Endodontology

[Downloaded free from http://www.endodontologyonweb.org on Thursday, April 7, 2022, IP: 195.158.14.172]

---

18
Antony, et al.: Bacterial microleakage of bioceramic root‑end filling materials
Endodontology / Volume 34 / Issue 1 / January‑March 2022
Results of Post hoc test‑bonferroni
1. Baseline reading – There is a statistically 
significant difference between all the groups 
(Group 4> Group 1> Group 2> Group 3)
2. First week – There is a statistically significant difference 
of the three materials with the control group only. No 
significant difference is found between the materials
3. Second week – Group 1 has got statistically significant 
difference with Group 3 and not with Group 2. Group 2 
and 3 have got no significant difference
4. Third, 4
th
, 5
th
, and 6
th
weeks – Group 1 showed 
significantly higher value than Group 2 and 3. There is no 
significant difference between Groups 2 and 3.
(Group 4> Group 1> Group 2 and Group 3).
Repeated‑measures ANOVA was used to assess the changes 
in the OD value obtained for each material over a period 
of 1–6 weeks. For all the groups, there was a statistically 
significant difference in the OD value over the 6‑week 
period [Table 2].
Post hoc test results
For Groups 1, 2, and 3, the baseline reading was significantly 
lower compared to 3
rd
, 4
th
, 5
th
, and 6
th
weeks.
For Group 3, the mean difference of OD between 1
st
versus 
3
rd
, 4
th
, 5
th
, and 6
th
weeks is statistically significant with 
P < 0.05.
DISCUSSION
Provision of an effective and three‑dimensional apical seal is 
one of the most important factors that is to be considered 
while selecting a retrograde restorative material.
[10]
In this 
study, the sealing ability of white ProRoot MTA, which is a 
widely used retrograde filling material, was compared with 
Biodentine and the newer generation calcium phosphate 
silicate cement, EndoSequence RRM putty, for a time 
period of 6 weeks. Several in vitro methods have been 
proposed for assessment of the sealing ability of restorative 
materials. Bacterial leakage models were used in this study 
as it is found to better simulate the clinical conditions when 
comparaed to dye leakage method because of the smaller 
size of dye particles (Timpawat et al).
[11]
While doing 
root‑end resection, at least 3 mm of the root‑end must be 
eliminated to reduce 98% of the apical ramifications and 
93% of the lateral canals and that perpendicular resection 
minimizes the number of exposed dentinal tubules.
[12]
As 
the angle of the bevel increases the apical leakage also 
increases. This is due to the exposure of wider apical 
surface and greater number of dentinal tubules which leads 
to the increased permeability.
[13]
So a 90° angle was used 
for root end resection. Sonic and ultrasonic devices have 
been demonstrated to produce cleaner, well‑centered, and 
conservative root‑end cavities (Khabbaz et al).
[14]
According to the results obtained, the turbidity values of the 
control group were higher than the three tested materials 
in all the 6 weeks which depicts the presence of active 
growth in the inoculum and the BHI broth. The bacterial 
inoculum is in direct contact with the tested materials 
present in the root end cavities and all the three tested 
materials have been shown to possess some antibacterial 
effect.
[15,16]
ProRoot MTA and Biodentine have demonstrated 
good antifungal and antibacterial properties when studied 
using tube dilution methods. The antimicrobial efficacy 
may be due to the release of calcium ions and hydroxyl ions 
which results in an increase in pH.
[17]
Biodentine showed 
a higher release of free calcium ions when compared to 
ProRoot MTA due to the presence of both calcium silicate 
and calcium chloride.
[18]
Hence Biodentine has got higher 
alkalinizing capacity and improved antibacterial efficacy. 
But it was demonstrated that the elevated pH of white 
MTA was sustained for a longer period of time, as the 
material continues to cure over a period of several weeks 
(Hansen et al).
[19]
EndoSequence RRM putty and ProRoot 
MTA have demonstrated similar antimicrobial efficacy 
against clinical Isolates of E. faecalis. (Lovato et al).
[20]