Comparative evaluation of the sealing ability of filling materials on root end cavities treated with smear layer removing agents: A confocal laser scanning microscopic study

Aim: This study aims to evaluate and compare the sealing ability of Biodentine™ and mineral trioxide aggregate (MTA) plus® on root end cavities treated with 17% ethylene diamine tetraacetic acid (EDTA), 0.2% Chitosan and 1% Phytic acid using Confocal Laser Scanning Microscope (CLSM)-An in vitro study. Materials and Methods: Sixty extracted single rooted teeth were instrumented and obturated with gutta-percha. The apical 3 mm of each tooth was resected and 3 mm root-end preparation was made using ultrasonic tip. 17% EDTA (n = 20), 0.2% Chitosan (n = 20) and 1% Phytic acid (n = 20) was used as a smear layer removing agent and each above group was further subdivided and restored with a root end filling material, Biodentine (n = 10) and MTA Plus (n = 10). The samples were coated with varnish except at the root end and after drying, they were immersed in Rhodamine B dye for 24 h. The teeth were then rinsed, sectioned longitudinally, and observed under CLSM. Results: In the present study, MTA Plus® treated with 1% Phytic acid showed the least microleakage followed by Biodentine™ treated with 1% Phytic acid which was statistically not significant. MTA Plus® treated with 17% EDTA showed the highest microleakage when compared to other tested groups. There was a significant difference in microleakage between MTA Plus® and Biodentine™ when treated with 17% EDTA and 0.2% Chitosan. However, more microleakage was seen with Biodentine™ group than MTA plus® group. Conclusion: Root end cavities restored with MTA plus and treated with Phyitc acid showed superior sealing ability. Furthermore, smear layer removing agents will aid in better adaptability of root end filling material.