Clinical outcomes of Bio-MA and ProRoot® MTA in orthograde apical barrier and root perforation repair: a preliminary phase of randomized controlled trial

Main Article Content

Nuttida Tungsuksomboon
Supachai Sutimuntanakul
Danuchit Banomyong

Abstract

Objective: To preliminarily evaluate treatment outcomes of Bio-MA, a new calcium-silicate based cement (CSC), compared with ProRoot® MTA, a commercial product, in orthograde apical barrier and root perforation repair.


Materials and Methods: Forty-seven patients were recruited at the Endodontic Clinic, Faculty of Dentistry, Mahidol University, Thailand. Non-surgical orthograde apical barrier (n=23 teeth) and root perforation repair (n=24 teeth) were performed under standard treatment protocols. Bio-MA or ProRoot® MTA, was randomly used as orthograde apical barrier and root perforation repair material. The recall period was at least 6 months or longer. Clinical outcomes based on clinical and radiographic criteria were assessed by calibrated examiners and interpreted as ‘healed’, ‘healing’ or ‘disease’. Outcomes of ‘healed’ and ‘healing’ were combined as ‘success’.


Results: Forty-one teeth, 19 teeth of orthograde apical barrier and 22 teeth of root perforation repair, were recalled with average periods of 11.3±2.8 and 12.8±3.7 months. Bio-MA and ProRoot® MTA orthograde were 77.8% and 80% ‘healed’, and 22.2% and 20% ‘healing’, respectively. Root perforation repair with Bio-MA and ProRoot® MTA were 92.3% and 100% ‘healed’. Only one tooth of Bio-MA (7.7%) was ‘healing’. The overall results showed 100% success (‘healed’ and ‘healing’), and no ‘disease’ case was observed. No significant difference in clinical outcomes between Bio-MA and ProRoot® MTA was observed, when used as orthograde apical barrier and root perforation repair materials (p≥.05).


Conclusion(s):There were no significant difference in treatment outcomes of orthograde apical barrier androot perforation repair between Bio-MA and ProRoot® MTA. Clinical outcomes of Bio-MA and ProRoot® MTA were each a 100% success.

Article Details

How to Cite
1.
Tungsuksomboon N, Sutimuntanakul S, Banomyong D. Clinical outcomes of Bio-MA and ProRoot® MTA in orthograde apical barrier and root perforation repair: a preliminary phase of randomized controlled trial. M Dent J [Internet]. 2021 Apr. 26 [cited 2024 May 5];41(1):19-34. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/242693
Section
Original articles

References

Kim YJ, Chandler NP. Determination of working length for teeth with wide or immature apices: a review. Int Endod J 2013; 46: 483-91.

Martin T. Treatment of immature teeth with non-vital pulps and apical periodontitis. Endod Topics 2006; 14: 51-59.

Fuss Z, Trope M. Root perforations: Classification and treatment choices based on prognostic factors. Endod Dent Traumatol 1996; 12: 255-64.

Mahmoud Torabinejad JDJ. Principles and practice of endodontics. 5th ed. Philadelphia: W.B. Saunders Company; 2015; 338-54.

Allam CR. Treatment of stripping perforations. J Endod 1996; 22: 699-702.

Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: The Toronto study. Phases I and II: Orthograde retreatment. J Endod 2004; 30: 627-33.

Torabinejad M, Parirokh M. Mineral trioxide aggregate: A comprehensive literature review — Part II: Leakage and biocompatibility investigations. J Endod 2010; 36: 190-202.

Mente J, Leo M, Panagidis D, Ohle M, Schneider S, Lorenzo Bermejo J, et al. Treatment outcome of mineral trioxide aggregate in open apex teeth. J Endod 2013; 39: 20-26.

Mente J, Leo M, Panagidis D, Saure D, Pfefferle T. Treatment outcome of mineral trioxide aggregate: Repair of root perforations-long-term results. J Endod 2014; 40: 790-96.

Siew K, Lee AH, Cheung GS. Treatment outcome of repaired root perforation: A systematic review and meta-analysis. J Endod 2015; 41: 1795-804.

Witherspoon DE, Small JC, Regan JD, Nunn M. Retrospective analysis of open apex teeth obturated with mineral trioxide aggregate. J Endod 2008; 34: 1171-76.

