Comparative Analysis of Calcium Silicate-based Root Filling Materials Using an Open Apex Model

Abstract

Introduction: Many new calcium silicate-based root filling materials have emerged in the market; however, their performance in the orthograde obturation of an open apex has not been evaluated. The purpose of this study was to compare the marginal adaptation of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), NeoMTA Plus (Avalon Biomed Inc, Bradenton, FL), and Endosequence BC RRM-Fast Set Putty (BC RRM-FS; Brasseler USA, Savannah, GA) after orthograde placement in roots with open apices.

Methods: Palatal roots of maxillary molars were instrumented to create divergent open apices and divided into 4 groups for orthograde obturation: ProRoot MTA, NeoMTA Plus, BC RRM-FS, and BC RRM-FS + BC Sealer. Using a scanning electron microscope, the quality of material adaptation at the anatomic apex was evaluated by 5 blinded examiners; 3 mm of the root end was sectioned, and gap distance was measured at the material-dentin interface. Statistical analyses were performed using the Kruskal-Wallis test.

Results: There were no significant differences in marginal adaptation among the 4 groups at the level of the anatomic apex (P = .175). BC RRM-FS + BC Sealer had a significantly smaller gap size after 3-mm root end resection compared with the other 3 groups (P < .01). No differences were observed among the other 3 materials.

Conclusions: All materials showed comparable marginal adaptation at the anatomic apex when used for orthograde obturation of open apices. Application of BC Sealer before the delivery of BC RRM-FS Putty enhanced the quality of adaptation coronal to the apex.

Keywords: Apexification; calcium silicate materials; mineral trioxide aggregate; obturation; open apex.