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A Randomized Controlled Study of Mineral Trioxide Aggregate and Super Ethoxybenzoic Acid as Root-end Filling Materials in Endodontic Microsurgery: Long-term Outcomes

      Abstract

      Introduction

      The purpose of the present study was to evaluate the long-term clinical outcome of endodontic microsurgery when mineral trioxide aggregate (MTA) and super ethoxybenzoic acid (Super EBA; Harry J. Bosworth, Skokie, IL) were used as root-end filling materials. Additionally, this study aimed to compare the clinical outcome of endodontic microsurgery at the 1-year follow-up with that at the 4-year follow-up.

      Methods

      Two hundred sixty teeth were randomly assigned to either the MTA or Super EBA group in equal numbers using the minimization method. Endodontic microsurgery was performed according to the Yonsei protocol. The previous study of 192 teeth examined at the 1-year follow-up revealed a success rate of 95.6% for MTA and 93.1% for Super EBA. Patients were recalled 4 years after surgery, and treated teeth were classified as successes or failures with Molven's criteria. The Pearson chi-square test and the McNemar test were conducted to analyze and compare the success rates.

      Results

      A total of 182 teeth were examined at the 4-year follow-up. The success rate was 91.6% for MTA and 89.9% for Super EBA. Statistical analysis of the success rate did not show any significant difference between the 2 materials (P = .8). The overall success rate at the 4-year follow-up was 89.5%, which was slightly lower compared with 94.3% at the 1-year follow-up. However, there was no significant difference between the follow-up periods (P = .063).

      Conclusions

      This study identified no significant difference in the 4-year success rates of MTA and Super EBA as root-end filling materials in endodontic microsurgery. Additionally, compared with short-term outcomes, long-term follow-up outcomes were not significantly different.

