Periapical Bone Regeneration after Endodontic Microsurgery with Three Different Root-end Filling Materials: Amalgam, SuperEBA, and Mineral Trioxide Aggregate

Abstract 

Introduction

The purpose of this study was to determine the bone regeneration potential to different root-end filling materials by evaluating the distance between the materials and newly regenerated bone after root-end surgery.

Material and Methods

Periapical lesions were induced in premolars and molars of five female beagle dogs. The teeth were treated endodontically after the development of the lesions. After 1 week, the teeth underwent root-end surgery using modern microsurgical techniques. Three different root-end filing materials were used: amalgam (Tytin; Kerr Mfg Co, Romulus, MI), SuperEBA (Bosworth, Skokie, IL), and mineral trioxide aggregates (MTA; Dentsply, York, PA). After 4 months, the dogs were sacrificed, and the jaws were prepared for histological sectioning. The distances from the root-end filling materials to the regenerated bone were determined by the evaluation of microradiographic images of the sections with imaging software (Sigma Scan/Image; Jandel Scientific Software, San Rafael, CA). The results were statistically analyzed with analysis of variance using Sigma Stat software (Jandel Scientific Software, San Rafael, CA).

Results

The mean distances from the newly regenerated bone were 0.397 ± 0.278 mm in the MTA group, 0.756 ± 0.581 mm in the SuperEBA group, and 1.290 ± 0.386 mm in the amalgam group. There was a statistically significant difference between the amalgam and MTA groups (p < 0.05). No significant differences existed for amalgam versus SuperEBA and SuperEBA versus MTA.

Conclusion

MTA showed the most favorable periapical tissue response. The distance from MTA to the regenerated bone was similar to the normal average periodontal ligament thickness in dogs.

Key Words: Amalgam, apical bone regeneration, microradiograph, mineral trioxide aggregate, root-end seal, SuperEBA