Marginal adaptation of mineral trioxide aggregate (MTA) to root dentin surface with orthograde/retrograde application techniques: A microcomputed tomographic analysis

Khalid Al Fouzan; Mohammed Awadh; Moahmmed Badwelan; Abeer Gamal; Amrita Geevarghese; Samar Babhair; Mansour Al-Rejaie; Khalid Al Hezaimi; Ilan Rotstein

doi:10.4103/0972-0707.153069

Marginal adaptation of mineral trioxide aggregate (MTA) to root dentin surface with orthograde/retrograde application techniques: A microcomputed tomographic analysis

J Conserv Dent. 2015 Mar-Apr;18(2):109-13. doi: 10.4103/0972-0707.153069.

Authors

Khalid Al Fouzan¹, Mohammed Awadh², Moahmmed Badwelan², Abeer Gamal², Amrita Geevarghese³, Samar Babhair⁴, Mansour Al-Rejaie⁵, Khalid Al Hezaimi⁶, Ilan Rotstein⁷

Affiliations

¹ Consultant, Division of Endodontics, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
² Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
³ Lecturer, Department of Dental Public Health, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
⁴ Resident, Saudi Endodontics Board, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
⁵ Head, Division of Endodontics, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
⁶ Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
⁷ Professor of Endodontics, Associate Dean for Continuing Oral Health Professional Education, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.

Abstract

Background: Achieving a good apical seal for root canals is known to be associated with good mineral trioxide aggregate (MTA) adaptation to dentin.

Aims: This study aims to compare the marginal adaptation of MTA with root dentin between orthograde and retrograde application techniques using microcomputed tomography (micro-CT) analysis.

Settings and design: Fifty-two single-rooted human teeth were divided into four equal groups: (Group 1) Retrograde MTA (RMTA), (Group 2) Orthograde MTA (OMTA), (Group 3) Etched RMTA (ERMTA), and (Group 4) Etched OMTA (EOMTA).

Materials and methods: For Group 1, 3-mm retrograde cavities were prepared and filled with MTA. For Group 2, the apical 6 mm of the canals were filled with MTA and sealed with sealer cement and warm gutta-percha. In Groups 3 and 4, canals were treated the same as Groups 1 and 2, respectively, except that before placing the MTA, canals were irrigated with 17% ethylenediaminetetraacetic acid (EDTA). After 48 hours, all the teeth were analyzed using a micro-CT scanner.

Statistical analysis: Mean dentin-MTA contact and the mean length and width of each gap was analysed using one-way analysis of variance (ANOVA). Statistical significance was set at an α level of 5%.

Results: No significant difference in gap volumes was observed in the dentin-MTA adaptation in both orthograde and retrograde application techniques. However, significant difference in the gap volumes was observed between RMTA and ERMTA (P = 0.045). Etching significantly improved the MTA-Dentin adaptation (P < 0.05). The type of application technique did not significantly improve the dentin-MTA adaptation, instead with the use of 17% EDTA, a significant improvement could be achieved.

Conclusion: Within the limitations of the present study, it concludes that MTA adaptation to dentin tooth structure is not significantly different between an orthograde and retrograde approach. However, the use of EDTA significantly improved the MTA-Dentin adaptation.

Keywords: Acid etching; marginal adaptation; microcomputed tomography; mineral trioxide aggregate.