A comparative study of materials and storage modes for human teeth in apicoectomy: scanning electron microscopy analysis.

Aim: Periradicular surgery is a procedure that includes surgical exposure of the diseased apex, root-end cavity preparation, and retrofilling of the root canal. The aim of this study was to compare the outcomes of periradicular surgery in vitro using different dental materials and storage methods for human teeth specimens.
Methods: The sample comprised 60 human single-rooted teeth, divided into two groups according to mode of storage (hydrated or non-hydrated); each group was then subdivided by retrofilling material (mineral trioxide aggregate or resin-modified glass ionomer cement). Each specimen was analyzed by digital radiography and scanning electron microscopy (SEM). Quantitative assessment of the gap between the retrofilling material and dentin surface was conducted by observation of apical views (2000x magnification) of four areas of each specimen.
Results: The gap between retrofilling material and the internal dentin surface of the root was found to be significantly wider in hydrated teeth (P=0.002). Comparison of the two retrofilling materials showed that, regardless of tooth storage method, use of glass ionomer cement was associated with significantly wider gaps between the filling material and dentin surface (P=0.001). Comparisons of tooth storage mode versus retrofilling material showed a statistical interaction (P=0.009) between these factors.
Conclusion: Mineral trioxide aggregate (MTA®) provided the best apical sealing, regardless of storage medium. Resin-modified glass ionomer cement (Vitremer®) was associated with substantially larger mean gap values when used in hydrated teeth.