Share This Article:

Evaluation of 4 different bone graft substitutes and autogenous bone grafting in root-end resection osteotomies after retrograde root-filling with Intermediate Restorative Material (IRM): An experimental study in dogs

Full-Text HTML Download Download as PDF (Size:341KB) PP. 203-208
DOI: 10.4236/ojst.2013.32035    3,739 Downloads   5,544 Views   Citations


Purpose: To investigate the periapical tissue response after root end filling with intermediate restorative material (IRM) and filling of the root-end resection bone defects with autogenous bone or a bone graft substitute in comparison to empty controls. Materials and Methods: Vital roots of the second, third and fourth mandibular premolars in six healthy mongrel dogs were apectomized. The root canals were prepared and sealed with IRM following a standardized surgical procedure. The resection bone defects were either filled with autogenous bone (PB) or one of the bone graft substitutes; CERAMENTTM|BONE VOID FILLER, ChronOS?, TigranTM PTG, Easygraft? CLASSIC or left empty. After 120 days the animals were sacrificed and the specimens were analyzed radiologically and histologically. Kruskal-Wallis and Mann-Whitney tests were performed for statistical evaluation. Results: 34 sections were analyzed histologically. The evaluation revealed a variation in the outcome amongst the tested options, regarding reestablishment of the periapical bone healing and inflammatory infiltration in the sections. According to the tested variables, there was no statistical significant difference between the materials when comparing all groups as a whole. When comparing individual materials to each other there was statistical differences among some of the tested materials. Conclusion: The healing outcome after periapical surgery of a five-wall resection defect could not be increased by infill with autogenous bone or bone graft substitutes. The most important factor for the healing outcome in periapical surgery is the quality of the root-end sealing. The healing outcome after some of the tested bone substitutes, might be improved by longer healing time.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Wälivaara, D. and Abrahamsson, P. (2013) Evaluation of 4 different bone graft substitutes and autogenous bone grafting in root-end resection osteotomies after retrograde root-filling with Intermediate Restorative Material (IRM): An experimental study in dogs. Open Journal of Stomatology, 3, 203-208. doi: 10.4236/ojst.2013.32035.


