Apical Sealing Ability of Mineral Trioxide Aggregate, Intermediate Restorative Material and Calcium Enriched Mixture Cement: A Bacterial Leakage Study

Introduction: This in vitro study compared the apical sealing ability of three common root end filling materials namely mineral trioxide aggregate (MTA), intermediate restorative material (IRM) and calcium-enriched mixture (CEM) cement using a bacterial leakage model. Methods and Materials: The study was conducted on 83 single-rooted human teeth. Tooth crowns were cut and root canals were prepared using the step-back technique. Apical 3 mm of the roots were cut and a three-mm-deep cavity was prepared using an ultrasonic instrument. The samples were divided into three groups (n=25) according to the root-end filling material including MTA, IRM and CEM cement. The roots were inserted into cut-end microtubes. After sterilization with ethylene oxide, microtubes were placed in sterile vials containing 10 mL of Brain Heart Infusion (BHI) broth and incubated at 37°C and 0.1 mL of Enterococcus faecalis suspension compatible with 0.5 McFarland standard (1.5×108 cell/ ml), which was refreshed daily. This procedure was continued for 70 days. The data were analyzed using the chi-square, Kruskal-Wallis and log rank tests. The level of significance was set at 0.05. Results: No significant difference was found in bacterial microleakage among three groups; MTA showed slightly (but not significantly) less microleakage than IRM and CEM. However, the difference in the mean time of microleakage was significant among the groups (P<0.04) and in MTA samples leakage occurred in a longer time than CEM (P<0.012). Conclusion: The three tested root end filling materials had equal sealing efficacy for preventing bacterial leakage.