Dentinal Surface Roughness after Apicoectomy Improves Cell Attachment

Apicoectomy is an endodontic surgery useful to treat persistent apical periodontitis in case of nonsurgical treatment failure. The aim of this study was to compare dentinal roughness following apicoectomies using different instruments, and cellular attachment viability over these surfaces.

Sixty-four single-rooted human extracted teeth were selected, endodontically treated, and apicectomies performed. High-speed carbide burs: Zekrya (Dentsply), ultrasonic tips Blade Sonic (Helse) or OT12 (Mectron) were used. Time required for resection, the root-end surface roughness and viability of the attached cells (ATCC PCS-201-018) were analyzed. As control, high speed burs cut samples were obtained and polished using a multiblade burs sequence. Results were analyzed statistically using ANOVA or Kruskal-Wallis tests at the significance level of 5%.

OT12 was the fastest and Blade Sonic the slowest to perform the apicoectomies (P < .05). Regardless of the cut time, both ultrasonic instruments resulted in higher surface roughness. Cell attachment was observed on all specimens and the human primary gingival fibroblasts attachment demonstrated a time-dependent increase where the best results were obtained by the ultrasonic instruments.

A rougher dentinal surface improved the cell attachment. OT12 tips showed a favorable cell attachment with the fastest apicoectomy. Although the cutting time has presented statistical differences between conditions, none could negatively impact the total time of a microsurgery. Future clinical studies can investigate dentinal surfaces correlating it with repair, following apicoectomy.