Micro-CT Assessment of Hydraulic Calcium Silicate Cements for Perforating Internal Resorption in 3D-printed Tooth Replicas at Different Root Thirds: An In Vitro Study

Torres-Carrillo A.J.S.; Mazzi-Chaves J.F.; Creazzo G.; Salazar-Gamarra R.E.; Assis H.C.D.; Ordinola-Zapata R.; Sousa-Neto M.D.; Lopes-Olhê F.C. · Journal of Endodontics (2026) · DOI: 10.1016/j.joen.2026.05.002

Resumen

Introduction Effective repair of perforating internal resorption (PIR) requires adequate defect filling; however, the influence of defect location on the filling ability of hydraulic calcium silicate cements (HCSCs) remains unclear. This micro-computed tomography (micro-CT) study evaluated Bio-C Repair (BCR), Biodentine (BD), and white MTA-Angelus (WMTA) in three dimensional-printed tooth replicas with PIR defects in different root thirds. The null hypothesis was that material performance would not differ according to defect location. Methods A maxillary central incisor was instrumented to size R50 and scanned by micro-CT. PIR defects were digitally created in the apical, middle, and cervical thirds. Ninety replicas were printed and distributed by defect location ( n = 30) and HCSC type ( n = 10). After obturation, scans quantified cement-filling and extrusion. Surface characteristics were assessed by confocal laser scanning microscopy. Data were analyzed with Welch's analysis of variance (ANOVA) with Games-Howell post hoc and Kruskal–Wallis tests ( P < .05). Results In apical PIRs, WMTA achieved greater filling and sealing than BCR and BD ( P < .05), including superior filling of the adjacent apical canal ( P < .001). No differences were observed in the middle third ( P > .05). In cervical PIRs, all materials showed high filling, although BD exhibited greater extrusion than WMTA ( P < .01). BCR presented higher surface roughness in apical PIRs ( P < .05). Conclusions HCSC performance in PIR repair was influenced by defect location. WMTA demonstrated more predictable apical adaptation, whereas BD showed greater cervical extrusion under simulated periodontal conditions.

Instituciones: Universidad Científica del Sur