout with 2.5% sodium hypochlorite (NaOCl) solution and a 19% EDTA lubricant (MD-ChelCream, Meta Biomed Inc., Chungbuk, Korea). A final rinse was carried out using normal saline. The apical 3 mm of the roots were resected at an angle of 90 degrees to the long axis of the root with tungsten carbide fissure burs (HM 31L 010, Meisinger, Neuss,Germany) and 3 mm deep root- end cavities were cut with zirconium nitride-coated ultrasonic retrotips (ProUltra Tip No. SURG 1,) Dentsply/Maillefer) powered by an ultrasonic generator (EMS, Nyon, Switzerland). A medium power setting was selected with water cooling, and all preparations were made by a single operator. The roots were supported in a 167 Aydemir, et al.: Comparison of the Sealing Ability of Biodentine silicone-lined jig to simulate periodontium and the cavities measured with a periodontal probe to ensure consistent depth (PCPUNC15, Hu-Friedy, Chicago, IL, USA). A new retrotip was used for every 10 cavities. The cavities were irrigated with NaOCl, rinsed with normal saline and dried with paper points. The roots were randomly divided into three groups. The cavities of the first group were filled with Biodentine, the second group with iRoot BP Plus and the third group with white ProRoot MTA (Dentsply/ Tulsa Dental, Tulsa, OK, USA). The fillings were placed by a single operator and their quality was verified with buccolingual and mesiodistal radiographs. The teeth were stored at 37°C and 100% humidity during the experiment and the sealing effectiveness assessed using a fluid filtration method at 2, 10 and 28 d (...truncated)