[1] Chong, B.S. and Pitt Ford, T.R. (2005) Root-end filling materials: Rationale and tissue response. Endodontic Topics, 2005, 114-130. doi:10.1111/j.1601-1546.2005.00164.x
[2] Walivaara, D.A., Abrahamsson, P., Isaksson, S., Blomqvist, J.E. and Samfors, K.A. (2007) Prospective study of periapically infected teeth treated with periapical surgery including ultrasonic preparation and retrograde intermediate restorative material root-end fillings. Journal of Oral and Maxillofacial Surgery, 5, 931-935. doi:10.1016/j.joms.2005.12.077
[3] Walivaara, D.A., Abrahamsson, P., Samfors, K.A. and Isaksson, S. (2009) Periapical surgery using ultrasonic preparation and thermoplasticized gutta-percha with AH Plus sealer or IRM as retrograde root-end fillings in 160 consecutive teeth: A prospective randomized clinical study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 5, 784-789. doi:10.1016/j.tripleo.2009.06.010
[4] Walivaara, D.A., Abrahamsson, P., Fogelin, M. and Isaksson, S. (2011) Super-EBA and IRM as root-end fillings in periapical surgery with ultrasonic preparation: A prospective randomized clinical study of 206 consecutive teeth. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 2, 258-263. doi:10.1016/j.tripleo.2011.01.016
[5] Vaishnavi, C., Mohan, B. and Narayanan, L.L. (2011) Treatment of endodontically induced periapical lesions using hydroxyapatite, platelet-rich plasma, and a combination of both: An in vivo study. Journal of Conservative Dentistry, 2, 140-146. doi:10.4103/0972-0707.82614
[6] Dietrich, T., Zunker, P., Dietrich, D. and Bernimoulin, J.P. (2003) Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: Results after 12 months. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 4, 474-482. doi:10.1067/moe.2003.39
[7] Taschieri, S., Del Fabbro, M., Testori, T. and Weinstein, R. (2007) Efficacy of xenogeneic bone grafting with guided tissue regeneration in the management of bone defects after surgical endodontics. Journal of Oral and Maxillofacial Surgery, 6, 1121-1127. doi:10.1016/j.joms.2006.10.022
[8] Sreedevi, P., Varghese, N. and Varugheese, J.M. (2011) Prognosis of periapical surgery using bonegrafts: A clinical study. Journal of Conservative Dentistry, 1, 68-72. doi:10.4103/0972-0707.80743
[9] Pantchev, A., Nohlert, E. and Tegelberg, A. (2009) Endodontic surgery with and without inserts of bioactive glass PerioGlas—A clinical and radiographic follow-up. Oral and Maxillofacial Surgery, 1, 21-26.
[10] Isaksson, S., Alberius, P., Klinge, B. and Jonsson, J. (1992) Contribution of autogeneic membranous bone chips and bone paste to healing of rabbit skull defects. Scandinavian Journal of Dental Research, 5, 274-278.
[11] Klinge, B., Alberius, P., Isaksson, S. and Jonsson, J. (1992) Osseous response to implanted natural bone mineral and synthetic hydroxylapatite ceramic in the repair of experimental skull bone defects. Journal of Oral and Maxillofacial Surgery, 3, 241-249. doi:10.1016/0278-2391(92)90320-Y
[12] Dahlin, C., Gottlow, J., Linde, A. and Nyman, S. (1990) Healing of maxillary and mandibular bone defects using a membrane technique. An experimental study in monkeys. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 1, 13-19.
[13] Taschieri, S., Del Fabbro, M., Testori, T., Saita, M. and Weinstein, R. (2008) Efficacy of guided tissue regeneration in the management of through-and-through lesions following surgical endodontics: A preliminary study. The International Journal of Periodontics & Restorative Dentistry, 3, 265-271.
[14] Pecora, G., De Leonardis, D., Ibrahim, N., Bovi, M. and Cornelini, R. (2001) The use of calcium sulphate in the surgical treatment of a “through and through” periradicular lesion. International Endodontic Journal, 3, 189-197. doi:10.1046/j.1365-2591.2001.00369.x
[15] Nilsson, M., Wang, J.S., Wielanek, L., Tanner, K.E. and Lidgren, L. (2004) Biodegradation and biocompatability of a calcium sulphate-hydroxyapatite bone substitute. The Journal of Bone and Joint Surgery, British Volume, 1, 120-125.
[16] Jensen, S.S., Bornstein, M.M., Dard, M., Bosshardt, D.D. and Buser, D. (2009) Comparative study of biphasic calcium phosphates with different HA/TCP ratios in mandibular bone defects. A long-term histomorphometric study in minipigs. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 1, 171-181.
[17] Truedsson, A., Wang, J.S., Lindberg. P., Gordh. M., Sunzel, B. and Warfvinge, G. (2010) Bone substitute as an on-lay graft on rat tibia. Clinical Oral Implants Research, 4, 424-429. doi:10.1111/j.1600-0501.2009.01875.x
[18] Wohlfahrt, J.C., Monjo, M., Ronold, H.J., Aass, A.M., Ellingsen, J.E. and Lyngstadaas, S.P. (2010) Porous titanium granules promote bone healing and growth in rabbit tibia peri-implant osseous defects. Clinical Oral Implants Research, 2, 165-173. doi:10.1111/j.1600-0501.2009.01813.x
[19] Chong, B.S., Pitt Ford, T.R. and Hudson, M.B. (2003) A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. International Endodontic Journal, 8, 520-526. doi:10.1046/j.1365-2591.2003.00682.x
[20] Walivaara, D.A., Abrahamsson, P., Isaksson, S., Salata, L.A., Sennerby, L. and Dahlin, C. (2012) Periapical tissue response after use of intermediate restorative material, gutta-percha, reinforced zinc oxide cement, and mineral trioxide aggregate as retrograde root-end filling materials: a histologic study in dogs. Journal of Oral and Maxillofacial Surgery, 9, 2041-2047. doi:10.1016/j.joms.2012.01.033
[21] Favieri, A., Campos, L.C., Burity, V.H., Santa Cecilia, M. and Abad Eda, C. (2008) Use of biomaterials in periradicular surgery: A case report. Journal of Endodontics, 4, 490-494. doi:10.1016/j.joen.2008.01.012

comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.