Marginal adaptation of the Mineral Trioxide Aggregate with and without calcium chloride in root-end cavities
Adaptação marginal do agregado de trióxido mineral com e sem cloreto de cálcio em retrocavidades
Faria-Júnior, Norberto Batista de; Bortoluzzi, Eduardo Antunes; Berbert, Fábio Luiz Camargo Villela; Tanomaru-Filho, Mário; Guerreiro-Tanomaru, Juliane Maria
Rev. odontol. UNESP, vol.40, n2, p.84-90, 2011
Abstract
Objective: To evaluate the marginal adaptation of the Mineral Trioxide Aggregate (MTA) with and without calcium chloride (CaCl2) in root-end cavities. Method: Twenty extracted single-rooted teeth were instrumented and obturated with gutta-percha and AH Plus. All roots were resected using a Zekrya bur and root-end cavities were prepared by using ultrasonic retrotips. Epoxy resin replicas of root-end surfaces after root-end cavity preparation were obtained, sputter coated with gold, and examined by using a scanning electron microscope (SEM). The samples were divided into two experimental groups (n = 10 teeth) according to the root-end filling material employed: G1 - MTA; and G2 - MTA + CaCl2. After the root-end filling, the teeth were stored in moist gauze at 37 °C for 24 hours. New replicas of the root-end surfaces were obtained and examined under a SEM. Marginal adaptation of the filling materials were categorized as: 1) continuous margin; 2) non-continuous margin. Besides, percentages of continuous margin were calculated. The results were analyzed by the Mann-Whitney test. Results: Visible gaps were seen in 2 roots in G1 and in 3 roots in G2. A continuous margin was observed with 95,59% of MTA and 87,48% of MTA + CaCl2 root-end fillings. There was not statistical difference between the two groups (p > 0.05). Conclusion: The addition of CaCl2 to MTA did not alter its marginal adaptation capability to the dentin walls of root-end cavities.
Keywords
Oral surgery, retrograde obturation, dental marginal adaptation
Resumo
Objetivo: Avaliar a adaptação marginal do Agregado de Trióxido Mineral (MTA) com e sem cloreto de cálcio (CaCl2) em retrocavidades. Método: Vinte dentes unirradiculados foram instrumentados e obturados com guta-percha e AH-Plus. Os ápices das raízes foram cortados com uma broca Zekrya e preparos retrógrados foram realizados com pontas ultrassônicas. Réplicas em resina dos ápices preparados foram obtidas, metalizadas com ouro e examinadas em microscopia eletrônica de varredura (MEV). Os espécimes foram divididos em dois grupos experimentais (n = 10 dentes), de acordo com o material retrobturador empregado: G1 – MTA e G2 – MTA + CaCl2. Após as retrobturações, os dentes foram mantidos em ambiente úmido a 37 °C por 24 horas. Novas réplicas de resina foram obtidas e levadas ao MEV. A adaptação marginal dos cimentos foi classificada como: 1) margem contínua; 2) margem não contínua. Além disso, os percentuais de margem contínua foram calculados. Os resultados foram analisados pelo teste de Mann-Whitney. Resultados: Falhas de adaptação foram observadas em duas raízes no G1 e três raízes no G2. O percentual de margem contínua foi de 95,59% no grupo com MTA e 87,48% no grupo com MTA + CaCl2. Não houve diferença estatística significativa entre os dois grupos (p > 0,05). Conclusão: A adição do cloreto de cálcio ao MTA não alterou a sua capacidade de adaptação marginal às paredes dentinárias das retrocavidades.
Palavras-chave
Cirurgia bucal, obturação retrógrada, adaptação marginal dentária
References
1. von Arx T. Failed root canals: the case for apicoectomy (periradicular surgery). J Oral Maxillofac Surg. 2005; 63: 832-7.
2. Rubinstein RA, Kim S. Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and super-EBA as root-end filling material. J Endod. 1999; 25: 43-8.
3. Rubinstein RA, Kim S. Long-term follow-up of cases considered healed one year after apical microsurgery. J Endod. 2002; 28: 378-83.
4. Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod. 2006; 32: 601-23.
5. Gondim E, Jr., Kim S, de Souza-Filho FJ. An investigation of microleakage from root-end fillings in ultrasonic retrograde cavities with or without finishing: a quantitative analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 755-60.
6. Fernandez-Yanez Sanchez A, Leco-Berrocal MI, Martinez-Gonzalez JM. Metaanalysis of filler materials in periapical surgery. Med Oral Patol Oral Cir Bucal. 2008; 13: E180-5.
7. Tanomaru-Filho M, Bronzi ES, Wilhelmsen NSW, Duarte MAH. Capacidade Seladora do Sealer 26 e AH Plus em Obturações Retrógradas. Rev Paul Odontol. 1999; 21: 34-6.