      Key Words

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      References

        • Ng Y.L.
        • Mann V.
        • Rahbaran S.
        • et al.
        Outcome of primary root canal treatment: systematic review of the literature—part 1. Effects of study characteristics on probability of success.
        Int Endod J. 2007; 40: 921-939
        • Frank A.L.
        • Glick D.H.
        • Patterson S.S.
        • Weine F.S.
        Long-term evaluation of surgically placed amalgam fillings.
        J Endod. 1992; 18: 391-398
        • Molven O.
        • Halse A.
        • Grung B.
        Surgical management of endodontic failures: indications and treatment results.
        Int Dent J. 1991; 41: 33-42
        • Setzer F.C.
        • Shah S.B.
        • Kohli M.R.
        • et al.
        Outcome of endodontic surgery: a meta-analysis of the literature—part 1: comparison of traditional root-end surgery and endodontic microsurgery.
        J Endod. 2010; 36: 1757-1765
        • Tsesis I.
        • Rosen E.
        • Taschieri S.
        • et al.
        Outcomes of surgical endodontic treatment performed by a modern technique: an updated meta-analysis of the literature.
        J Endod. 2013; 39: 332-339
        • Tang Y.
        • Li X.
        • Yin S.
        Outcomes of MTA as root-end filling in endodontic surgery: a systematic review.
        Quintessence Int. 2010; 41: 557-566
        • Torabinejad M.
        • Rastegar A.F.
        • Kettering J.D.
        • Pitt Ford T.R.
        Bacterial leakage of mineral trioxide aggregate as a root-end filling material.
        J Endod. 1995; 21: 109-112
        • Samara A.
        • Sarri Y.
        • Stravopodis D.
        • et al.
        A comparative study of the effects of three root-end filling materials on proliferation and adherence of human periodontal ligament fibroblasts.
        J Endod. 2011; 37: 865-870
        • Song M.
        • Yoon T.S.
        • Kim S.Y.
        • Kim E.
        Cytotoxicity of newly developed pozzolan cement and other root-end filling materials on human periodontal ligament cell.
        Restor Dent Endod. 2014; 39: 39-44
        • Maltezos C.
        • Glickman G.N.
        • Ezzo P.
        • He J.
        Comparison of the sealing of Resilon, Pro Root MTA, and Super-EBA as root-end filling materials: a bacterial leakage study.
        J Endod. 2006; 32: 324-327
        • Nekoofar M.H.
        • Stone D.F.
        • Dummer P.M.
        The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate.
        Int Endod J. 2010; 43: 782-791
        • Rubinstein R.A.
        • Kim S.
        Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and super-EBA as root-end filling material.
        J Endod. 1999; 25: 43-48
        • Rubinstein R.A.
        • Kim S.
        Long-term follow-up of cases considered healed one year after apical microsurgery.
        J Endod. 2002; 28: 378-383
        • Taschieri S.
        • Del Fabbro M.
        • Testori T.
        • Weinstein R.
        Endoscopic periradicular surgery: a prospective clinical study.
        Br J Oral Maxillofac Surg. 2007; 45: 242-244
        • Chong B.S.
        • Pitt Ford T.R.
        • Hudson M.B.
        A prospective clinical study of mineral trioxide aggregate and IRM when used as root-end filling materials in endodontic surgery.
        Int Endod J. 2003; 36: 520-526
        • Song M.
        • Kim E.
        A prospective randomized controlled study of mineral trioxide aggregate and super ethoxy-benzoic acid as root-end filling materials in endodontic microsurgery.
        J Endod. 2012; 38: 875-879
        • von Arx T.
        • Jensen S.S.
        • Hanni S.
        • Friedman S.
        Five-year longitudinal assessment of the prognosis of apical microsurgery.
        J Endod. 2012; 38: 570-579
        • Song M.
        • Nam T.
        • Shin S.J.
        • Kim E.
        Comparison of clinical outcomes of endodontic microsurgery: 1 year versus long-term follow-up.
        J Endod. 2014; 40: 490-494
        • Walters S.J.
        Sample size and power estimation for studies with health related quality of life outcomes: a comparison of four methods using the SF-36.
        Health Qual Life Outcomes. 2004; 2: 26
        • Testori T.
        • Capelli M.
        • Milani S.
        • Weinstein R.L.
        Success and failure in periradicular surgery: a longitudinal retrospective analysis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 87: 493-498
        • Kim E.
        • Song J.S.
        • Jung I.Y.
        • et al.
        Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin.
        J Endod. 2008; 34: 546-551
        • Pocock S.J.
        Clinical Trials: A Practical Approach.
        Wiley, Chichester, UK1983
        • Song M.
        • Jung I.Y.
        • Lee S.J.
        • et al.
        Prognostic factors for clinical outcomes in endodontic microsurgery: a retrospective study.
        J Endod. 2011; 37: 927-933
        • Molven O.
        • Halse A.
        • Grung B.
        Observer strategy and the radiographic classification of healing after endodontic surgery.
        Int J Oral Maxillofac Surg. 1987; 16: 432-439
        • Akl E.A.
        • Briel M.
        • You J.J.
        • et al.
        Potential impact on estimated treatment effects of information lost to follow-up in randomised controlled trials (LOST-IT): systematic review.
        BMJ. 2012; 344: e2809
        • von Arx T.
        • Hanni S.
        • Jensen S.S.
        5-year results comparing mineral trioxide aggregate and adhesive resin composite for root-end sealing in apical surgery.
        J Endod. 2014; 40: 1077-1081
        • Gagliani M.M.
        • Gorni F.G.
        • Strohmenger L.
        Periapical resurgery versus periapical surgery: a 5-year longitudinal comparison.
        Int Endod J. 2005; 38: 320-327
        • von Arx T.
        • Jensen S.S.
        • Hanni S.
        Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery.
        J Endod. 2007; 33: 123-128
        • Al-Sa'eed O.R.
        • Al-Hiyasat A.S.
        • Darmani H.
        The effects of six root-end filling materials and their leachable components on cell viability.
        J Endod. 2008; 34: 1410-1414
        • Ho Y.C.
        • Huang F.M.
        • Chang Y.C.
        Mechanisms of cytotoxicity of eugenol in human osteoblastic cells in vitro.
        Int Endod J. 2006; 39: 389-393
        • Maseki T.
        • Nakata K.
        • Kohsaka T.
        • et al.
        Lack of correlation between the amount of eugenol released from zinc oxide-eugenol sealer and cytotoxicity of the sealer.
        J Endod. 1991; 17: 76-79
        • Trope M.
        • Lost C.
        • Schmitz H.J.
        • Friedman S.
        Healing of apical periodontitis in dogs after apicoectomy and retrofilling with various filling materials.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 81: 221-228
        • Pizzoferrato A.
        • Ciapetti G.
        • Stea S.
        • et al.
        Cell culture methods for testing biocompatibility.
        Clin Mater. 1994; 15: 173-190
        • Rosengren A.
        • Faxius L.
        • Tanaka N.
        • et al.
        Comparison of implantation and cytotoxicity testing for initially toxic biomaterials.
        J Biomed Mater Res A. 2005; 75: 115-122
        • Molven O.
        • Halse A.
        • Grung B.
        Incomplete healing (scar tissue) after periapical surgery–radiographic findings 8 to 12 years after treatment.
        J Endod. 1996; 22: 264-268
        • Halse A.
        • Molven O.
        • Grung B.
        Follow-up after periapical surgery: the value of the one-year control.
        Endod Dent Traumatol. 1991; 7: 246-250
        • Jesslen P.
        • Zetterqvist L.
        • Heimdahl A.
        Long-term results of amalgam versus glass ionomer cement as apical sealant after apicectomy.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79: 101-103