Fracture Resistance of Teeth with Simulated Perforating Internal Resorption Cavities Repaired with Different Calcium Silicate–based Cements and Backfilling Materials

doi:10.1016/j.joen.2018.01.019

Journal of Endodontics

Volume 44, Issue 5, May 2018, Pages 860-863

https://doi.org/10.1016/j.joen.2018.01.019 Get rights and content

Highlights

•
Roots backfilled with MTA, MTA Plus, and Biodentine showed similar fracture resistance.
•
Roots backfilled with CSCs showed highest fracture resistance values.

Abstract

Introduction

This study assessed the fracture resistance (FR) of teeth with simulated perforating internal resorption cavities repaired with different calcium silicate–based cements (CSCs) and backfilling materials.

Methods

Ninety-six mandibular premolar teeth were used. Twelve of the teeth were assigned as negative control group. Remaining roots were instrumented with rotary files, and standardized internal resorption cavities were prepared on the middle half of roots with burs. Twelve of the samples were not further interfered and were assigned as a positive control group. The apical 4 mm of the remaining 72 root canals was obturated with single-cone technique and divided into 6 groups according to CSCs used for repairing of cavities and backfilling materials as follows: MTA + MTA, MTA + gutta-percha/sealer, Biodentine + Biodentine, Biodentine + gutta-percha/sealer, MTA Plus + MTA Plus, and MTA Plus + gutta-percha/sealer. Specimens were embedded in acrylic resin and then subjected to fracture testing. The forces when the fracture occurred were analyzed with analysis of variance and Bonferroni tests at P = .05.

Results

No significant difference was found among CSCs irrespective of backfilling materials (P > .05). Groups MTA + gutta-percha/sealer, Biodentine + gutta-percha/sealer, and MTA Plus + gutta-percha/sealer showed significantly lower FR compared with groups MTA + MTA, Biodentine + Biodentine, and MTA Plus + MTA Plus, respectively (P < .05). The highest FR was observed in group Biodentine + Biodentine, and the lowest was in group MTA Plus + gutta-percha/sealer. FR of positive control group was statistically lower than groups completely filled with CSCs (P < .05), whereas FR of negative control group was statistically higher than the groups combined with gutta-percha and sealer (P < .05).

Conclusions

The backfilling with CSCs may be a preferable material rather than gutta-percha/sealer combination for the roots with perforated internal resorptions.

Section snippets

Materials and Methods

Mandibular mature, caries-free premolar teeth that were extracted because of periodontal reasons were selected. With the aim of specimen standardization, the mesiodistal and buccolingual diameters of the teeth were measured at the cementoenamel junction with a digital caliper. Roots presenting a difference of 20% from the mean were discarded (12). A total of 96 single-rooted teeth with a single canal and no visible caries or cracks on the root surface were used. Teeth were decoronated at the

Results

The mean and standard deviation values of the fracture strength test are shown in Table 1. There was a statistically significant difference between the groups according to the analysis of variance test (P < .05). Bonferroni test revealed that the groups MTA + MTA, Biodentine + Biodentine, and MTA Plus + MTA Plus had statistically higher resistance to fracture compared with the group MTA + gutta-percha/sealer, Biodentine + gutta-percha/sealer, and MTA Plus + gutta-percha/sealer, respectively (P

Discussion

Weakened tooth structure because of the IRR is susceptible to fracture (11). Therefore, the materials that were suggested to have reinforcing capacity should be preferred for repairing the resorption areas to prevent fractures (15). In the present study, the reinforcing capability of different CSCs including MTA, MTA Plus, and Biodentine in restoration of teeth with simulated perforated internal resorption was aimed to test. Defects were simulated in the middle third of the root on the mesial

Acknowledgments

The authors deny any conflicts of interest related to this study.

References (25)

S. Patel et al.
Is the resorption external or internal?
Dent Update
(2007)
C. Gabor et al.
Prevalence of internal inflammatory root resorption
J Endod
(2012)
F.F. Silveira et al.
Double 'pink tooth' associated with extensive internal root resorption after orthodontic treatment: a case report
Dent Traumatol
(2009)
M.K. Caliskan et al.
Prognosis of permanent teeth with internal resorption: a clinical review
Endod Dent Traumatol
(1997)
E. Nilsson et al.
Management of internal root resorption on permanent teeth
Int J Dent
(2013)
M. Torabinejad et al.
Clinical applications of mineral trioxide aggregate
J Endod
(1999)
L. Grech et al.
Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials
Dent Mater
(2013)
J. Camilleri et al.
The setting characteristics of MTA Plus in different environmental conditions
Int Endod J
(2013)
M.G. Gandolfi et al.
Ion release, porosity, solubility, and bioactivity of MTA Plus tricalcium silicate
J Endod
(2014)
H.C. Hsien et al.
Repair of perforating internal resorption with mineral trioxide aggregate: a case report
J Endod
(2003)