Gorni FG, Andreano A, Ambrogi F, Brambilla E, Gagliani M. Patient and clinical characteristics associated with primary healing of iatrogenic perforations after root canal treatment: Results of a long-term Italian study. J Endod 2016; 42: 211-15.

Chala S, Abouqal R, Rida S. Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: Systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: e36-42.

Lin JC, Lu JX, Zeng Q, Zhao W, Li WQ, Ling JQ. Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. J Formos Med Assoc 2016; 115: 523-30.

de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, et al. Treatment outcome in endodontics: The Toronto study — Phases 3 and 4: Orthograde retreatment. J Endod 2008; 34: 131-37.

Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: Part 1: Periapical health. Int Endod J 2011; 44: 583-609.

Kratchman SI. Perforation repair and one-step apexification procedures. Dent Clin North Am 2004; 48: 291-307.

Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview — Part I: Vital pulp therapy. Int Endod J 2018; 51: 177-205.

Settawacharawanich S, Sutimuntanakul S, Phuvaravan S, Plang-ngern S. The chemical compositions and physicochemical properties of a Thai white Portland cement [M.Sc. Project Report]. Mahidol University; 2006.

Kogan P, He J, Glickman GN, Watanabe I. The effects of various additives on setting properties of MTA. J Endod 2006; 32: 569-72.

Bortoluzzi EA, Broon NJ, Bramante CM, Felippe WT, Tanomaru Filho M, Esberard RM. The influence of calcium chloride on the setting time, solubility, disintegration, and pH of mineral trioxide aggregate and white Portland cement with a radiopacifier. J Endod 2009; 35: 550-54.

Warotamawichaya S, Sutimuntanakul S. Effect of calcium chloride on setting time of Thai white Portland cement [Postgraduated Project Report]. Mahidol University; 2011.

Kulan P, Karabiyik O, Kose GT, Kargul B. Biocompatibility of Accelerated Mineral Trioxide Aggregate on Stem Cells Derived from Human Dental Pulp. J Endod 2016; 42: 276-79.

Pisalchaiyong N, Sutimuntanakul S, Korsuwannawong S, Vajrabhaya L. Evaluating cytotoxicity of Thai white Portland cement in cell culture using MTT assay. Mahidol Dent J 2010; 30: 17-25.

Chaimanakarn C, Sutimuntanakul S, Jantarat J. Subcutaneous tissue response to calcium silicate-based cement [M.Sc. Project Report]. Mahidol University; 2014.

Trongkij P, Sutimuntanakul S, Lapthanasupkul P, Chaimanakarn C, Wong R, Banomyong D. Effects of the exposure site on histological pulpal responses after direct capping with 2 calcium-silicate based cements in a rat model. Restor Dent Endod 2018; 43: e36.

Piaggio G, Elbourne DR, Pocock SJ, Evans SJ, Altman DG. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA 2012; 308: 2594-604.

Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340: c332.

Nagendrababu V, Duncan HF, Bjørndal L, Kvist T, Priya E, Jayaraman J, et al. PRIRATE 2020 guidelines for reporting randomized trials in Endodontics: Explanation and elaboration. Int Endod J 2020; 53: 774-803.

Moorrees CF, Fanning EA, Hunt EE, Jr. Age variation of formation stages for ten permanent teeth. J Dent Res 1963; 42: 1490-502.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74.

Shimon F. Prognosis of initial endodontic therapy. Endod Topics 2002; 2: 59-88.

Berman LH, Kuttler S. Fracture necrosis: Diagnosis, prognosis assessment, and treatment recommendations. J Endod 2010; 36: 442-46.

Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997; 30: 297-306.

Matt GD, Thorpe JR, Strother JM, McClanahan SB. Comparative study of white and gray mineral trioxide aggregate (MTA) simulating a one- or two-step apical barrier technique. J Endod 2004; 30: 876-79.

Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod 1995; 21: 349-53.

Frank AL. Therapy for the divergent pulpless tooth by continued apical formation. J Am Dent Assoc 1966; 72: 87-93.

Orstavik D. Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 1996; 29: 150-55.

Igor T, Zvi F. Diagnosis and treatment of accidental root perforations. Endod Topics 2006; 13: 95-107.

Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995; 28: 12-18.