The application of MTA as apical plug for root canal obturation: In vitro study

Abstract

Introduction Prognosis of endodontically treated tooth is directly correlated to the quality of apical obturation. Modern concept of endodontics in particular way points out the quality of apical filling. The aim of this study was to assess the quality of root canal obturation with MTA apical plug using the method of gas (argon) penetration. Material and Methods Sixty-six freshly extracted single rooted (single canal) teeth were divided into the two experimental (30 teeth) and one control group (6). All canals were instrumented using hand and rotary files in step-back technique and copious irrigation of 1%NaOCl. In the first experimental group teeth were obturated using different sealers: Gutta Flow (Roeko), AH Plus (DeTrey), Acroseal (Septodont) and mono gutta-percha cone (10 canals each). In the second experimental group obturation involved 3 mm of MTA-Angelus apical plug while the remaining canal space was filled with the same three sealers as in the first group. The rate of gas permeability by Leak detector-Edwards LD 416 was measured in all teeth. Results The best seal was found in teeth obturated with Gutta Flow and MTA plug with average diffusion rate of 264.4 sec while the worst quality of obturation was found with Acroseal (178.5 sec-the highest gas permeability). All samples with MTA plug exhibited significantly lower leakage than the samples filled without MTA apical plug. Conclusion Root canals filled with MTA apical plug exhibited statistically significant lower gas permeability in comparison to the ones filled with sealer and guttapercha cones only.

Uvod Prognoza uspeha endodontski treatiranih zuba je u direktnoj korelaciji sa kvalitetom opturisanog endodontskog prostora. Savremena koncepcija endodontskog tretmana poseban akcenat stavlja na kvalitet preparacije i opturacije apeksnog dela kanala. Cilj ovog rada je bio da se metodom merenja gasne propustljivosti (argona) proveri kvalitet opturacije kanala korena zuba nakon primene mineral-trioksid agregata (MTA) kao apeksnog čepa. Materijal i metod U istraživanje je uključeno 66 jednokorenskih-jednokanalskih zuba razvrstanih u dve grupe (po 30 zuba), dok je šest zuba korišćeno kao kontrola. Preparacija svih kanala je urađena ručnim instrumentima i primenom step-back tehnike uz obilnu irigaciju 1% NaOCl. U prvoj grupi zuba je opturacija realizovana silerima uz pomoć gutaperka konusa Gutta Flow-Roeko (10), AH Plus-DeTrey (10) i Acroseal-Septodont (10). Drugu grupu su činili zubi kod kojih je u apeksnom delu kanala aplikovan MTA, a potom su kanali ispunjeni primenom tri silera kao u prvoj grupi. Svi zubi iz obe grupe su podvrgnuti metodi merenja brzine gasne propustljivosti pomoću aparata Argon Leak Detector, Edwards LD 416. Rezultati Najbolju hermetičnost su pokazali uzorci kanala ispunjeni primenom Gutta Flow+MTA sa prosečnom brzinom (264,4 sek.), a najslabiji kvalitet opturacije sa Acroseal silerom (najveća gasna propustljivost 178,5 sek.). Svi uzorci druge grupe sa MTA čepom su pokazali statistički značajno manju propustljivost nego oni u prvoj grupi sa silerom i gutaperkom bez MTA čepa. Zaključak Opturacija kanala sa postavljenim MTA apeksnim čepom pokazala je značajno manju propustljivost gasa u poređenju sa uzorcima ispunjenim endodontskim silerom i gutaperka konusima.