Comparative Evaluation of Radiopacity of CEM, Three Types of MTA, Gutta-percha, and Dentin using Digital Radiography

Radiography is considered a valuable tool in endodontic procedures, and radiopacity is an essential priority in every filling material. Proper radiopacity is essential for the differentiation of filled canal from anatomic structures and surrounding tissues. Moreover, proper radiopacity should be independent from characteristics, such as material thickness and its solubility in variable fluids (e.g., saliva). The purpose of this study was to evaluate the radiopacity of calcium-enriched mixture (CEM), three types of mineral trioxide aggregate (MTA), gutta-percha, and dentin using digital radiography.

Five disc-shaped specimens (with a diameter and thickness of 10 and 1 mm, respectively) were fabricated from each material, including Angelus MTA, MTA+, Root MTA, CEM, dentin, and gutta-percha. After setting the materials, digital radiographs were taken using graduated aluminum step wedge. The radiopacity was assessed using the software ImageJ (version 1.49). For statistical analysis, analysis of variance and Tukey’s test were used at a significance level of 0.05. 

Root MTA and gutta-percha presented the highest radiopacity equal to approximately 4 mm of aluminum; however, dentin showed the lowest MAT reported as 0.7 mm of aluminum. Three types of MTA did not demonstrate a significant difference in radiopacity with each other and gutta-percha. The mean of CEM radiopacity was significantly lower than those reported for MTA types and gutta-percha.

Angelus MTA, MTA+, and Root MTA show the optimum radiopacity according to international standards; nevertheless, the radiopacity of CEM is lower than the optimum standard of 3 mm of aluminum.