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VOLUME 25 , ISSUE 12 ( December, 2024 ) > List of Articles

REVIEW ARTICLE

Assessment of Treatment Outcomes with Complete Orthograde Obturation with Bioceramic Materials: A Scoping Review

Murali H Rao, Rajkumar Krishnan, Mamatha Kumaraswamy, Aditya Keshav, Pavithra Gopal, Elizabeth Thomas

Keywords : Bioceramic materials, Biodentine, Mineral trioxide aggregate, Obturation, Treatment outcome

Citation Information : Rao MH, Krishnan R, Kumaraswamy M, Keshav A, Gopal P, Thomas E. Assessment of Treatment Outcomes with Complete Orthograde Obturation with Bioceramic Materials: A Scoping Review. J Contemp Dent Pract 2024; 25 (12):1190-1197.

DOI: 10.5005/jp-journals-10024-3764

License: CC BY-NC 4.0

Published Online: 05-03-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: Bioceramic sealers are being used as obturation materials as they are known for hard tissue induction and facilitating periapical healing. Based on some in vitro studies, one can hypothesize that mineral trioxide aggregate (MTA) and biodentine used as the sole obturating material could reinforce the tooth and provide a better sealability than an MTA/biodentine apical plug with gutta-percha obturation. However, there are not many high-quality studies regarding outcomes of complete MTA/biodentine obturations compared with traditional obturation methods. The aim of this review is to organize findings of clinical outcomes and the quality of complete obturation of root canals from various in vitro studies and to identify the gaps in research done in this area. Methods: The preferred reporting items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews guidelines were followed to conduct a thorough literature search in June 2024 across PubMed, Google Scholar, Scopus, Science Direct, and Scielo. The research question was formulated using PICO: population: permanent dentition in adults or children; intervention: orthograde monoblock obturation; comparator: traditional orthograde root canal filling methods; outcome: success defined by asymptomatic, functional tooth, and radiographic evidence of healing. Results: Out of 511 initially identified studies, 474 studies did not meet initial eligibility criteria for inclusion, and only 37 studies were selected. After full-text scrutiny, only 23 were subjected to qualitative assessment. Conclusion: The findings of the data concluded that complete obturation with MTA and biodentine could be a viable alternative to an apical plug followed by gutta-percha obturation or bioceramic sealer with gutta-percha obturation. The lack of randomized controlled trials and long-term retrospective studies precludes clinicians from utilizing this technique. Clinical significance: Bioceramic materials can be used for complete obturation of canals, both in primary and retreatment cases, bringing about periapical healing and regeneration of tissues. They are found to reinforce and improve the strength of radicular structure on account of the monoblock effect.

