Efficacy of Mineral Trioxide Aggregate and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study

Abstract

Aim: To compare the bacterial leakage of mineral trioxide aggregate (MTA) and biodentine when used as an apical plug in immature permanent teeth.

Materials and methods: It was a randomized double-blind in vitro study. A total of 60 teeth were divided into 2 groups of MTA and biodentine, which were further divided into 2 subgroups (n = 30) each based on the apical plug thickness of 2 and 4 mm. The teeth were cleaned and shaped; root-end resection and canal preparation were done. Mineral trioxide aggregate and biodentine were mixed and filled as apical plugs of 2 or 4 mm thickness. Enterococcus faecalis was used to assess the bacterial leakage of the filled samples.

Statistical analysis: The comparison between the two groups was done by Chi-square test for categorical data. All p values <0.05 were considered as statistically significant.

Results: A 4 mm apical plug of biodentine showed the least amount of bacterial leakage followed by 2 mm MTA and 4 mm MTA. A 2 mm apical plug of biodentine showed the maximum bacterial leakage. But this was not statistically significant over a period of 3 months. There was a statistically significant difference (p value = 0.042) among the total number of samples that leaked in the 2 and 4 mm biodentine group.

Conclusion: Mineral trioxide aggregate and biodentine had a similar apical sealing ability. The apical sealing ability of biodentine at 4 mm thickness was greater than 2 mm thickness.

Clinical significance: The apical leakage of the materials used in apexification is one of the main causes of endodontic failures in immature necrotic teeth. Materials like MTA and biodentine have overcome various drawbacks of calcium hydroxide as apexification material. The thickness of the apical plug plays an important role in preventing any microorganism from entering the periapical area, hence maintaining an adequate seal.

How to cite this article: Abbas A, Kethineni B, Puppala R, et al. Efficacy of MTA and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study. Int J Clin Pediatr Dent 2020;13(6):656-662.

Keywords: Apical plugs; Bacterial leakage; Biodentine; Enterococcus faecalis; Mineral trioxide aggregate..

Figs 1A to D

Radiographs were taken after placement of biodentine and mineral trioxide aggregate

Figs 2A and B

Microtube assembly placed in the widal tube and sealed with parafilm tape

Fig. 3

Inoculation of E. faecalis into the root canal