Modern methods and materials used to treat root perforation: effectiveness comparison

Abstract

This study aims to experimentally compare the efficacy of different endodontic materials (iRoot BP Plus, Biodentine, MTA, Rootdent, and Trioxide) in the treatment of pulpitis and perforations on extracted tooth specimens. Additionally, the study aims to investigate the influence of iRoot BP Plus endodontic material on the regenerative processes following pulp amputation in laboratory animals. The secondary goal is to evaluate the effect of iRoot BP Plus on the restoration process in laboratory animals after pulp removal. The study presents a micropermeability analysis of the selected biomaterials performed on a sample of 50 single-rooted apical teeth in 2022. All teeth underwent endodontic treatment. Changes in molar morphology were investigated with eight laboratory animals (rabbits, 3 months old, all males) after simulated pulp removal and subsequent treatment with the iRoot BP Plus biomaterials. iRoot BP Plus appeared to be more effective in retrograde apical root filling than other biomaterials, as evidenced by its higher sealing effect. An experiment involving animal participants revealed the presence of protective adaptive mechanisms, which manifested in the form of an inflammatory process within 6 weeks after the dental pulp was removed. The connective tissue replaced the necrosis, and new capillaries began to form intensively. These dental outcomes suggest that iRoot BP Plus enables hermetical sealing in tooth restoration with good adhesion. Thus, it may have the ability to promote more active tissue regeneration after pulp removal.

Fig. 1

Sample of a single-rooted tooth extracted for permeability study

Fig. 2

Comparison of dye penetration among five different biomaterials for pulpitis and perforation treatment

Fig. 3

Dye penetration depths: (A) – iRoot BP Plus, (B) – MTA, (C) – Biodentine, (D) – Trioxident, (E) – Rootdent. Note: A, B – No dye penetration; C, D – Marginal dye penetration along the filling-tooth interface; E – Complete dye penetration along the filling-tooth interface and into the filling material

Fig. 4

Microscopic evaluation of the treated area after dental pulp amputation (A) and dentinal tubule preservation in enamel (B) at 200x magnification, stained with Van Gieson and Mallory’s Dyes, respectively