8. Torabinejad M, Smith PW, Kettering JD, Pitt Ford TR. Comparative investigation of marginal adaptation of mineral trioxide aggregate and other commonly used root-end filling materials. J Endod. 1995; 21: 295-9.
9. Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod. 1993; 19: 591-5.
10. Xavier CB, Weismann R, de Oliveira MG, Demarco FF, Pozza DH. Root-end filling materials: apical microleakage and marginal adaptation. J Endod. 2005; 31: 539-42.
11. Torabinejad M, Higa RK, McKendry DJ, Pitt Ford TR. Dye leakage of four root end filling materials: effects of blood contamination. J Endod. 1994; 20: 159-63.
12. Camilleri J, Montesin FE, Di Silvio L, Pitt Ford TR. The chemical constitution and biocompatibility of accelerated Portland cement for endodontic use. Int Endod J. 2005; 38: 834-42.
13. Estrela C, Bammann LL, Estrela CR, Silva RS, Pecora JD. Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, Sealapex and Dycal. Braz Dent J. 2000; 11: 3-9.
14. Ribeiro DA, Duarte MA, Matsumoto MA, Marques ME, Salvadori DM. Biocompatibility in vitro tests of mineral trioxide aggregate and regular and white Portland cements. J Endod. 2005; 31: 605-7.
15. Bortoluzzi EA, Broon NJ, Bramante CM, Consolaro A, Garcia RB, de Moraes IG, et al. Mineral Trioxide Aggregate with or without calcium chloride in pulpotomy. J Endod. 2008; 34: 172-5.
16. Bortoluzzi EA, Broon NJ, Bramante CM, Garcia RB, de Moraes IG, Bernardineli N. Sealing ability of MTA and radiopaque Portland cement with or without calcium chloride for root-end filling. J Endod. 2006; 32: 897-900.
17. Bortoluzzi EA, Juarez Broon N, Duarte MAH, Demarchi ACO, Bramante CM. The use of a setting accelerator and its effect on pH and calcium ion release of mineral trioxide aggregate and white Portland cement. J Endod. 2006; 32: 1194-7.
18. Tagger M, Tamse A, Katz A, Korzen BH. Evaluation of the apical seal produced by a hybrid root canal filling method, combining lateral condensation and thermatic compaction. J Endod. 1984; 10: 299-303.
19. Gondim E, Zaia AA, Gomes BP, Ferraz CC, Teixeira FB, Souza-Filho FJ. Investigation of the marginal adaptation of root-end filling materials in root-end cavities prepared with ultrasonic tips. Int Endod J. 2003; 36: 491-9.
20. Faria-Junior NB, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Leonardo RT, Berbert FLCV. Evaluation of ultrasonic and ErCr:YSGG laser retrograde cavity preparation. J Endod. 2009; 35: 741-4.
21. Berbert FLCV, Faria-Junior NB, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Bonetti-Filho I, Leonardo RT, et al. An in vitro evaluation of apicoectomies and retropreparations using different methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: e57-63.
22. Peters CI, Peters OA. Occlusal loading of EBA and MTA root-end fillings in a computer-controlled masticator: a scanning electron microscopic study. Int Endod J. 2002; 35: 22-9.
23. Shipper G, Grossman ES, Botha AJ, Cleaton-Jones PE. Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study. Int Endod J. 2004; 37: 325-36.
24. Reyes-Carmona JF, Felippe MS, Felippe WT. The biomineralization ability of mineral trioxide aggregate and Portland cement on dentin enhances the push-out strength. J Endod. 2010; 36: 286-91.
25. Reyes-Carmona JF, Felippe MS, Felippe WT. Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid. J Endod. 2009; 35: 731-6.
26. Lee ES. A new mineral trioxide aggregate root-end filling technique. J Endod. 2000; 26: 764-5.
27. Aminoshariae A, Hartwell GR, Moon PC. Placement of mineral trioxide aggregate using two different techniques. J Endod. 2003; 29: 679‑82.
28. Fitzpatrick EL, Steiman HR. Scanning electron microscopic evaluation of finishing techniques on IRM and EBA retrofillings. J Endod. 1997; 23: 423-7.
29. Tobon-Arroyave SI, Restrepo-Perez MM, Arismendi-Echavarria JA, Velasquez-Restrepo Z, Marin-Botero ML, Garcia-Dorado EC. Ex vivo microscopic assessment of factors affecting the quality of apical seal created by root-end fillings. Int Endod J. 2007; 40: 590-602.
30. Abdullah D, Ford TR, Papaioannou S, Nicholson J, McDonald F. An evaluation of accelerated Portland cement as a restorative material. Biomaterials. 2002; 23: 4001-10.