Long-term Healing of Experimental Apical Periodontitis after Apicoectomy Using Different Sealing Methods on Resected Root End

Abstract

This study evaluated the apical periodontal healing after root-end sealing using Super-Bond C & B®, and root-end filling using Super-EBA™ or ProRoot®MTA, when root canal infection persisted. Apical periodontitis was induced by contaminating root canals with dental plaque in mandibular premolars of 4 beagles. After 1 month, in the SB group (n=15), Super-Bond C & B® was applied to the resected surface following apicoectomy. In the EBA (n=14) and MTA (n=14) groups, a root-end cavity was prepared and filled with Super-EBA™ and ProRoot®MTA. In the control group (n=10), the root-end surface was not filled. The observations of periradicular radiolucency, the histological observation and histometrical analyses were performed at 48 weeks after surgery. The results were as follows. The areas of periradicular radiolucency and histological bone defect areas in the SB, EBA and MTA groups were significantly less than those in the control group. There were no significant differences between the SB, EBA and MTA groups. The percentage of new cementum on the apical dentin surface in the EBA and MTA groups was significantly more than that in the SB and control groups. There were no significant differences between the EBA and MTA groups. The percentage of exposed dentin that was not covered with Super-Bond C & B® or new cementum in the SB group was significantly less than that in the EBA, MTA and control groups. The EBA and MTA groups showed a significantly lower percentage than the control group. The percentage of resorbed dentin in the SB, EBA, and MTA groups was significantly less than that in the control group. There was a significant correlation between the percentage of exposed dentin and the percentage of resorbed dentin in the SB, EBA, and MTA groups. It was suggested that sealing of the resected dentin surface is important for long-term healing. It might be difficult for the new cementum to seal the resected root end surface completely following apicoectomy, and root-end sealing using Super-Bond C & B® has better potential when root canal infection remains.