M. Jacobovitz et al.

Treatment of inflammatory internal root resorption with mineral trioxide aggregate: a case report

Int Endod J

(2008)

F. Goldberg et al.

Reinforcing effect of a resin glass ionomer in the restoration of immature roots in vitro

Dent Traumatol

(2002)

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Citation Excerpt :
Using materials with bonding properties with dentin to form an integrated structure may enhance the fracture resistance of roots and reduce microleakage.6,7 In recent years, it has been reported that hydrophilic bioceramic root canal sealers, such as iRoot SP, can hydrate with the water in the dentine tubules of the root canal wall to produce hydroxyapatite (HAP), which can then be firmly combined with the dentin to enhance the mechanical strength of the root.8–11 However, it has been reported that the breaking strength of dentin is reduced by 33% when exposed to mineral trioxide aggregate (MTA) for 5 weeks.
The root fracture resistance of endodontically treated teeth is decreased significantly, and it is more likely to fracture. This study aimed to evaluate the effect of a novel root canal sealer based on bioactive glass (BG) on root fracture resistance and explore its mechanism.
The BG-based root canal sealer (BG Sealer) was prepared by mixing a kind of bioactive glass (10.8% P₂O₅, 54.2% SiO₂, 35% CaO, mol.%, named PSC), zirconia (ZrO₂) powder, sodium alginate (SA) and phosphate solution (PS). A pH meter was used to measure the pH of simulated body fluid (SBF) after immersion with BG Sealer at different time. After preparing the samples of BG sealer with a diameter of 4 mm and a height of 6 mm, the compressive strength was tested by a universal testing machine. The scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to detect and analyze the mineral status of root canal systems filled with BG Sealer. The push out test was used to measure the push out bond strength of BG Sealer. The fracture resistance of root canals filled with BG Sealer was detected by the compressive loading test. Bioceramic root canal sealer iRoot SP was set as the control group.
(1) Physicochemical properties: The pH value of SBF immersed with BG Sealer increased slightly up to 7.68, while the pH of SBF immersed with iRoot SP increased to 12.08. The compressive strength of the novel BG Sealer was 4.62 ± 1.70 MPa, which was lower than that of iRoot SP (P < 0.05). (2) Mineralization: The hydroxyapatite layers were observed on the surface of BG Sealer and iRoot SP after being immersed in SBF for 4 weeks. BG Sealer and iRoot SP were both able to penetrate into the dentin tubules, duplicate the morphology of root canals well, and form a layer of hydroxyapatite. (3) Adhesion to dentin: There was no significant difference between the push out bond strength of the novel BG Sealer and iRoot SP (P > 0.05). (4) Fracture resistance: After immersion in SBF for 4 weeks, the fracture resistance of roots filled with BG Sealer and iRoot SP was 454.16 ± 155.39 N and 445.50 ± 164.73 N, respectively, both of which were not statistically different from that of the roots unprepared and unfilled (394.07 ± 62.12 N) (P > 0.05), whereas higher than that of the roots prepared and unfilled (235.36 ± 83.80 N) (P < 0.05).
The novel BG Sealer has good adhesion to the root dentin, can penetrate into the dentin tubules to generate minerals, and meanwhile can improve the fracture resistance of the roots after root canal treatment. It is expected to be a bioactive root canal sealer with good clinical application prospects.
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Basic ResearchFracture Resistance of Teeth with Simulated Perforating Internal Resorption Cavities Repaired with Different Calcium Silicate–based Cements and Backfilling Materials

Highlights

Abstract

Introduction

Methods

Results

Conclusions

Section snippets

Materials and Methods

Results

Discussion

Acknowledgments

Is the resorption external or internal?

Dent Update

Prevalence of internal inflammatory root resorption

J Endod

Double 'pink tooth' associated with extensive internal root resorption after orthodontic treatment: a case report

Dent Traumatol

Prognosis of permanent teeth with internal resorption: a clinical review

Endod Dent Traumatol

Management of internal root resorption on permanent teeth

Int J Dent

Clinical applications of mineral trioxide aggregate

J Endod

Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials

Dent Mater

The setting characteristics of MTA Plus in different environmental conditions

Int Endod J

Ion release, porosity, solubility, and bioactivity of MTA Plus tricalcium silicate

J Endod

Repair of perforating internal resorption with mineral trioxide aggregate: a case report

J Endod

Treatment of inflammatory internal root resorption with mineral trioxide aggregate: a case report

Int Endod J

Reinforcing effect of a resin glass ionomer in the restoration of immature roots in vitro

Dent Traumatol

Basic Research
Fracture Resistance of Teeth with Simulated Perforating Internal Resorption Cavities Repaired with Different Calcium Silicate–based Cements and Backfilling Materials