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VOLUME 12 , ISSUE 1 ( January-April, 2024 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of Sealing Ability and Pushout Strength of Four Different Furcation Repair Materials: An In Vitro Study

Suman Sharma, Purshottam Jasuja, Heena Khurana, Shveta Munjal, Ekta Gakhar, Gurkiran Kaur

Keywords : Biodentine, Calcium-enriched material cement, Cention N, Dye extraction, Furcation repair, Perforation, Pushout strength, Spectrophotometer, Stereomicroscope

Citation Information : Sharma S, Jasuja P, Khurana H, Munjal S, Gakhar E, Kaur G. Comparative Evaluation of Sealing Ability and Pushout Strength of Four Different Furcation Repair Materials: An In Vitro Study. 2024; 12 (1):21-28.

DOI: 10.5005/djas-11014-0040

License: CC BY-NC-ND 4.0

Published Online: 30-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Introduction: In endodontic practice, technical accidents are commonly encountered such as furcation perforation. For everlasting success, furcation perforations shall be corrected rapidly with an ideal perforation sealing material. For an ideal perforation sealing material, the desirable properties include an adequate seal, minimal microleakage, good biocompatibility, high pushout strength, stability in blood-contaminated areas, bactericidal, induction of mineralization, osteogenesis, and cementogenesis, radio-opacity and ease of clinical manipulation. Mineral trioxide aggregate (MTA) is the commonly used furcation repair material, but it presents sundry clinical shortfalls for instance prolonged setting time, difficulty in handling, and tooth discoloration. To remodel the attributions of MTA, new materials have been introduced which include Biodentine, calcium-enriched material (CEM) cement, and Cention N (CN). Biodentine is used as a dentin substitute because of its excellent sealing potential, high compressive strength, high pushout strength, less setting time, good biocompatibility, and biomineralization properties. Calcium-enriched material cement is a water-based tooth-colored material that yields a biological glue, is biocompatible, and ability to induce osteogenesis and cementogenesis. Cention N is an “alkasite” restorative material, like compomer or ormocer materials. It is radiopaque and releases ions such as fluoride, calcium, and hydroxyl. Objectives: To evaluate and equate the sealing capability and pushout strength of ProRoot MTA, CEM cement, CN, and Biodentine as furcation perforation repair materials. Materials and methods: A total of 60 extracted permanent mandibular molars were collected, and furcation perforations were made between the roots in a standardized manner. Based on kind of perforation repair material, samples were arbitrarily categorized into four discrete groups having 15 teeth each. In group I, samples were restored with ProRoot MTA. In group II, samples were restored with CEM Cement. In group III, samples were repaired with CN, and in group IV, samples were revived with Biodentine. After which, five samples from each group were selected for sealing ability testing using the dye extraction method by spectrophotometer, five samples from each group were selected for microleakage testing using the dye infiltration method followed by sectioning and evaluation of the sectioned samples by stereomicroscope, and five samples from each group were selected for Pushout strength evaluation by embedding them in acrylic using polyvinyl chloride (PVC) molds and subjecting them to universal testing machine. The data collected was statistically analyzed. Results: The mean spectrophotometric dye absorbance was significantly higher in CN followed by CEM cement and dye absorbance was least in ProRoot MTA and Biodentine. Infiltration loss was significantly higher among ProRoot MTA and Biodentine compared to CEM cement and CN. The mean pushout strength was significantly higher in Biodentine followed by ProRoot MTA and CN and it was the least in CEM cement. Conclusion: Biodentine showed the best sealing ability and highest pushout strength among the four materials used, that is, MTA, CEM cement, and CN. Therefore, Biodentine can be used as a replacement for MTA, CEM cement, and CN as a furcation perforation repair material.


