presented by mohamed sami - cairo university · presented by mohamed sami. acknowledgement dr....

Physical and Biological Properties of

Three Root Repair MaterialsThree Root Repair Materials

(A Comparative Study)

Presented By

Mohamed Sami

Acknowledgement

� Dr. Ihab Hassanein, I am honored and pleased to have had the chance to work under your supervision and

learn from your valuable experience.

� Dr. Abeer Mahmoud, for your remarkable supervision, Dr. Abeer Mahmoud, for your remarkable supervision, sincere encouragement, kind guidance, valuable

criticism and enlightening suggestions.

� Dr. Ashraf Abou Sea’da, I am highly indebted to your knowledge, expertise and continuous encouragement.

IntroductionIntroduction

Introduction

� Root Perforation is an undesirable incident that can

occur at any stage of root canal therapy.

� Perforations were the second greatest cause of failure � Perforations were the second greatest cause of failure

of root canal treatments. (Hansen et al. 2011).

� Several materials reported for repair e.g. IRM, resin

cements, GI and MTA.

Introduction

� An ideal endodontic repair material should provide

adequate sealing ability, it should be non-toxic, non-

carcinogenic, biocompatible, insoluble in tissue fluids

and dimensionally stable.

� Recently bioactive materials are introduced as root

repair materials such as Biodentine which was

introduced as a dentine replacement material,

Endosequence which is a pre-mixed bio-ceramic

material and a modified type of MTA, MicroMega MTA,

which include Calcium Carbonate and Chloride

accelerator in addition to the conventional MTA

components.

Aim of the StudyAim of the Study

Aim of The Study

�Comparing between 3 materials,

Biodentine, Endosequence and

MM –MTA with respect to:MM –MTA with respect to:

� Solubility

�Sealing ability

�Biocompatibility.

Materials and Methods

A. Solubility

�

A. Solubility – Testing and

Evaluation

Sample kept in distilled water

for solubility Testing

B. Sealing ability

� Evaluated by fluid filtration method.

� Samples were caries free, complete roots and not

fracture lines.

� Caliber for furcation thickness.

Roots sectioned horizontally.

B. Sealing ability

Sample taken out after setting of rubber mold

B. Sealing ability

Artificial perforation made in furcation area

B. Sealing ability

Root end sealed with composite and apicalview of the artificial furcation perforationafter removal from rubber base mold

B. Sealing ability

B. Sealing ability

Tooth in rubber mold with perforation repaired.

Schematic illustrating the modified hermetic cell (assembled double chamber).

B. Sealing ability

Hermetic cell assembly.

B. Sealing ability

Pressure Tank with Gauge

B. Sealing ability – Fluid

Filtration Device

Pressure Reservoir


Filtration Device

T- Junction


Filtration Device

Plastic Syringe Connected to T-Junction


Filtration Device

B. Sealing ability – Testing

and Evaluation

� Evaluation within same group at different intervals of

time.

� Evaluation among different groups at specific intervals � Evaluation among different groups at specific intervals

of time.

� Evaluation among groups regardless of time.

C. Biocompatibility

� Biocompatibility was evaluated when the materials were used in furcation perforation repair of dogs premolars.

� Inflammatory cell count

� After 1 month evaluation period� After 1 month evaluation period

� After 3 month evaluation periods

� 8 premolars were used in each dog

� 2 MM-MTA

� 2 Biodentine

� 2 Endosequence

� 2 as controls.

Subgroup A

(Biodentine)

Subgroup B

(Endosequence)

Subgroup C

(MTA)

Subgroup D

(control)

Total

Group I

8 8 8 8 32

C. Biocompatibility – Sample

Classification

(1 month)

8 8 8 8 32

Group II

(3 months)

8 8 8 8 32

Total 16 16 16 16 64

� Histologic evaluation carried out using image analysis

software.

� The inflammatory cell count calculated represents the

C. Biocompatibility – Testing

and Evaluation

� The inflammatory cell count calculated represents the

number of chronic inflammatory cells in the microscopic

field

� The inflammatory response was determined using 4

steps:

� Step 1: A photomicrograph was captured to show the H&E

stained section (40x)


and Evaluation

� Step 2: The image was converted into 8-bit monochrome

type

� Step 3: Image analysis was performed based on the color

code threshold to give the inflammatory cell count

� Step 4: Inflammatory cell counted was then calculated

after removal of undesired areas


and Evaluation (Step 1)

� A captured photomicrograph showing the H&E stained

section (40X).

� The image converted to 8-bit monochrome

type.



� Image Analysis was Performed based on the color code

threshold to give the inflammatory cell count.



� The inflammatory cell count was then calculated after removal of

undesired areas.



Results

A. Solubility – Effect of

Material

� After 1 week

All lost weight. MM-MTA > Endosequence> Biodentine and different was significant.

� After 2 months

Biodentine increased in weight.

� MM-MTA showed highest mean of weight loss followed byEndosequence.

� The difference between the 3 groups was significant.

A. Solubility – Effect of Time

� Biodentine showed the highest mean of weight

loss after 1 week. weight gain after 2 months.

Difference was significant.

� Endosequence weight loss after 1 week > 2

months and was significant.

� MM-MTA weight loss after 1 week > 2 months and

difference was significant.

B. Sealing ability

� Material had no significant effect on sealing ability.

� Time had no significant effect on sealing ability.

� There was no significant difference among groups

regardless of time or material.

C. Biocompatibility – Effect of

Material

Inflammatory cell count after 1 month

Biodentine> control= Endosequence> MM-MTA and


Inflammatory cell count after 3 months

Biodentine > control > MM-MTA > Endosequence and



Time

Biodentine

Count after 3 month > 1 months and was significant.

ControlControl

Count after 1 month > 3 months and was insignificant.

Endosequence

Count after 1 month > 3 months and difference was significant.

MM-MTA

Count after 3 months>1 month difference was insignificant.

Inflammatory cell count

After 1 Month After 3 Months


Time/Biodentine



Time/Control Group

Inflammatory Cell Count




Time/Endosequence




Time/MM-MTA

ConclusionConclusion

Conclusion

� Endosequence was the most biocompatible root repair

material with the least inflammatory cell count

� Endosequence, Biodentine and MTA all presented � Endosequence, Biodentine and MTA all presented

acceptable sealing ability

� Biodentine is the least soluble root repair material.

Thank you Thank you

presented by mohamed sami - cairo university · presented by mohamed sami. acknowledgement dr....

Documents