Sealing ability and marginal adaptation of NeoMTA and Endoseal MTA for strip perforation repair in mandibular first molars: an in vitro micro-computed tomography study

Strip perforation is a challenging endodontic complication that may compromise tooth prognosis. Calcium silicate–based materials are widely used for perforation repair; however, evidence comparing contemporary bioceramic materials in strip perforation defects remains limited. This study aimed to compare the sealing ability and marginal adaptation of NeoMTA and Endoseal MTA using micro-computed tomography (micro-CT). Thirty-two extracted human mandibular first molars were randomly allocated to NeoMTA ( n = 16) or Endoseal MTA ( n = 16). Standardized strip perforations were created in the danger zone of the mesial roots and repaired using group-specific procedures. Specimens underwent high-resolution micro-CT analysis. The primary outcome was total defects percentage, defined as the combined volume of marginal gaps, lateral interfacial gaps, and internal voids relative to total perforation volume. Additional measures included gap-, void-, and adaptation-related parameters. Intergroup comparisons were performed using independent-samples t-tests or Mann–Whitney U tests (α = 0.05), with Holm–Bonferroni adjustment across the eight repair-related outcomes. Baseline perforation volumes did not differ significantly between groups ( P = 0.755). Mean total defects percentages were 14.66% ± 10.77% for NeoMTA and 9.28% ± 7.68% for Endoseal MTA, with no significant difference between groups ( P = 0.196). No significant intergroup differences were observed for any secondary or exploratory outcome ( P > 0.05). All eight repair-related outcomes also remained nonsignificant after Holm–Bonferroni adjustment (adjusted P = 1.000 for each). Effect size analysis demonstrated only negligible-to-small differences between materials. NeoMTA and Endoseal MTA demonstrated no statistically significant differences in micro-CT measures of defect burden and marginal adaptation in strip perforation repair. Within the limitations of this in vitro study, both materials exhibited similar micro-CT defect characteristics, and the null hypothesis of no between-group difference could not be rejected.