BMC Oral Health. 2026 Feb 10. doi: 10.1186/s12903-026-07787-9. Online ahead of print.
ABSTRACT
BACKGROUND: Apexification in immature teeth represents a clinical challenge due to the difficulty of achieving an effective apical seal and sufficient mechanical resistance. Bioceramic materials such as MTA Repair HP, Bio-C Repair, Biodentine, and PBS Cimmo HP have been developed to improve sealing ability and bond strength. The objective of this study was to evaluate and compare, in vitro, the apical marginal adaptation by Scanning Electron Microscopy (SEM) and bond strength through the push-out test of these four calcium silicate- based cements used as an apical barrier.
METHODS: Forty simulated models of immature teeth with open apex were created. The specimens were divided into four groups to create an apical plug: G1 (MTA Repair HP), G2 (Bio-C Repair), G3 (Biodentine) and G4 (Cimmo HP). The apical portion of the specimens was sectioned, into2.5 mm slices. The adaptation of the apical barrier was assessed using SEM and the bond strength was evaluated by the push-out test. Data were analyzed by one-way ANOVA and Tukey’s post hoc test (p < 0.05).
RESULTS: MTA Repair HP showed significantly better marginal adaptation compared to Cimmo HP (p < 0.05), while no statistical difference were found among the other materials. In contrast, PBS Cimmo HP exhibited the highest bond strength, significantly superior to Bio-C Repair (p < 0.05). No significant differences were found among the other materials. Both MTA Repair HP and Biodentine demonstrated consistent performance in both tests. Adhesive fracture was the most frequent type of failure observed across all materials.
CONCLUSION: MTA Repair HP, provided superior marginal adaptation, favoring its indication for apical sealing and prevention of leakage. Conversely, Cimmo HP, with its higher compressive strength, may be better suited for cases requiring greater mechanical resistance. Understanding the distinct properties of these materials assists clinicians in selecting the most appropriate bioceramic cement for apexification procedures.
PMID:41668039 | DOI:10.1186/s12903-026-07787-9