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  1. Haapasalo M, Parhar M, Huang X, et al. Clinical use of bioceramic materials. Endod Top 2015;32(1):97–117. DOI: 10.1111/etp.12078.
  2. Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review—Part I: Chemical, physical, and antibacterial properties. J Endod 2010;36(1):16–27. DOI: 10.1016/j.joen.2009.09.006.
  3. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999;25(3):197–205. DOI: 10.1016/S0099-2399(99)80142-3.
  4. Ørstavik D. Materials used for root canal obturation: Technical, biological and clinical testing. Endod Top 2005;12(1):25–38. DOI: 10.1111/j.1601-1546.2005.00197.x.
  5. Trope M, Bunes A, Debelian G. Root filling materials and techniques: Bioceramics a new hope? Endod Top 2015;32(1):86–96. DOI: 10.1111/etp.12074.
  6. Tay FR, Pashley DH. Monoblocks in root canals: A hypothetical or a tangible goal. J Endod 2007;33(4):391–398. DOI: 10.1016/j.joen.2006.10.009.
  7. Bogen G, Kuttler S. Mineral trioxide aggregate obturation: A review and case series. J Endod 2009;35(6):777–790. DOI: 10.1016/j.joen.2009.03.006.
  8. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018;169(7):467–473. DOI: 10.7326/M18-0850.
  9. Srinivasan S, Vengidesh R, Ramachandran A, et al. An immature traumatic teeth management with apical pathology using the novel BiodentineTM obturation: A case report. Cureus 2021;13(12):e20818. DOI: 10.7759/cureus.20818.
  10. Panda S, Das A, Agnihotri Y, et al. Management of a persistent radicular cyst in the maxillary right lateral incisor: A case report. Cureus 2024;16(8):e66421. DOI: 10.7759/cureus.66421.
  11. Jaiswal S, Gupta S, Sawani S, et al. Bioactive closure of non vital immature tooth with open apices - A contemporary approach. People's Journal of Scientific Research 2014;7(2):70–74. DOI: 10.5281/zenodo.8252436.
  12. Agrawal V, Patil D. A novel approach in treating horizontally fractured canine using RIBBOND splint and MTA as an obturating material and intra-radicular splint: A case report. Indian J Dent Res 2014;25(1):95. DOI: 10.4103/0970-9290.131148.
  13. Terauchi Y, Torabinejad M, Wong K, et al. The effect of mineral trioxide aggregate obturation levels on the outcome of endodontic retreatment: An observational study. J Endod. 2023;49(6):664–674. DOI: 10.1016/j.joen.2023.04.004.
  14. Aggarwal V, Singla M. Management of inflammatory root resorption using MTA obturation – a four year follow up. Br Dent J 2010;208(7):287–289. DOI: 10.1038/sj.bdj.2010.293.
  15. Hayashi M, Shimizu A, Ebisu S. MTA for obturation of mandibular central incisors with open apices: Case report. J Endod 2004;30(2):120–122. DOI: 10.1097/00004770-200402000-00015.
  16. Alsulaimani RS. Single-visit endodontic treatment of mature teeth with chronic apical abscesses using mineral trioxide aggregate cement: A randomized clinical trial. BMC Oral Health 2016;16(1):78. DOI: 10.1186/s12903-016-0276-y.
  17. El Backly RM, Kotry GS, Moussa H. Multidisciplinary management of a fused maxillary incisor: Case report with 5-year follow-up. Clin Case Rep 2021;9(2):775–786. DOI: 10.1002/ccr3.3629.
  18. Estrela C, Holland R, Estrela CRDA, et al. Characterization of successful root canal treatment. Braz Dent J 2014;25(1):3–11. DOI: 10.1590/0103-6440201302356.
  19. Friedman S. Treatment outcome: The potential for healing and retained function. Endodontics 2008;6:1162–1232. DOI: 10.1080/19424396.2004.12223997.
  20. Smith CS, Setchell DJ, Harty FJ. Factors influencing the success of conventional root canal therapy—a five-year retrospective study. Int Endod J 1993;26(6):321–333. DOI: 10.1111/j.1365-2591.1993.tb00765.x.
  21. Ng Y-L, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: A systematic review of the literature. Int Endod J 2010;43(3):171–189. DOI: 10.1111/j.1365-2591.2009.01671.x.
  22. Ng YL, Mann V, Rahbaran S, et al. Outcome of primary root canal treatment: Systematic review of the literature – Part 2. Influence of clinical factors. Int Endod J 2008;41(1):6–31. DOI: 10.1111/j.1365-2591.2007.01323.x.
  23. Tomson RME, Polycarpou N, Tomson PL. Contemporary obturation of the root canal system. Br Dent J 2014;216(6):315–322. DOI: 10.1038/sj.bdj.2014.205.
  24. Camilleri J, Pitt Ford TR. Mineral trioxide aggregate: A review of the constituents and biological properties of the material. Int Endod J 2006;39(10):747–754. DOI: 10.1111/j.1365-2591.2006.01135.x.
  25. Karapinar-Kazandag M, Basrani B, Tom-Kun Yamagishi V, et al. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol 2016;32(2):146–152. DOI: 10.1111/edt.12230.
  26. Elnaghy AM, Elsaka SE. Fracture resistance of simulated immature teeth filled with Biodentine and white mineral trioxide aggregate – An in vitro study. Dent Traumatol 2016;32(2):116–120. DOI: 10.1111/edt.12224.
