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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
B. Sealing ability – Fluid
Filtration Device
T- Junction
B. Sealing ability – Fluid
Filtration Device
Plastic Syringe Connected to T-Junction
B. Sealing ability – Fluid
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)
C. Biocompatibility – Testing
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
C. Biocompatibility – Testing
and Evaluation (Step 1)
� A captured photomicrograph showing the H&E stained
section (40X).
� The image converted to 8-bit monochrome
type.
C. Biocompatibility – Testing
and Evaluation (Step 2)
� Image Analysis was Performed based on the color code
threshold to give the inflammatory cell count.
C. Biocompatibility – Testing
and Evaluation (Step 3)
� The inflammatory cell count was then calculated after removal of
undesired areas.
C. Biocompatibility – Testing
and Evaluation (Step 4)
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
difference was significant.
Inflammatory cell count after 3 months
Biodentine > control > MM-MTA > Endosequence and
difference was significant.
C. Biocompatibility – Effect of
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
C. Biocompatibility – Effect of
Time/Biodentine
After 1 Month After 3 Months
C. Biocompatibility – Effect of
Time/Control Group
Inflammatory Cell Count
Inflammatory Cell Count
After 1 Month After 3 Months
C. Biocompatibility – Effect of
Time/Endosequence
Inflammatory Cell Count
After 1 Month After 3 Months
C. Biocompatibility – Effect of
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