Differences in physical characteristics and sealing ability of three tricalcium silicate-based cements used as root-end-filling materials.

Purpose: To evaluate differences in physical characteristics and sealing ability of root-end-fillings made with these materials compared to the gold standard (ProRoot MTA).

Methods: The physical characteristics of ProRoot MTA, Medcem MTA and Biodentine were evaluated regarding setting time, flow, film thickness, solubility and radiopacity according to the German Institute for Standardization (EN-ISO 6878). To investigate their sealing ability as root-end-fillings, a glucose penetration model was used. 60 human extracted single-rooted teeth were endodontically treated, root-end resections performed and divided in three groups of 20 teeth, using either ProRoot MTA, Medcem MTA or Biodentine as root-end-filling material. After 30 days, glucose concentrations were determined photometrically, followed by statistical analysis (Kruskal-Wallis test, Mann-Whitney U-test).

Results: Biodentine showed the fastest setting time (< 12 minutes) and lowest film thickness (0.11± 0.01 mm), whereas Medcem MTA showed the best values regarding solubility (< 0.1%) and flow (9.5± 0.02 mm). ProRoot MTA revealed the highest radiopacity (7.58± 0.1 mm aluminum equivalent). The glucose leakage in the Medcem MTA group was significantly lower than in the ProRoot MTA group (P= 0.011). Biodentine showed lower leakage than ProRoot MTA (P= 0.031).

Clinical Significance: As Medcem MTA showed significantly lower leakage than the other materials tested, it may be an alternative for root-end-fillings with comparable physical characteristics to the current gold standard. With the exception of the high solubility, Biodentine performed well regarding leakage and setting time.