Comparison of Microleakage of Canal Fillings Using Gutta-Percha and Resin Sealer with Bioceramic Materials (Cold Ceramic, Cem Cement) in Cases of Apical Constriction Loss Using the Dye Penetration Method
Mahdi Tabrizizadeh, Fatemeh Ayatollahi, Golnoush Sadat Golestaneh
Introduction:
Achieving an apical seal in teeth lacking an apical constriction is one of the most challenging aspects of root canal therapy. Currently, the application of bioceramic plugs is replacing traditional obturation methods. However, the marginal sealing ability and the capacity to prevent microleakage in these bioceramic materials are heavily influenced by methodological factors, cement thickness, and adaptation to dentinal walls. The aim of this study was to compare the microleakage of two bioceramic materials with gutta-percha and resin sealer in open-apex conditions.
Materials and Methods:
In this in vitro study, 81 extracted single-rooted teeth were collected. Following disinfection, working length determination, and canal preparation, the teeth were divided into five experimental groups (15 specimens each): canal obturation using a Cold Ceramic apical plug (3 mm and 10 mm), a CEM Cement apical plug (3 mm and 10 mm), and gutta-percha with AH Plus resin sealer using the lateral condensation technique (10 mm length), as well as positive and negative control groups (3 specimens each). The samples were stored in normal saline for one month and subsequently immersed in a 2% methylene blue dye solution for 3 days. The specimens were sectioned longitudinally, and microleakage was measured on two opposite surfaces under a stereomicroscope, with the mean values recorded for statistical analysis.
Results:
The highest mean microleakage was observed in the 10 mm Cold Ceramic apical plug group, whereas the lowest mean microleakage belonged to the 3 mm Cold Ceramic apical plug group; however, this difference was not statistically significant (p > 0.05). Overall, no statistically significant difference in mean microleakage was found between any of the experimental groups (p > 0.05).
Discussion and Conclusion:
In teeth with a lost apical constriction, the placement of a bioceramic apical plug at thicknesses of 3 mm and 10 mm established an adequate seal and can be recommended for clinical practice.
Keywords: Open apex, Bioceramics, Microleakage.