Comparison of root end sealing ability of three retrograde filling materials in teeth with root apices resected at 900 using dye penetration method under fluorescent microscope

Abstract

Background: The main factor contributing to surgical endodontic dissatisfaction is an inadequate seal at the apex. The material used for retrograde filling should prevent contaminants from penetrating periradicular tissue. So the objective of this study was to evaluate and compare the ability of Mineral Trioxide Aggregate (MTA), Zirconomer and bioactive bone cement to seal the root end as retrograde filling material with apices resected at 900 angles using dye penetration method under fluorescent microscope. Methods: 36 extracted teeth samples were cut at Cementoenamel junction horizontally. Following the customary protocols of, cleaning, shaping and obturation with gutta percha and AH Plus sealer, resection of samples was done 3mm at the apical end at 90 degree angle along the long axis of the tooth with the help of diamond disc. A depth of 3mm of root end cavity was made with diamond coated ultrasonic surgical tip. The samples were randomly allocated in 3 groups: Group I: MTA ; Group II : Zirconomer; Group III: Bioactive Bone Cement . Coating of nail varnish was done with the roots except at the tip. Each material was compacted in the retrocavity using small pluggers. All the retrofilled samples were kept in acridine orange for 24 hours, following which cleaning & bucco-lingual sectioning (vertical) was carried out. Confocal laser scanning fluorescent microscope was used for checking the dye penetration in these samples thereby evaluating sealing ability. Results: Group III (Bioactive Bone Cement) had the highest root end sealing ability with mean (1.4 ± 0.51) followed by Group I (MTA) (2.3 ± 0.65) and lastly Group II (Zirconomer) (4.1 ± 0.57) as root end filling material with apices resected at 900 angle using dye penetration method under fluorescent microscopy which were statistically significant. Conclusions: Bioactive Bone cement can be recommended as an acceptable retrograde filling material.