  27. Girish K, Mandava J, Chandra Rr, et al. Effect of obturating materials on fracture resistance of simulated immature teeth. J Conserv Dent 2017;20(2):115. DOI: 10.4103/0972-0707.212238.
  28. Küçükkaya Eren S, Aksel H, Askerbeyli Örs S, et al. Obturation quality of calcium silicate-based cements placed with different techniques in teeth with perforating internal root resorption: A micro-computed tomographic study. Clin Oral Investig 2019;23(2):805–811. DOI: 10.1007/s00784-018-2502-2.
  29. Keleş A, Torabinejad M, Keskin C, et al. Micro-CT evaluation of voids using two root filling techniques in the placement of MTA in mesial root canals of Vertucci type II configuration. Clin Oral Investig 2018;22(5):1907–1913. DOI: 10.1007/s00784-017-2282-0.
  30. Al-Rayesse R, Al-Jabban O, Eid A, et al. Influence of bioceramic cements on the quality of obturation of the immature tooth: An in vitro microscopic and tomographic study. Bioengineering 2024;11(3):213. DOI: 10.3390/bioengineering11030213.
  31. Hendra E, Dwisaptarini AP, Iskandar BO, et al. The effects of apical diameter and obturation material on apical leakage. In Yogyakarta, Indonesia; 2024. pp. 020006. DOI 10.1063/5.0216100.
  32. Yoo JS, Chang SW, Oh SR, et al. Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: A scanning electron microscopy study. Int J Oral Sci 2014;6(4):227–232. DOI: 10.1038/ijos.2014.30.
  33. AL-Haddad A, Che Ab Aziz ZA. Bioceramic-based root canal sealers: A review. Int J Biomater 2016;2016:1–10. DOI: 10.1155/2016/9753210.
  34. Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review—Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 2010;36(3):400–413. DOI: 10.1016/j.joen.2009.09.009.
  35. Witherspoon DE, Small JC, Regan JD, et al. Retrospective analysis of open apex teeth obturated with mineral trioxide aggregate. J Endod 2008;34(10):1171–1176. DOI: 10.1016/j.joen.2008.07.005.
  36. AlJasser R, Bukhary S, AlSarhan M, et al. Regenerative therapy modality for treatment of true combined endodontic-periodontal lesions: A randomized controlled clinical trial. Int J Environment Res Public Health 2021;18(12):6220. DOI: 10.3390/ijerph18126220.
  37. Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg 2011;128(1):305–310. DOI: 10.1097/PRS.0b013e318219c171.
  38. Chang SW, Oh TS, Lee W, et al. Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion: A case series. Int J Oral Sci 2013;5(1):54–57. DOI: 10.1038/ijos.2013.16.
  39. Karp J, Bryk J, Menke E, et al. The complete endodontic obturation of an avulsed immature permanent incisor with mineral trioxide aggregate: A case report. Pediatr Dent 2006;28(3):273-278. PMID: 16805362.
  40. Parolia A, Yu A, Feghali M. Management of teeth with open apex and apical periodontitis using MTA and OrthoMTA: A case series and review. G Ital Endodonzia 2022;36(1). DOI: 10.32067/GIE.2021.35.02.43.
  41. Raldi DP. Treatment options for teeth with open apices and apical periodontitis. 2009;75(8):591–596. PMID: 19840502.
  42. Kamatchi M, Thiyagarajan G, Manoharan M, et al. Biodentine as BioRoot inlay: A case report. Int J Clin Pediatr Dent 2023;16(2):400–404. DOI: 10.5005/jp-journals-10005-2580.
  43. Adiga S, Ataide I, Fernandes M, et al. Nonsurgical approach for strip perforation repair using mineral trioxide aggregate. J Conserv Dent 2010;13(2):97. DOI: 10.4103/0972-0707.66721.
  44. Nikhil V, Arora V, Jha P, et al. Non surgical management of trauma induced external root resorption at two different sites in a single tooth with Biodentine: A case report. Endodontology 2012;24(2):150. DOI: 10.4103/0970-7212.352085.
  45. Al-Kahtani A. Avulsed immature permanent central incisors obturated with mineral trioxide aggregate: A case report. J Int Oral Health 2013;5(3):88–96. PMID: 24155609.
  46. Teja KV, Ramesh S. Nonsurgical management of strip perforation using platelet-rich fibrin and MTA by matrix concept – A case report with one year follow-up. Contemp Clin Dent 2021;12(1):84–87. DOI: 10.4103/ccd.ccd_392_20.
  47. Sonali K, Suresh AV, Abhishek P, et al. Altered apical morphology (Reverse Architecture): Use of indirect ultrasonic technique for orthograde MTA placement in maxillary premolars. Case Rep Dent 2016;2016:1–5. DOI: 10.1155/2016/1046405.
  48. Subay RK, Subay MO, Tuzcu SB. Endodontic management of root perforating internal replacement resorption. Eur J Dent 2018;12(03):450–453. DOI: 10.4103/ejd.ejd_31_17.
  49. Sinha Y, Tilokani A, Pradhan PK, et al. Advanced management of open apex utilizing platelet-rich fibrin and bone graft as apical barriers with mineral trioxide aggregate (MTA) obturation: A detailed case report. Cureus 2024;16(5):e60883. DOI: 10.7759/cureus.60883.
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