Comparative evaluation of intracanal medicaments on sealing ability of MTA and Hydroxyapatite apical plug in simulated immature teeth - An in vitro study.

BACKGROUND

Immature teeth must be managed by apexification as there is no definite apical stop. Use of intracanal medicaments prior to apexification affect the sealing ability of apical plug. Present study was done to compare the effect of various intracanal medicaments: Metapex, Chlorhexidine digluconate, Curcuma longa, and Triple antibiotic paste (TAP) on the sealing ability of MTA and Hydroxyapatite as an apical plug.

METHODOLOGY: 130 single-rooted teeth were divided into two experimental groups (n=60 each) [Group I: MTA; Group II: Hydroxyapatite], and two control groups (n=5 each) [Group IIIA: MTA; Group IIIB: Hydroxyapatite] based on the apical plug used. Experimental groups were subdivided, based on intracanal medicaments [Group IA and IIA - Metapex; Group IB and IIB - 2% Chlorhexidine digluconate, Group IC and IIC - Curcuma longa, Group ID and IID - TAP]. After biomechanical preparation, simulation of immature apex was done using peeso-reamer. Intracanal medicaments were placed, and study samples were incubated for 7 days. Then all medicaments were removed using H-files, followed by retrograde apical placement, obturation, and restoration. Samples were subjected to dye penetration test, followed by clearing procedure. Apical microleakage was assessed using stereomicroscope at 40X. Data collected was subjected to statistical analysis using SPSS version 20.0 (p=0.05).

RESULTS

Apical dye penetration was minimum in control group, followed by Group IB (0.17±.46) < IIB (0.53±.57) < IIC (0.90±.96) < IID (0.93±.59) < IC (1.83±.83) < ID (1.91±.81) < IIA (2.13±.81) < IA (2.31±.73).Intragroup comparison for apical microleakage was statistically significant (p<0.001), whereas intergroup comparisons were statistically significant except for group IA v/s IIA, IB v/s IIB, IC v/s IIA, ID v/s IIA.

CONCLUSION

Hydroxyapatite showed better sealing ability than MTA with all intracanal medicaments. Sealing ability was minimal with Metapex, followed by Turmeric, TAP, and 2% Chlorhexidine.