Evaluation of MTA insertion techniques in apically prepared teeth simulating incomplete root formation: an in vitro study

Authors

DOI:

https://doi.org/10.33448/rsd-v11i11.33745

Keywords:

Apexification; Endodontics; Root canal.

Abstract

Apexification with MTA in incomplete rhizogenesis allows the formation of the apical barrier quickly and safely, however, there is difficulty in its insertion in the root canals. In this study, the efficacy of apical sealing in human teeth was comparatively evaluated in vitro, when the devices: MTA carrier, Lentulo spiral and gutta-percha cone were used. Sixty extracted anterior teeth were used, with lengths between 20 and 25 mm. The preparation of root canals was carried out by using Gates-Glidden drills, progressively, from number 1 to number 4, and for the simulation of apical divergence, the 5 was used, in a retrograde fashion. The sample was randomized into 3 groups (n=20) to make the apical plugs. Group 01, Lentulo, group 2, the MTA carrier and group 3, gutta-percha #80. The quality of the apical barriers was evaluated by a resident in Endodontics, through digital periapical radiographs. A score from 0 to 3 was considered, verifying the correspondence of the apical plug to the radiographic apex, the filling of the apical 4 mm of the root, and the absence of space between the material and the canal walls. The results showed that there was no significant difference between the groups (p> 0.05) and the scores in descending order were: 2 (48.3%), 1 (23.3%), 3 (18.4%) and 0 (10%). It was concluded that there was no difference in the effectiveness of apical sealing in human teeth, in vitro, simulating incomplete rhizogenesis, when compared to the Lentulo spiral, the MTA carrier, and gutta percha cone.

References

Adel, M.; Salmani, Z.; Youssefi, N & Heidari, B (2021). Comparison of microleakage of mineral trioxide aggregate apical plug applied by the manual technique and indirect use of ultrasonic with different powers J Dent, 22(4), 290-295.

Agrafioti, A.; Giannakoulas, D G.; Filippatos C G & Kontakiotis E G (2017). Analysis of clinical studies related to apexification techniques. Eur J Paediatr Dent, 18(4), 273-284.

Alhamoui, F A.; Steffen, H & Splieth, C H (2014). The sealing ability of ProRoot MTA when placed as an apical barrier using three different techniques: an in-vitro apexification model. Quintessence Int, 45(10), 821-827.

Basturk, F B.; Nekoofar, M H.; Gunday, M & Dummer, P M H (2014). Effect of various mixing and placement techniques on the flexural strength and porosity of mineral trioxide aggregate. J Endod, 40(3), 441-445.

Basturk, F B.; Nekoofar, M H.; Gunday, M & Dummer, P M H (2015). Effect of varying water-to-powder ratios and ultrasonic placement on the compressive strength of mineral trioxide aggregate. J Endod, 41(4), 531-534.

Bonte, E.; Beslot, A.; Boukpessi, T & Lasfargues, J J (2014). MTA versus Ca(OH)2 in apexification of non-vital immature permanent teeth: a randomized clinical trial comparison. Clin Oral Investig, 19(6), 1381-1388.

Bücher, K.; Meier, F.; Diegritz, C.; Kaaden, C.; Hickel, R & Kuhnisch, J (2016). Long-term outcome of MTA apexification in teeth with open apices. Quintessence Int, 7(6), 473-482.

Cehreli, Z C.; Sara, S.; Uysal, S & Turgut, M D (2011). MTA apical plugs in the treatment of traumatized immature teeth with large periapical lesions. Dental Traumatol, 27(1), 59-62.

Coneglian, P Z A.; Orosco, F A.; Bramante, C M.; De Moraes, I G.; Garcia, R B & Bernardinelli, N (2007). In vitro sealing of white and gray mineral trioxide aggregate (MTA) and white portland cement used as apical plugs. J Appl Oral Sci, 15(3), 181-185.

DeAngelis, L.; Chockalingam, R.; Hamidi-Ravari, A.; Hay, S.; Lum, V.; Sathorn, C & Parashos, P (2013). In vitro assessment of mineral trioxide aggregate setting in the presence of interstitial fluid alone. J Endod, 39(3), 402-405.

Erdogan G (1997). The treatment of nonvital immature teeth with calcium hydroxide-sterile water paste: Two case reports. Quintessence Int, 28, 681-686.

Escobar-García, D M.; Aguirre-Lópes, E.; Méndez-Gonzales, V & Pozos-Guillén, A (2016). Cytotoxicity and initial biocompatibility of endodontic biomaterials (MTA and BiodentineTM) used as root-end filling materials. BioMed Res Int. 2016:1-7

Evren, O K.; Altunsoy, M.; Tanriver, M.; Capar, I D.; Kaikan, A & Gok, T (2016). Fracture resistance of simulated immature teeth after apexification with calcium silicate-based materials. Eu J Dent, 10(2), 188-192.

