Root-end filling with cement-based materials: An in vitro analysis of bacterial and dye microleakage

Abstract

Background: One ideal property of a root-end fi lling material is its apical sealing ability. The aim of this in vitro study was to assess bacterial and dye microleakage of white and gray mineral trioxide aggregate (WMTA and GMTA), Portland cement and calcium-enriched mixture (CEM) cement used as root-end fi lling material, and to assess the agreement between these two test methods.

Materials and Methods: Fifty-four single-rooted teeth were used. The roots were randomly divided into four study and two control groups. After decoronation, root canals were instrumented and fi lled with gutta-percha and AH26 sealer. Root-ends were resected 3 mm above the root-end and 3 mm deep cavities were prepared. Root-end cavities were fi lled with each material. Enterococcus faecalis and methylene blue dye were used for determination of bacterial and dye leakage respectively. Data were analyzed using Fisher’s Exact Test, one-way ANOVA, Kaplan-Meier analysis, and Cohen’s Kappa.

Results: There was 100% bacterial leakage in Portland cement and CEM cement, 58.3% in GMTA, and 91.7% in WMTA. GMTA showed signifi cantly less bacterial leakage than Portland cement and CEM cement (P < 0.05). In those samples with leakage occurrence, times of observation of leakage were not signifi cantly different; however, by survival analysis, the results of the GMTA group were signifi cantly different from those of the CEM cement and Portland groups. The difference in complete dye leakage was not signifi cant. There was poor agreement between dye and bacterial leakage methods.

Conclusion: CEM cement provides leakage results comparable to other commonly used root-end fi lling materials such as WMTA.

Key Words: Enterococcus faecalis, microleakage, mineral trioxide aggregate