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

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Nuttida Tungsuksomboon
Supachai Sutimuntanakul
Danuchit Banomyong


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.


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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 2023 Dec. 5];41(1):19-34. Available from:
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