Healing after Root-end Sealing using 4-META/MMA-TBB Resin following Apicoectomy

Objectives: 4-META/MMA-TBB resin (Super-Bond C&B®) has many advantages, such as high adhesive ability to dentin and cementum, and high biocompatibility to periodontal tissue, which make it an effective root-end sealing material. In this study, we evaluated the apical periodontal healing after root-end sealing using Super Bond C&B®, and root-end filling using reinforced zinc oxide eugenol cement (SuperEBA®), and mineral trioxide aggregate (ProRoot ®MTA), when there was remaining root canal infection.

Methods: Sixty-eight mandibular premolar roots of 5 beagles were used. The pulp was removed, and apical periodontitis was induced by contaminating root canals with dental plaque. After 1 month, there was no significant difference in the area of periradicular radiolucency among the 4 groups. After reflecting the mucoperiosteal flap, root ends were resected and inflammatory tissue was removed. In the SB group (n=17), the root-end surface was made slightly concave with a round bur. Subsequently, Super-Bond C&B was applied to the root-end surface, and the flap was sutured back. In the EBA (n=18) and MTA (n=19) groups, a 3-mm deep root-end cavity was prepared with an ultrasonic tip and filled with SuperEBA and ProRoot MTA, respectively. In the control group (n=14), the root-end surface was not prepared. Fourteen weeks after surgery, the resorbed area of alveolar bone was measured histologically.

Results: The area of bone resorption in SB, EBA, MTA, and control groups was 1.23 ± 1.06mm², 2.04 ± 1.57mm², 1.50 ± 1.70mm², and 6.45 ± 1.04mm², respectively. Bone resorption in SB, EBA and MTA groups was significantly less than that in control group (p<0.01). There were no significant differences between SB, EBA and MTA groups.

Conclusion: Root-end sealing using 4-META/MMA-TBB resin following apicoectomy and root-end filling using reinforced zinc oxide eugenol cement and mineral trioxide aggregate induced good healing of apical periodontitis, when there was remaining root canal infection.