title: Marginal adaptation of mineral trioxide aggregate (MTA) to root dentin surface with orthograde/retrograde application techniques: A microcomputed tomographic analysis.
abstract: BACKGROUND
  Achieving a good apical seal for root canals is known to be associated with good mineral trioxide aggregate (MTA) adaptation to dentin.
  
  
  OBJECTIVE
  This study aims to compare the marginal adaptation of MTA with root dentin between orthograde and retrograde application techniques using microcomputed tomography (micro-CT) analysis.
  
  
  METHODS
  Fifty-two single-rooted human teeth were divided into four equal groups: (Group 1) Retrograde MTA (RMTA), (Group 2) Orthograde MTA (OMTA), (Group 3) Etched RMTA (ERMTA), and (Group 4) Etched OMTA (EOMTA).
  
  
  METHODS
  For Group 1, 3-mm retrograde cavities were prepared and filled with MTA. For Group 2, the apical 6 mm of the canals were filled with MTA and sealed with sealer cement and warm gutta-percha. In Groups 3 and 4, canals were treated the same as Groups 1 and 2, respectively, except that before placing the MTA, canals were irrigated with 17% ethylenediaminetetraacetic acid (EDTA). After 48 hours, all the teeth were analyzed using a micro-CT scanner.
  
  
  METHODS
  Mean dentin-MTA contact and the mean length and width of each gap was analysed using one-way analysis of variance (ANOVA). Statistical significance was set at an α level of 5%.
  
  
  RESULTS
  No significant difference in gap volumes was observed in the dentin-MTA adaptation in both orthograde and retrograde application techniques. However, significant difference in the gap volumes was observed between RMTA and ERMTA (P = 0.045). Etching significantly improved the MTA-Dentin adaptation (P < 0.05). The type of application technique did not significantly improve the dentin-MTA adaptation, instead with the use of 17% EDTA, a significant improvement could be achieved.
  
  
  CONCLUSIONS
  Within the limitations of the present study, it concludes that MTA adaptation to dentin tooth structure is not significantly different between an orthograde and retrograde approach. However, the use of EDTA significantly improved the MTA-Dentin adaptation.
authors.affiliation: Consultant, Division of Endodontics, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Fouzan
authors.affiliation: Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Awadh
authors.affiliation: Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Moahmmed
authors.initials: M
authors.lastname: Badwelan
authors.affiliation: Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Abeer
authors.initials: A
authors.lastname: Gamal
authors.affiliation: Lecturer, Department of Dental Public Health, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Amrita
authors.initials: A
authors.lastname: Geevarghese
authors.affiliation: Resident, Saudi Endodontics Board, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Samar
authors.initials: S
authors.lastname: Babhair
authors.affiliation: Head, Division of Endodontics, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, KAMC, National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Mansour
authors.initials: M
authors.lastname: Al-Rejaie
authors.affiliation: Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Hezaimi
authors.affiliation: Professor of Endodontics, Associate Dean for Continuing Oral Health Professional Education, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
authors.forename: Ilan
authors.initials: I
authors.lastname: Rotstein
keywords: Acid etching; marginal adaptation; microcomputed tomography; mineral trioxide aggregate
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