Key Points
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Comparison of the sealing properties of three commonly used materials for repair of large perforations.
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Bacteria could penetrate into dentine even distant from the perforation filling.
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Teeth repaired with mineral trioxide aggregate were more resistant to bacterial leakage.
Abstract
Objective To evaluate the sealing ability of different repair materials and the pathway of bacterial penetration after closure of large pulp chamber floor perforations. Materials and methods Perforations were made in the furcation area of extracted human molars and sealed with either mineral trioxide aggregate (MTA), glass ionomer cement or resin composite. The bacterial leakage method was used with Enterococcus faecalis as microbial tracer. The time of leakage (in days) was recorded for each specimen. Statistical analysis of bacterial leakage was performed using the survival analysis and pairwise comparison of groups. A p-value less than 0.05 was considered statistically significant. Leaking specimens were prepared and inspected for the presence of bacteria by a scanning electron microscope (SEM). Results The percentage of leaking samples was significantly higher in resin composite than in the other groups and the negative control group (p <0.05). SEM inspection revealed the presence of bacteria in all leaking specimens. Bacteria were observed along the filling-dentine interface as well as in dentinal tubules at some distance from the filling. Conclusions The resin composite material leaked significantly more than the MTA and glass ionomer cements when used to repair large furcation perforations. Bacteria could penetrate into dentine even at a distance from the perforation filling.
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References
Fuss Z, Trope M . Root perforations: classification and treatment choices based on prognostic factors. Endod Dent Traumatol 1996; 12: 255–264.
Tsatsas D V, Meliou H A, Kerezoudis N P . Sealing effectiveness of materials used in furcation perforation in vitro. Int Dent J 2005; 55: 133–141.
Simon J H, Glick D H, Frank A L . The relationship of endodontic-periodontic lesions. J Periodontol 1972; 43: 202–208.
Petersson K, Hasselgren G, Tronstad L . Endodontic treatment of experimental root perforations in dog teeth. Endod Dent Traumatol 1985; 1: 22–28.
Kvinnsland I, Oswald R J, Halse A, Gronningsaeter A G . A clinical and roentgenological study of 55 cases of root perforation. Int Endod J 1989; 22: 75–84.
Alhadainy H A, Himel V T . Comparative study of the sealing ability of light-cured versus chemically cured materials placed into furcation perforations. Oral Surg Oral Med Oral Pathol 1993; 76: 338–342.
Rud J, Rud V, Munksgaard E C . Retrograde sealing of accidental root perforations with dentin-bonded composite resin. J Endod 1998; 24: 671–677.
Alhadainy H A, Himel V T . Evaluation of the sealing ability of amalgam, Cavit, and glass ionomer cement in the repair of furcation perforations. Oral Surg Oral Med Oral Pathol 1993; 75: 362–366.
Krupalini K S, Udayakumar, Jayalakshmi K B. A comparative evaluation of medicated calcium sulphate, hydroxylapatite, mineral trioxide aggregate (MTA) as barrier and their effect on the sealing ability of furcation perforation repair material-an in vitro study. Indian J Dent Res 2003; 14: 156–161.
De Bruyne M, De Moor R . The use of glass ionomer cements in both conventional and surgical endodontics. Int Endod J 2004; 38: 129–136.
Maher W P, Johnson R L, Hess J, Steiman H R . Biocompatibility of retrograde filling materials in the ferret canine. Amalgam and IRM. Oral Surg Oral Med Oral Pathol 1992; 73: 738–745.
Torabinejad M, Hong C U, Pitt Ford T R, Kettering J D . Antibacterial effects of some root end filling materials. J Endod 1995; 21: 403–406.
Asgary S, Parirokh M, Eghbal M J, Brink F . Chemical differences between white and gray mineral trioxide aggregate. J Endod 2005; 31: 101–103.
Camilleri J, Montesin F E, Brady K, Sweeney R, Curtis R V, Ford T R . The constitution of mineral trioxide aggregate. Dent Mater 2005; 21: 297–303.
Ferris D M, Baumgartner J C . Perforation repair comparing two types of mineral trioxide aggregate. J Endod 2004; 30: 422–424.
Main C, Mirzayan N, Shabahang S, Torabinejad M . Repair of root perforations using mineral trioxide aggregate: a long-term study. J Endod 2004; 30: 80–83.
Breault L G, Fowler E B, Primack P D . Endodontic perforation repair with resin-ionomer: a case report. J Contemp Dent Pract 2000; 15: 48–59.
Alhadainy H A, Abdalla A I . Artificial floor technique used for the repair of furcation perforations: a microleakage study. J Endod 1998; 24: 33–35.
Himel V T, Alhadainy H A . Effect of dentin preparation and acid etching on the sealing ability of glass ionomer and composite resin when used to repair furcation perforations over plaster of Paris barriers. J Endod 1995; 21: 142–145.
