Evaluation of Apical Microleakage in MTA Apexification Model Filled with Thermoplastic Gutta percha, Luxa core Composite and Chemfil Glass – Ionomer

Background: Treatment of the immature pulpless tooth presents both an endodontic and
restorative challenge. A more favorable long–term prognosis may be achieved with a mineral
trioxide aggregate (MTA) apexification procedure followed by an internal bonding technique. We
investigated the efficacy of this treatment option by evaluation the sealing ability of restorative
materials used to strengthen the weakened root in this new treatment concept.
Materials and Methods: Forty – nine single rooted bicuspid extracted human teeth were used in
this study. After preparation in a standardized in- vitro open apex model, MTA (proroot-Angelus)
was placed as orthograde apical barrier at a thickness of 4 mm (except 2 teeth saved as positive
control). Then samples were divided into three groups (n=15). Group 1 was filled with a flowable
dual cure composite (Luxa Core-Dual; DMG) from MTA barrier to 2 mm below the orifices. Group
2 was filled with a self cure glass ionomer (ChemFil; Dentsply) and group 3, was filled with AH26
sealer and thermoplastisized gutta percha. Four teeth were used as positive and negative controls.
The teeth were immersed in 1 % basic fuchsin for 7 days. The roots were split and examined with
steromicroscope (x20) for dye leakage.
Results: 100 % of the MTA barriers showed leakage and 86.6 % of them showed complete dye
penetration through the barriers. We found a significant difference in dye leakage between groups
filled with restoration material (composite resin or glass ionomer ) and group that filled with sealer
and gutta percha ( P< 0.01 ).
Conclusion: Based on these results it appears that restoration materials may not adequately seal
obliterate entire remaining canal.