Marginal adaptation and porosity of calcium silicate-based cements in furcation perforations: a micro-CT comparative study

This ex-vivo study compares the adaptation, porosity, and sealing performance of ProRoot MTA, NeoPutty, and Biodentine in standardized, simulated furcation perforations created in extracted mandibular molars using clinical evaluation and high-resolution micro-computed tomography (micro-CT). Thirty-six mandibular molars with furcation perforations were randomly assigned to three groups (n = 12). Clinical evaluation assessed adaptation, porosity, and overfilling, while micro-computed tomography (micro-CT) provided quantitative data on voids and gaps. Statistical analysis used chi-square, Kruskal-Wallis, and Mann-Whitney U tests. NeoPutty and ProRoot MTA showed superior adaptation compared to Biodentine (p < 0.05). Biodentine showed higher porosity (28.44%) than ProRoot MTA (0%) and NeoPutty (8.3%) (p < 0.001). Biodentine also had the highest void volume (1.05 mm³) and gap volume (1.37 mm³), while ProRoot MTA recorded the lowest void volume (0.59 mm³), and NeoPutty had the smallest gap volume (0.85 mm³). No significant differences were observed in overfilling rates. Overall, ProRoot MTA exhibited the most consistent sealing ability, whereas NeoPutty emerged as a viable alternative due to its favorable handling and reliable adaptation. Biodentine, by contrast, showed the poorest performance in terms of structural integrity and sealing capacity. Within the limitations of this study, these findings support the use of ProRoot MTA or NeoPutty for furcation perforation repair, while suggesting more cautious use of Biodentine in such applications.