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  1. Endodontics: Colleagues for Excellence. Fall/Winter: Coronal Leakage – Clinical and Biological Implications in Endodontic Success. Chicago, IL: American Association of Endodontists; 2002, pp.1–6.
  2. Youssef N. Repair of furcation perforation in pediatric patients. EC Clin Med Case Rep 2019;2(9):1–4.
  3. Balachandran J, Gurucharan. Comparison of sealing ability of bioactive bone cement, mineral trioxide aggregate and super EBA as furcation repair materials: A dye extraction study. J Conserv Dent 2013;16(3):247–351. DOI: 10.4103/0972-0707.111326.
  4. Torabinejad M, Watson TF, Ford TP. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod 1993;19(12):591–595. DOI: 10.1016/S0099-2399(06)80271-2.
  5. Reddy NV, Srujana P, Daneswari V, et al. Sealing ability of MTA vs Portland cement in the repair of furcal perforations of primary molars: A dye extraction leakage model: An in vitro study. Int J Clin Pediatr Dent 2019;12(2):83-87. DOI: 10.5005/jp-journals-10005- 1597.
  6. Kadali N, Alla RK, Guduri V, et al. Mineral trioxide aggregate: An overview of composition, properties and clinical applications. Int J Dent Mater 2020;2(1):11–18. DOI: 10.37983/IJDM.2020.2103.
  7. Eghbal MJ, Fazlyab M, Asgary S. Repair of an extensive furcation perforation with CEM cement: A case study. Iran Endod J 2014;9(1): 79–82. PMID: 24396381.
  8. Mazumdar P, Das A, Das UK. Comparative evaluation of microleakage of three different direct restorative materials (silver amalgam, glass ionomer cement, Cention N), in class II restorations using stereomicroscope: An in vitro study. Indian J Dent Res 2019;30(2): 277–281. DOI: 10.4103/ijdr.IJDR_481_17.
  9. Cardoso M, Pires MDA, Correlo V, et al. Biodentine for furcation perforation repair: An animal study with histological, radiographic and micro-computed tomographic assessment. Iran Endod J 2018;13(3):323–330. DOI: 10.22037/iej.v13i3.19890.
  10. Pagaria S, Singh BD, Dubey A. Review article: Biodentine as a new calcium silicate based cement. Chettinad Health City Med J 2015;4(4):182–184.
  11. Sinkar RC, Patil SS, Jogad NP, et al. Comparison of sealing ability of ProRoot MTA, RetroMTA, and Biodentine as furcation repair materials: An ultraviolet spectrophotometric analysis. J Conserv Dent 2015;18(6):445–448. DOI: 10.4103/0972-0707.168803.
  12. Nikoloudaki GE, Kontogiannis T, Meliou HA, et al. A comparative in vitro study of sealing ability of four different materials used in furcation perforation. Open J Stomatol 2014;4:402–411. DOI: 10.4236/ojst.2014.48054.
  13. Zarzour DS, Habib AA, Douman M, et al. Comparative evaluation of sealing ability of three materials used in furcal perforation repair (in vitro). World J Dent 2021;12(3):178–182. DOI: 10.5005/jp-journals-10015-1821.
  14. Kassab P, El Hachem C, Habib M, et al. The pushout bond strength of three calcium silicate-based materials in furcal perforation repair and the effect of a novel irrigation solution: A comparative in vitro study. J Contemp Dent Pract 2022;23(3):289–294. PMID: 35781432.
  15. Singla M, Verma KG, Goyal V, et al. Comparison of push-out bond strength of furcation perforation repair materials—glass ionomer cement type II, hydroxyapatite, mineral trioxide aggregate, and Biodentine: An in vitro study. Contemp Clin Dent 2018;9(3):410–414. DOI: 10.4103/ccd.ccd_162_18.
  16. Selvakumar H, Kavitha S, Vijayakumar R, et al. Study of pulp chamber morphology of primary mandibular molars using spiral computed tomography. J Contemp Dent Pract 2014;15(6):726–729. DOI: 10.5005/jp-journals-10024-1606.