Alhadainy H A, Himel V T . An in vitro evaluation of plaster of Paris barriers used under amalgam and glass ionomer to repair furcation perforations. J Endod 1994; 20: 449–452.
Shuman I E. Repair of a root perforation with a resin-ionomer using an intentional replantation technique. Gen Dent 1999; 47: 392–395.
Behnia A, Strassler H E, Campbell R . Repairing iatrogenic root perforations. J Am Dent Assoc 2000; 131: 196–201.
Daoudi M F, Saunders W P . In vitro evaluation of furcal perforation repair using mineral trioxide aggregate or resin modified glass lonomer cement with and without the use of the operating microscope. J Endod 2002; 28: 512–515.
Tsesis I, Fuss Z . Diagnosis and treatment of accidental root perforations. Endod Topics 2006; 13: 95–107.
Barthel C R, Moshonov J, Shuping G, Orstavik D . Bacterial leakage versus dye leakage in obturated root canals. Int Endod J 1999; 32: 370–375.
Torabinejad M, Ung B, Kettering J D . In vitro bacterial penetration of coronally unsealed endodontically treated teeth. J Endod 1990; 16: 566–569.
Wu M K, Wesselink P R . Endodontic leakage studies reconsidered. Part I. Methodology, application and relevance. Int Endod J 1993; 26: 37–43.
Kersten H W, Moorer W R . Particles and molecules in endodontic leakage. Int Endod J 1989; 22: 118–124.
Vertucci F. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005; 10: 3–29.
Haapasalo M, Orstavik D . In vitro infection and disinfection of dentinal tubules. J Dent Res 1987; 66: 1375–1379.
Sundqvist G, Figdor D, Persson S, Sjogren U . Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85: 86–93.
Peciuliene V, Balciuniene I, Eriksen H M, Haapasalo M . Isolation of Enterococcus faecalis in previously root-filled canals in a Lithuanian population. J Endod 2000; 26: 593–595.
Weldon J K, Jr., Pashley D H, Loushine R J, Weller R N, Kimbrough W F . Sealing ability of mineral trioxide aggregate and super-EBA when used as furcation repair materials: a longitudinal study. J Endod 2002; 28: 467–470.
Tsai Y L, Lan W H, Jeng J H . Treatment of pulp floor and stripping perforation by mineral trioxide aggregate. J Formos Med Assoc 2006; 105: 522–526.
Hamad H A, Tordik P A, McClanahan S B . Furcation perforation repair comparing gray and white MTA: a dye extraction study. J Endod 2006; 32: 337–340.
Miyagak D C, de Carvalho E M, Robazza C R, Chavasco J K, Levorato G L . In vitro evaluation of the antimicrobial activity of endodontic sealers. Braz Oral Res 2006; 20: 303–306.
Yasuda Y, Kamaguchi A, Saito T . In vitro evaluation of the antimicrobial activity of a new resin-based endodontic sealer against endodontic pathogens. J Oral Sci 2008; 50: 309–313.
Eldeniz A U, Hadimli H H, Ataoglu H, Orstavik D . Antibacterial effect of selected root-end filling materials. J Endod 2006; 32: 345–349.
Sipert C R, Hussne R P, Nishiyama C K, Torres S A. In vitro antimicrobial activity of Fill Canal, Sealapex, Mineral Trioxide Aggregate, Portland cement and EndoRez. Int Endod J 2005; 38: 539–543.
Tanomaru-Filho M, Tanomaru J M, Barros D B, Watanabe E, Ito I Y . In vitro antimicrobial activity of endodontic sealers, MTA-based cements and Portland cement. J Oral Sci 2007; 49: 41–45.
Fuss Z, Abramovitz I, Metzger Z . Sealing furcation perforations with silver glass ionomer cement: an in vitro evaluation. J Endod 2000; 26: 466–468.
Haznedaroglu F, Ersev H, Odabasi H, Yetkin G, Batur B, Asci S et al. Incidence of patent furcal accessory canals in permanent molars of a Turkish population. Int Endod J 2003; 36: 515–519.
Acknowledgements
The authors would like to thank Mr S. Stølen (Institute of Oral Biology, University of Oslo, Norway) for his help with the scanning electron microscopy, Ms I. S. Dragland (NIOM, Haslum, Norway) for laboratory assistance, Ms I. Nedzelskiene (Department of Dental and Oral Pathology, Kaunas University of Medicine, Lithuania) for statistical assistance, and local suppliers for materials.
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Lodiene, G., Kleivmyr, M., Bruzell, E. et al. Sealing ability of mineral trioxide aggregate, glass ionomer cement and composite resin when repairing large furcal perforations. Br Dent J 210, E7 (2011). https://doi.org/10.1038/sj.bdj.2011.198
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DOI: https://doi.org/10.1038/sj.bdj.2011.198
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