The Effect of Resection on the Sealer-Dentin Interface in Roots Obturated with Tricalcium Silicate Sealer: A Confocal Laser Scanning Microscopy and India Ink Penetration In Vitro Pilot Study
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Anatomical considerations may limit access to teeth for root-end preparation and root-end filling. Having the canal pretreated and filled with a calcium silicate based filling material, apical surgery can be limited to resection of the root end only, thus simplifying the surgical procedure. The purpose of this study was to evaluate the effect of root-end resection on roots obturated with Rhodamine B dye-laced tricalcium silicate sealer (TCS) placed orthograde and allowed to achieve final set prior to root-end resection. Following endodontic instrumentation of extracted single rooted teeth half the specimens had 3 mm of root-end resected utilizing a high-speed carbide bur. The resected specimens received an apical barrier and all specimens were obturated with TCS sealer. All specimens were stored for 10 days at 37°C in 100% humidity. After the TCS sealer final set the remaining unresected specimens had 3 mm of root-end resected utilizing a high-speed carbide bur. A Confocal Laser Scanning Microscope (CLSM) was utilized to examine the resected root ends and capture images. After examination with CLSM was complete, all specimens were placed in India ink for 48 hours. Following India ink exposure, all specimens were scored on their mesial and distal root surfaces, then split with a chisel and microscopic images were obtained. Both CLSM and India ink penetration microscopic images where examined and quantified using ImageJ software to determine the percent of cavosurface TCS sealer-dentin marginal breakdown. The mean percent cavosurface breakdown values for the resected and unresected specimens measured via CLSM were 11.53±15.59 and 4.32±8.77 percent, respectively. With the India ink evaluation, the mean percent cavosurface breakdown values were 13.87±19.68 percent for resected and 11.53±15.69 percent for unresected. Despite a trend for lower breakdown with unresected specimens, especially as measured via CLSM, with high standard deviation values, there was no statistically significant (p>0.05) difference between the resected and unresected specimens with either CLSM or India ink evaluations. However, there was a positive correlation between the integrity of the obturation material-dentin interface as evaluated using CLSM and India ink techniques.
Table of Contents
Introduction -- Materials and methods -- Results -- Discussion -- Conclusions