Perbedaan Kemampuan Penutupan dari MTA, Biodentine, RMGIC, dan SDR Sebagai Bahan Intra-Orifice Barrier pada Gigi Pasca Perawatan Endodontik ( In Vitro )

Abstract

Coronal microleakage is one of the causes of endodontic treatment failure. Intra-orifice barrier is an alternative method to reduce microleakage in endodontically treated teeth. This study aims to see the sealing ability difference of Mineral Trioxide Aggregate (MTA), Biodentine, Resin-Modified Glass Ionomer Cement (RMGIC), and Smart Dentin Replacement (SDR) as intra-orifice barrier materials in endodontically treated teeth. Thirty-two mandibular premolars that were extracted for orthodontic treatment were selected. The root canal of the tooth was prepared and obturated with gutta percha and AH Plus sealer using warm vertical compaction technique. Gutta percha was removed vertically 2 and 3 mm deep into the root canal using a hot plugger, the teeth were divided into two main groups with each group of 16 teeth according to the thickness of the intra-orifice barrier material. Each group was further divided into four sub-groups of 4 teeth according to the four types of intra-orifice barrier material. The teeth were thermocycled, sectioned at the crown portion, coated with wax and nail varnish, and immersed in a 0.5% Basic Fuchsin solution for 24 hours. Then, the root of the tooth was sectioned in the bucco-lingual direction and the dye penetration was measured by a microleakage score. Furthermore, visual analysis was performed under a Scanning Electron Microscope (SEM) to examine the microleakage in details. The statistical analysis of Kruskal-Wallis and Mann-Whitney statistic tests demonstrated that there were significant differences in microleakage (p<0.05) between MTA and RMGIC and also between RMGIC with SDR in 2 mm thickness, but there were no significant differences in 3 mm thickness. This study also demonstrated that the use of the same intra-orifice barrier materials was not significantly different in microleakage (p>0.05) in different thicknesses (2 mm and 3 mm). SDR and Biodentine demonstrate the best sealing ability in 2 mm and 3 mm thickness, respectively, while RMGIC demonstrates the worst sealing ability.

Kebocoran mikro mahkota merupakan salah satu penyebab kegagalan perawatan endodontik. Intra-orifice barrier adalah sebuah metode alternatif untuk mengurangi kebocoran mikro mahkota pada gigi pasca perawatan endodontik. Penelitian ini bertujuan untuk melihat perbedaan kemampuan penutupan (sealing ability) dari Mineral Trioxide Aggregate (MTA), Biodentine, Resin-Modified Glass Ionomer Cement (RMGIC), dan Smart Dentin Replacement (SDR) sebagai bahan intra-orifice barrier pada gigi pasca perawatan endodontik. Tiga puluh dua gigi premolar mandibula yang telah diekstraksi untuk keperluan perawatan ortodonti dipilih. Saluran akar gigi dipreparasi dan diobturasi dengan gutta percha dan sealer AH Plus menggunakan teknik warm vertical compaction. Gutta percha dibuang secara vertikal menggunakan hot plugger dengan kedalaman 2 mm dan 3 mm ke dalam saluran akar, gigi dibagi menjadi dua kelompok utama dengan setiap kelompok 16 gigi menurut ketebalan bahan intra-orifice barrier. Setiap kelompok dibagi lagi menjadi empat sub-kelompok dengan masing-masing 4 gigi menurut empat macam bahan intra-orifice barrier. Gigi dilakukan thermocycling, dipotong bagian mahkota gigi, dilapisi wax dan nail varnish, dan direndam dalam larutan Basic Fuchsin 0,5% selama 24 jam. Kemudian, akar gigi dibelah dalam arah buko-lingual dan pengukuran penetrasi zat warna melalui skor kebocoran mikro. Selanjutnya, dilakukan pengamatan dengan Scanning Electron Microscope (SEM) untuk melihat kebocoran mikro secara mendetail. Hasil uji statistik Kruskal-Wallis dan Mann-Whitney menunjukkan bahwa ada perbedaan yang bermakna (p<0.05) terhadap kebocoran mikro antara MTA dengan RMGIC dan RMGIC dengan SDR pada ketebalan 2 mm, tetapi tidak ada perbedaan yang bermakna pada ketebalan 3 mm. Penelitian ini juga menunjukkan bahwa penggunaan bahan intra-orifice barrier yang sama tidak berbeda bermakna (p>0.05) terhadap kebocoran mikro pada ketebalan yang berbeda (2 mm dan 3 mm). SDR dan Biodentine menunjukkan kemampuan penutupan yang paling baik masing-masing pada ketebalan 2 mm dan 3 mm, sedangkan RMGIC menunjukkan kemampuan penutupan yang paling buruk.