The Effect of Different Filling Materials Used on Immature Maxillary Central Teeth with Different Apical Diameters on Fracture Resistance
Abstract
Objective: This study aims to investigate the effect of different treatment options on immature maxillary central teeth simulated with two different apical diameters on fracture resistance.
Methods: Forty-eight maxillary central teeth with a singular root canal were collected for this in-vitro study. The specimens were decoronated to 17±0,12 mm long for ensuring standardization. All samples were randomly divided into two groups: 1,2mm group (G1) prepared with No. 4 Peaso Reamer and 1.8mm group (G2) prepared with No. 6 Peaso Reamer. Each parent group is divided into 4 subgroups (n=6) to form treatment groups. The positive control group was prepared without the access cavity to simulate the immature tooth (P) and negative control (N) group was prepared and filled calcium hydroxide. In group 3 MTA was condensed with a hand plugger to obtain a 3mm thick apical plug and remaining parts of the canals were filled with Guttaflow Bioseal cold filling system (G). In group 4, simulated immature roots were filled completely MTA (M). All samples were kept at 37° C and % 100 humidity for four weeks. Fracture test was performed by applying a load at an angle 135 degrees to the long axis of the teeth until a fracture occured using a universal test device.
Results: There was a statistically significant interaction between apical enlargement diameter and fill type on fracture resistance (p<0,05). The fracture resistances of the negative control groups in both of group 1 and group 2 were significantly different from those of the other groups (p<0,05). There was no statistically significant difference in fracture resistance according to filling type in 1,2mm apical diameter groups (p>0,05). GuttaFlow (G) group in the 1,8mm apical diameter group has the highest fracture resistance while the MTA (M) group has the closest fracture resistance to the negative control group.
Conclusion: Despite the restrictions in our study, the backfilling with GuttaFlow Bioseal in large apical diameter teeth may be beneficial in terms of fracture resistance.
Methods: Forty-eight maxillary central teeth with a singular root canal were collected for this in-vitro study. The specimens were decoronated to 17±0,12 mm long for ensuring standardization. All samples were randomly divided into two groups: 1,2mm group (G1) prepared with No. 4 Peaso Reamer and 1.8mm group (G2) prepared with No. 6 Peaso Reamer. Each parent group is divided into 4 subgroups (n=6) to form treatment groups. The positive control group was prepared without the access cavity to simulate the immature tooth (P) and negative control (N) group was prepared and filled calcium hydroxide. In group 3 MTA was condensed with a hand plugger to obtain a 3mm thick apical plug and remaining parts of the canals were filled with Guttaflow Bioseal cold filling system (G). In group 4, simulated immature roots were filled completely MTA (M). All samples were kept at 37° C and % 100 humidity for four weeks. Fracture test was performed by applying a load at an angle 135 degrees to the long axis of the teeth until a fracture occured using a universal test device.
Results: There was a statistically significant interaction between apical enlargement diameter and fill type on fracture resistance (p<0,05). The fracture resistances of the negative control groups in both of group 1 and group 2 were significantly different from those of the other groups (p<0,05). There was no statistically significant difference in fracture resistance according to filling type in 1,2mm apical diameter groups (p>0,05). GuttaFlow (G) group in the 1,8mm apical diameter group has the highest fracture resistance while the MTA (M) group has the closest fracture resistance to the negative control group.
Conclusion: Despite the restrictions in our study, the backfilling with GuttaFlow Bioseal in large apical diameter teeth may be beneficial in terms of fracture resistance.
Keywords
References
- 1. Andreasen JO, Andreasen FM, Bakland LK, Flores MT. Emergency record for acute dental trauma, and clinical examination form for the time of injury and follow-up examination. Trauma Dent Inj A Manual, 2nd edn Oxford Blackwell Munksgaard. 2003;18-21.
- 2. Andreasen FM, Andreasen JO, Bayer T. Prognosis of root‐fractured permanent incisors—prediction of healing modalities. Dent Traumatol. 1989;5(1):11–22.
- 3. Silujjai J, Linsuwanont P. Treatment outcomes of apexification or revascularization in nonvital immature permanent teeth: a retrospective study. J Endod. 2017;43(2):238–45. 4. Frank AL. Therapy for the divergent pulpless tooth by continued apical formation. J Am Dent Assoc [Internet]. 1966/01/01. 1966;72(1):87–93. Available from: https://www.ncbi.nlm.nih.gov/pubmed/5215726
- 5. Rafter M. Apexification: a review. Dent Traumatol. 2005;21(1):1–8.
- 6. Andreasen JO, Farik B, Munksgaard EC. Long‐term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18(3):134–7.
- 7. Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod. 2012;38(10):1330–6.
- 8. Malkondu Ö, Kazandağ MK, Kazazoğlu E. A review on biodentine, a contemporary dentine replacement and repair material. Biomed Res Int. 2014;2014.
- 9. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod. 1999;25(3):197–205.
- 10. Çiçek E, Yılmaz N, Koçak MM, Sağlam BC, Koçak S, Bilgin B. Effect of mineral trioxide aggregate apical plug thickness on fracture resistance of immature teeth. J Endod. 2017;43(10):1697–700.
- 11. Bouillaguet S, Wataha JC, Tay FR, Brackett MG, Lockwood PE. Initial in vitro biological response to contemporary endodontic sealers. J Endod. 2006;32(10):989–92.