首页 » 文章 » 文章详细信息
Acta Biomaterialia Odontologica Scandinavica Volume 5 ,Issue 1 ,2019-12-02
Fracture resistance of simulated immature teeth treated with a regenerative endodontic protocol
Original Article
Mohamed Raouf W. Ali 1 Manal Mustafa 2 Asgeir Bårdsen 1 Athanasia Bletsa 1 , 2
Show affiliations
DOI:10.1080/23337931.2019.1570822
Received 2018-10-19, accepted for publication 2019-1-3, Published 2019-1-3
PDF
摘要

This study aims to evaluate fracture resistance of simulated immature teeth after treatment with regenerative endodontic procedure (REP) using tricalcium silicate cements (TSCs) as cervical plugs. Bovine incisors were sectioned to standard crown/root ratio. Pulp tissue was removed and canals were enlarged to a standardized diameter. Teeth were then treated with a REP protocol consisting of NaOCl and EDTA irrigation, intracanal medication with triple-antibiotic paste for 14 days followed by a TSC cervical seal and composite restoration. Teeth were divided into groups according to the material used; Mineral-Trioxide-Aggregate (MTA), Biodentine, TotalFill. Teeth filled with guttapercha (GP) and intact teeth served as controls. All teeth subjected to an increasing compressive force (rate of 0.05 mm/s at a 45° angle to the long axis of the tooth) until fracture. All treated teeth exhibited significantly lower resistance to fracture compared to the intact teeth but no difference was found between the TSC groups (Kruskal-Wallis, Dunn’s multiple comparison, p < .05). TSCs applied at the cervical area of simulated immature teeth treated with REP did not reinforce fracture resistance.

关键词

bovine teeth;TotalFill;Biodentine;MTA;Fracture resistance

授权许可

© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

图表

Flow-chart showing teeth preparation. Bovine incisors were first sectioned to standard a certain crown/root ratio (a). Canals were thereafter prepared to simulate immature teeth (b). These teeth were divided to groups (1–4) according to the filling material used (1: MTA, 2: Biodentine, 3: TotalFill, 4: Gutta-percha). Some sectioned teeth, remained unprepared and served as controls (group 5).

The simulated immature teeth (groups 1–4, n = 41) had a statistically significant larger canal diameter (2,153 ± 0,07 mm) and lower dentin thickness measured at the CEJ (1,857 ± 0,027 mm) compared to the intact teeth (1,780 ± 0,13 mm and 2,704 ± 0,098 mm, respectively) (group 5, n = 10); Results are presented as mean ± SEM, Mann-Whitney test, *p < 0.05; ***p < 0.001.

Typical fracture pattern of the immature teeth under the fracture test. (a) and (b): Biodentine group; (c) and (d): Gutta-percha group; (e) and (f): Intact teeth group. The diagonal fracture line extends from the buccal aspect through the canal to the lingual aspect of the tooth. The treated immature teeth fractured at the interface between the material plug/or gutta-percha and composite filling (a-d). The fracture line of the intact teeth is mainly located within the crown (e-f). Lingual aspects: (a), (c) and (e); Lateral aspects: (b), (d) and (f). (×1 Magnification).

Intact teeth showed a significantly higher peak load to fracture in comparison to the other four groups (1669 ± 60.77 N). Simulated immature teeth filled with gutta-percha showed the lowest peak load to fracture (GP: 675.8 ± 86.84 N). Simulated immature teeth filled with TotalFill showed a higher peak load to fracture (804.5 ± 147.8 N) compared to the other TSCs (MTA: 724.2 ± 128.2 N and Biodentine: 779.4 ± 104.7 N). However, there was no statistically significant difference between the simulated immature teeth regardless of the material. Results are presented as mean ± SEM, Kruskal-Wallis test with Dunn’s multiple comparison, *p < 0.05; **p < 0.01.

通讯作者

Athanasia Bletsa.Department of Clinical Dentistry Faculty of Medicine, University of Bergen, Bergen, Norway;Oral Health Centre of Expertise in Western Norway, Bergen, Norwa.Nancy.Bletsa@uib.no

推荐引用方式

Mohamed Raouf W. Ali,Manal Mustafa,Asgeir Bårdsen,Athanasia Bletsa. Fracture resistance of simulated immature teeth treated with a regenerative endodontic protocol. Acta Biomaterialia Odontologica Scandinavica ,Vol.5, Issue 1(2019)

您觉得这篇文章对您有帮助吗?
分享和收藏
0

是否收藏?

