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

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. 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. 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). Based on these results it appears that restoration materials may not adequately seal obliterate entire remaining canal.