Ghasemi, N.; Janani, M.; Razi, T & Atharmoghaddam, F (2017). Effect of different mixing and placement methods on the quality of MTA apical plug in simulated apexification model. J Clin Exp Dent, 9(3), e351-e355.

Huybrechts, B.; Bud, M.; Bergmans, L.; Lambrechts, P & Jacobs, R (2009). Void detection in root fillings using intraoral analogue, intraoral digital and cone beam CT images. Int Endod J, 42(8), 675-685.

Kositbowornchai, S.; Hanwachirapong, D.; Somsopon, R.; Pirmisinthavee, S & Sooksuntisakoonchai, N (2006). Ex vivo comparison of digital images with conventional radiographs for detection of simulated voids in root canal filling material. Int Endod J, 39(4), 287-292.

Kumar, V.; Zammer, M.; Prasad, V & Mahantesh, T (2014). Boon of MTA Apexification in Young Permanent Posterior Teeth. Case Rep Dent, 2014, 1-5.

Lauris, J R P. Cálculo Amostral. http://calculoamostral.bauru.usp.br/calculoamostral/index.php

Lee, L W.; Hsiao, S H.; Lin, Y H.; Lee, Y L & Hung, W C (2019). Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier. J Formos Medl Assoc, 118(1), 362-370.

Lin, J C.; Lu, J X.; Zeng, Q.; Zhao, W.; Li, W Q & Ling, J Q (2016). Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. J Formos Med Assoc, 115(7), 523–530.

Morotomi T, Washio A, Kitamura C. Current and future options of dental pulp therapy. Jpn Dent Sci Rev, 55(1), 5-11

Orosco, F A.; Bramante, C M.; Garcia, R B.; Bernardinelli, N & Moraes, I G (2008). Sealing Ability of gray MTA Angelus, CPM and MBPC used as apical plugs. J Appl Oral Sci, 16(1), 50-54.

Parirokh, M & Torabinejad, M (2010). Mineral trioxide aggregate: a comprehensive literature review -- Part III: Clinical applications, drawbacks, and mechanism of action. J Endod, 36(3), 400-413.

Reyes-Carmona, J F.; Felippe, M S & Felippe, W T (2010). A phosphate-buffered saline intracanal dressing improves the biomineralization ability of mineral trioxide aggregate apical plugs. J Endod, 36(10), 1648-1652.

Sarris, S.; Tahmassebi, JF.; Duggal, M S & Cross, I A (2008). A clinical evaluation of mineral trioxide aggregate for root-end closure of non-vital immature permanent incisors in children-a pilot study. Dent Traumatol, 24(1), 79-85.

Sharma, S.; Grover, S.; Dudeja, P.; Sharma, V & Passi, D (2016). Non-surgical management of teeth with wide open apices and large periapical lesions: A conservative reality. J Clin Diagn Res, 10(11), ZJ01-ZJ02.

Sisli, S N & Ozbas H (2017). Comparative micro-computed tomographic evaluation of the sealing quality of ProRoot MTA and MTA Angelus apical plugs placed with various techniques. J Endod, 43(1), 147-151.

Sogukpinar, A & Arikan V (2020). Comparative evaluation of four endodontic biomaterials and calcium hydroxide regarding their effect on fracture resistance of simulated immature teeth. Eur J Paediatr Dent, 21(1), 23-28.

Tolibah, Y A.; Droubi, L.; Alkurd, S.; Abbara, M T.; Bshara, N.; Lazkani, T.; Kouchaji, C.; Ahmad, I A & Baghdadi, Z D (2022). Evaluation of a novel tool for apical plug formation during apexification of immature teeth. Int J Environ Res Public Health, 19(9), 5304.

Torabinejad, M.; Parirokh, M & Dummer, P M H (2018). Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview part II: other clinical applications and complications. Int Endod J, 51, 284-317.

Utneja, S.; Nawal, R R.; Talwar, S &Verma, M (2015). Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement - review of its composition, properties and applications. Restor Dent Endod, 40(1), 1-13.

Vijayran, M.; Chaudhary, S.; Manuja, N & Kulkarni, A U (2013). Mineral trioxide aggregate (MTA) apexification: a novel approach for traumatised young immature permanent teeth. BMJ Case Reports, 10(2013), bcr2012008094.

Published

28/08/2022

How to Cite

TOMAZOLI, A. T. P.; CABAU, L.; TOLENTINO, E. .; PAVAN, N. N. O. .; TOOKUNI, I. V. M.; ENDO, M. S. . Evaluation of MTA insertion techniques in apically prepared teeth simulating incomplete root formation: an in vitro study. Research, Society and Development, [S. l.], v. 11, n. 11, p. e456111133745, 2022. DOI: 10.33448/rsd-v11i11.33745. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/33745. Acesso em: 6 oct. 2022.

Issue

Section

Health Sciences