Periradicular Regeneration after Endodontic Surgery with Calcium-enriched Mixture Cement in Dogs

IntroductionThe aim of this in vivo study was to compare the response of periradicular tissues to mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as root-end fillings and to analyze hard tissue healing after periradicular surgery.MethodsIntentional periradicular lesions were induced in 32 premolar teeth in 4 beagle dogs. The root canals were prepared, dried, and obturated with laterally condensed gutta-percha with sealer, and the coronal access cavities were filled with amalgam. After surgical exposure of the apices, 2–3 mm of the apical root was resected, and root-end cavities were ultrasonically prepared. The root-end cavities were randomly filled with MTA or CEM cement. After 2 months, the animals were killed; tissue blocks were removed and prepared for histologic examination. Hard tissue healing including cementum and new bone formation in addition to concentration and extent of inflammation were evaluated.ResultsEight samples were excluded. The major finding was the cementum deposition adjacent to MTA in 11of 12 samples and CEM cement in 10 of 12 samples. With one-way analysis of variance, no significant difference was observed between the periradicular tissue response to tested materials.ConclusionsCEM cement and MTA were associated with regenerative periapical tissue response when used as root-end filling biomaterials.