参考文献
[1] JO Andreasen, EC Munksgaard et al.. Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dent Traumatol. 2006;22:154–156.
[2] M Torabinejad, M Parirokh. Mineral trioxide aggregate: a comprehensive literature review–part II: leakage and biocompatibility investigations. J Endod. 2010;36:190–202.
[3] RG Cauwels, LV Lassila et al. Fracture resistance of endodontically restored, weakened incisors. Dent Traumatol. 2014;30:348–355.
[4] U Glendor. Epidemiology of traumatic dental injuries-a 12 year review of the literature. Dent Traumatol. 2008;24:603–611.
[5] MC Valera, MT Albuquerque et al. Fracture resistance of weakened bovine teeth after long-term use of calcium hydroxide. Dent Traumatol. 2015;31:385–389.
[6] M Cvek. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Dent Traumatol. 1992;8:45–55.
[7] VG Clavijo, JM Reis et al. Fracture strength of flared bovine roots restored with different intraradicular posts. J Appl Oral Sci. 2009;17:574–578.
[8] JO Andreasen, B Farik et al.. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18:134–137.
[9] CF Moorrees, AM Gron et al. Growth studies of the dentition: a review. Am J Orthod. 1969;55:600–616.
[10] LV Zogheib, JR Pereira et al. Fracture resistance of weakened roots restored with composite resin and glass fiber post. Braz Dent J. 2008;19:329–333.
[11] GR Lawley, WG Schindler et al. Evaluation of ultrasonically placed MTA and fracture resistance with intracanal composite resin in a model of apexification. J Endod. 2004;30:167–172.
[12] N Katebzadeh, BC Dalton et al.. Strengthening immature teeth during and after apexification. J Endod. 1998;24:256–259.
[13] M Karapinar-Kazandag, B Basrani et al. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol. 2016;32:146–152.
[14] CF Moorrees, EA Fanning et al. Age variation of formation stages for ten permanent teeth. J Dent Res. 1963;42:1490–1502.
[15] JO Andreasen, HU Paulsen et al. A long-term study of 370 autotransplanted premolars. Part IV. Root development subsequent to transplantation. Eur J Orthod. 1990;12:38–50.
[16] D Felman, P Parashos. Coronal tooth discoloration and white mineral trioxide aggregate. J Endod. 2013;39:484–487.
[17] S Hatibovic-Kofman, L Raimundo et al. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate. Dent Traumatol. 2008;24:272–276.
[18] A Baron, K Lindsey et al. Effect of a Benzalkonium chloride surfactant-sodium hypochlorite combination on elimination of enterococcus faecalis. J Endod. 2016;42:145–149.
[19] AS Law. Considerations for regeneration procedures. J Endod. 2013;39:S44–S56.
[20] JS Rees. An investigation into the importance of the periodontal ligament and alveolar bone as supporting structures in finite element studies. J Oral Rehabil. 2001;28:425–432.
[21] KM Hargreaves, A Diogenes et al.. Treatment options: biological basis of regenerative endodontic procedures. J Endod. 2013;39:S30–S43.
[22] H Hemalatha, M Sandeep et al. Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements–an in vitro study. Dent Traumatol. 2009;25:433–438.
[23] PE Murray, F Garcia-Godoy et al.. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33:377–390.
[24] M Brito-Junior, RD Pereira et al. Fracture resistance and stress distribution of simulated immature teeth after apexification with mineral trioxide aggregate. Int Endod J. 2014;47:958–966.
[25] EA Bortoluzzi, EM Souza et al. Fracture strength of bovine incisors after intra-radicular treatment with MTA in an experimental immature tooth model. Int Endod J. 2007;40:684–691.
[26] G Sivieri-Araujo, M Tanomaru-Filho et al. Fracture resistance of simulated immature teeth after different intra-radicular treatments. Braz Dent J. 2015;26:211–215.
[27] KD Jamani, E Harrington et al.. Rigidity of elastomeric impression materials. J Oral Rehabil. 1989;16:241–248.
[28] CH Stuart, SA Schwartz et al.. Reinforcement of immature roots with a new resin filling material. J Endod. 2006;32:350–353.
[29] A Diogenes, NB Ruparel. Regenerative endodontic procedures: Clinical outcomes. Dent Clin North Am. 2017;61:111–125.
[30] CJ Soares, LM Barbosa et al. Fracture strength of composite fixed partial denture using bovine teeth as a substitute for human teeth with or without fiber-reinforcement. Braz Dent J. 2010;21:235–240.
[31] JD White, WR Lacefield et al. The effect of three commonly used endodontic materials on the strength and hardness of root dentin. J Endod. 2002;28:828–830.
[32] RG Cauwels, IY Pieters et al. Fracture resistance and reinforcement of immature roots with gutta percha, mineral trioxide aggregate and calcium phosphate bone cement: a standardized in vitro model. Dent Traumatol. 2010;26:137–142.
[33] WA Saupe, AH Gluskin et al.. Jr. A comparative study of fracture resistance between morphologic dowel and cores and a resin-reinforced dowel system in the intraradicular restoration of structurally compromised roots. Quintessence Int. 1996;27:483–491.
[34] CJ Soares, ECG Pizi et al. Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res. 2005;19:11–16.
[35] N Yoshida, Y Koga et al. In vivo measurement of the elastic modulus of the human periodontal ligament. Med Eng Phys. 2001;23:567–572.
[36] EB Tuna, ME Dincol et al. Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide. Dent Traumatol. 2011;27:174–178.
[37] H Sano, B Ciucchi et al. Tensile properties of mineralized and demineralized human and bovine dentin. J Dent Res. 1994;73:1205–1211.
[38] RB Fonseca, F Haiter-Neto et al. Radiodensity and hardness of enamel and dentin of human and bovine teeth, varying bovine teeth age. Arch Oral Biol. 2008;53:1023–1029.
[39] SJ Schmoldt, TC Kirkpatrick et al. Reinforcement of simulated immature roots restored with composite resin, mineral trioxide aggregate, gutta-percha, or a fiber post after thermocycling. J Endod. 2011;37:1390–1393.
[40] KM Galler, G Krastl et al. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016;49:717–723.
[41] CAT Carvalho, MC Valera et al. Structural resistance in immature teeth using root reinforcements in vitro. Dent Traumatol. 2005;21:155–159.
[42] AN Sawyer, SY Nikonov et al. Effects of calcium silicate-based materials on the flexural properties of dentin. J Endod. 2012;38:680–683.
[43] KM Galler. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J. 2016;49:926–936.