  17. Tsesis I, Fuss ZVI. Diagnosis and treatment of accidental root perforations. Endod Top 2006;13(1):95–107. DOI: 10.1111/j.1601-1546.2006.00213.x.
  18. Marques NCT, Neto NL, Oliveira, TM. Immediate and mediate furcal perforation treatment in primary molars: 24-month follow-up. Eur Arch Paediatr Dent 2016;17(6):489–494. DOI: 10.1007/s40368-016-0249-5.
  19. Sahu S, Ali N, Misuriya A, et al. Comparative evaluation of microleakage in class I cavities restored with amalgam, bulk-fill composite and Cention N: An in vitro confocal laser scanning microscope study. Int J Oral Care Res 2018;6(1):S81–S85.
  20. Alhabdan AA. Review of microleakage evaluation tools. J Int Oral Health 2017;9(4):141–145. DOI: 10.4103/jioh.jioh_160_17.
  21. El-Tahan AI, Tewfik H, Diab AH, et al. Sealing ability and dislodgement resistance of three materials for the repair of furcation perforation (in vitro study). J Fundamental Clin Res 2021;1(2):121–137. DOI: 10.21608/JFCR.2021.211107.
  22. Ahlberg KMF, Assavanop P, Tay WM. A comparison of the apical dye penetration patterns shown by methylene blue and India ink in root-filled teeth. Int Endod J 1995;28(1):30–34. DOI: 10.1111/j.1365-2591.1995.tb00153.x.
  23. Erkut S, Tanyel R, Keklikoğlu N, et al. A comparative microleakage study of retrograd filling materials. Turk J Med Sci 2006;36(2):113–120. © TÜB‹TAK.
  24. Eltoum NA, Bakry NS, Talaat DM, et al. Microleakage evaluation of bulk-fill composite in class II restorations of primary molars. Alex Dent J 2019;44(1):111–116. DOI: 10.21608/ADJALEXU.2019. 57614.
  25. Camps J, Pashley D. Reliability of the dye penetration studies. J Endod 2003;29(9):592–594. DOI: 10.1097/00004770-200309000-00012.
  26. Mohan TM Sudha K, Shoba C, et al. Comparative evaluation of sealing ability of ProRoot MTA, Biodentine and bone cement in the repair of furcation perforation: An in vitro study. Indian J Dent Adv 2019;10(4):176–180. DOI: 10.5866/2018.10.10176.
  27. Yahya MM. Sealing ability of Biodentine as a root perforation treatment material (an in vitro study). Tikrit J Dent Sci 2015;1:62–68. DOI: 10.25130/tjds.2015.1.8.
  28. Samuel A, Asokan S, Priya PG, et al. Evaluation of sealing ability of Biodentine™ and mineral trioxide aggregate in primary molars using scanning electron microscope: A randomized controlled in vitro trial. Contemp Clin Dent 2016;7(3):322–325. DOI: 10.4103/0976-237X.188547.
  29. Raskin A, Eschrich G, Dejou J. In vitro microleakage of Biodentine as a dentin substitute compared to Fuji II LC in cervical lining restorations. J Adhes Dent 2012;14(6):535–542. DOI: 10.3290/j.jad.a25690.
  30. Guneser MB, Akbulut MB, Eldeniz AU. Effect of various endodontic irrigants on the push-out bond strength of Biodentine and conventional root perforation repair materials. J Endod 2013;39(3): 380–384. DOI: 10.1016/j.joen.2012.11.033.
  31. Tomer AK, Dayal C, Malik N, et al. An in vitro evaluation of the push-out bond strength of Biodentine and MTA plus root perforation repair materials after irrigation with different endodontic irrigants. Int J Oral Care Res 2016;4(1):53–57. DOI: 10.5005/jp-journals-10051- 0013.
  32. Aggarwal V, Singla M, Miglani S, et al. Comparative evaluation of push-out bond strength of ProRoot MTA, Biodentine, and MTA Plus in furcation perforation repair. J Conserv Dent 2013;16(5):462–465. DOI: 10.4103/0972-0707.117504.
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