Influence of final irrigation with EDTA and chitosan on apical microleakage of different apical repair materials in simulated immature teeth: a confocal laser scanning microscopy study.

Abstract

This study assessed the effects of different final irrigation solutions and apical repair materials on apical microleakage in simulated immature teeth using confocal laser scanning microscopy (CLSM). Ninety-six extracted human permanent maxillary incisors were used to create a model of immature teeth with open apices. The teeth were randomly allocated into three groups according to the final irrigation solution: distilled water, 17% EDTA, and 0.2% chitosan. Each group was divided into four subgroups according to apical repair material: Biodentine, MTA Repair HP, TotalFill BC RRM Fast Set Putty (TotalFill FSP), and Endocem MTA Premixed Regular (EMPR). After material placement, the specimens were immersed in 0.2% rhodamine B dye, then sectioned longitudinally and analyzed using CLSM. Microleakage was quantified with ImageJ. Data were analyzed using aligned rank transform (ART) ANOVA followed by ART-based pairwise contrasts using the art.con() function with Tukey-adjusted p-values (p < .05). Final irrigation solutions, apical repair materials, and their interaction significantly affected apical microleakage (p < .05). Chitosan showed the lowest microleakage, followed by EDTA and distilled water (p < .05). Microleakage differed significantly among apical repair materials (p < .05), with increased values in the TotalFill FSP, Biodentine, MTA Repair HP, and EMPR groups. The chitosan-TotalFill FSP combination demonstrated the lowest microleakage values (1.24 ± 0.02 mm; p < .05), whereas the distilled water-EMPR combination showed the highest microleakage values (3.35 ± 0.03 mm; p < .05). Within the limitations of this in vitro study, final irrigation with chitosan and the use of TotalFill FSP improved the apical sealing in immature teeth with open apices.