Surgical management of a failed internal root resorption treatment: a histological and clinical report

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Microleakage of CEM cement in two different media

Sealing ability of root-end filling materials is of great importance. It can be investigated by measuring microleakage. The purpose of this in vitro study was to evaluate microleakage of calcium enriched mixture [CEM] cement in two different media including phosphate buffer solution [PBS] and distilled water. Twenty single-rooted human teeth were selected. All teeth were root-end filled with CEM cement. Samples were divided into two groups of 10 each and were placed in PBS or distilled water. The microleakage was measured after 12 and 24 h, 14 and 30 days with Fluid Filtration device. Data were statistically analyzed by repeated measures test. Sealing ability of CEM cement was significantly superior in PBS compared to distilled water [P<0.05]. This study also showed that time had no significant effect on the sealing ability of CEM cement. Media can significantly affect the microleakage of CEM cement. PBS can provide more phosphorous ions for hydroxyapatite formation of CEM cement; therefore, CEM cement can seal more effectively with PBS

Particle size of a new endodontic cement compared to root MTA and calcium hydroxide

Particle size and distribution can influence the properties of materials. This study analyzed and compared the particle size of Root MTA, calcium hydroxide [CH], and a new endodontic cement called calcium enriched material [CEM]. The particle size of each material was analyzed three times using 0.05 mg of test material with a particle size analyzer. The particle size distribution ranges, the cumulative percentage and the mean of particle sizes were calculated. One-way ANOVA, Tukey, and Chi-square tests were used for statistical analyses. Results demonstrated that the distribution of particles was dissimilar. Particle mean size in the three different materials was not significantly different. However, the cumulative percentage of CH and CEM cement particles size demonstrated significant difference [P<0.05]. Among the various particle size distributions, the particle distribution in the size range of