Comparison of apical microleakage between CEM cement and cold ceramic as root-end filling materials, an in vitro study
Year: 2026
Type: article
Abstract: Background Public attitudes toward oral health have shifted toward preserving natural tooth structure, thereby increasing the importance of conservative treatments, such as root canal therapy. In endodontics, achieving an effective apical seal is critical to prevent bacterial microleakage and subsequent treatment failure. While various root-end filling (REF) materials have been introduced, an ideal material that meets all clinical criteria remains elusive. The purpose of this study was to evaluate apical microleakage between two different root-end filling materials—Calcium-Enriched Mixture (CEM) Cement and Cold Ceramic. Methods Sixty-one root- filled teeth that were extracted were prepared, apically resected, and filled with either CEM Cement or Cold Ceramic (n = 25 each). Bacterial leakage was assessed over 90 days using Enterococcus faecalis in a dual-chamber model. Statistical analysis was performed using Fisher’s exact test, the Mann–Whitney U test, and Kaplan–Meier survival analysis. Results Apical microleakage was detected in 72% of specimens in the CEM Cement group and 92% in the Cold Ceramic group؛ But this difference was not statistically significant. The mean time to leakage was 13.83 days (median 11.5 days) for CEM Cement and 12.70 days (median 10 days) for Cold Ceramic, with no significant difference. Survival analysis using the Kaplan–Meier method demonstrated no statistically significant difference in time to apical leakage . Conclusion Our study indicates no statistically significant difference in apical microleakage between CEM Cement and Cold Ceramic. Both materials demonstrated comparable sealing performance, and further long-term clinical studies are warranted to assess their in vivo efficacy and clinical implications.
Source: BMC Oral Health
Institution: Birjand University of Medical Sciences
Language: English
Subfield: Oral Surgery
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7203886605
FWCI:
Cites:
Cited by:
Related to: