Apical Sealing Ability of Mineral Trioxide Aggregate, Intermediate Restorative Material and Calcium Enriched Mixture Cement: A Bacterial Leakage Study

INTRODUCTION This in vitro study compared the apical sealing ability of three common root end filling materials namely mineral trioxide aggregate (MTA), intermediate restorative material (IRM) and calcium-enriched mixture (CEM) cement using a bacterial leakage model. METHODS AND MATERIALS The study was conducted on 83 single-rooted human teeth. Tooth crowns were cut and root canals were prepared using the step-back technique. Apical 3 mm of the roots were cut and a three-mm-deep cavity was prepared using an ultrasonic instrument. The samples were divided into three groups (n=25) according to the root-end filling material including MTA, IRM and CEM cement. The roots were inserted into cut-end microtubes. After sterilization with ethylene oxide, microtubes were placed in sterile vials containing 10 mL of Brain Heart Infusion (BHI) broth and incubated at 37°C and 0.1 mL of Enterococcus faecalis suspension compatible with 0.5 McFarland standard (1.5×108 cell/ ml), which was refreshed daily. This procedure was continued for 70 days. The data were analyzed using the chi-square, Kruskal-Wallis and log rank tests. The level of significance was set at 0.05. RESULTS No significant difference was found in bacterial microleakage among three groups; MTA showed slightly (but not significantly) less microleakage than IRM and CEM. However, the difference in the mean time of microleakage was significant among the groups (P<0.04) and in MTA samples leakage occurred in a longer time than CEM (P<0.012). CONCLUSION The three tested root end filling materials had equal sealing efficacy for preventing bacterial leakage.