The Effect of Two Calcium Silicate Materials on the Fracture Strength of Simulated Immature Teeth during Regenerative Endodontic Treatment

BACKGROUND Necrotic immature permanent teeth undergoing Regenerative Endodontic Treatment (RET) are subjected to functional forces that might lead to their fracture before achieving apical closure. This study compared the fracture strength of simulated immature teeth treated with RET that were subjected to cyclic loading. METHODS Thirty human anterior teeth were randomly assigned into three groups (Group I: control, groups II and III: prepared to simulate immature teeth then subjected to RET with EndoSequence Root Repair Material (ESRRM) and white Mineral Trioxide Aggregate (WMTA) used as coronal barriers, respectively). All specimens were mounted on customized mold and subjected to cyclic loading until fracture or to a maximum of 165,000 cycles. The number of endured cycles and the maximum load applied at failure were recorded. Chi-square analysis was done to compare the frequency of fracture while One - Way ANOVA followed by Tukey’s Post Hoc test were done to compare means for the number of endured cycles and the maximum load applied to failure. RESULTS There was no significant difference between the three groups regarding the frequency of fracture (P > 0.05). There was no significant difference between the mean number of cycles endured or force at failure between group I and II or groups II and III (P > 0.05). However, group III endured significantly less force (P= 0.008) and significantly lower number of cycles (P = 0.014) compared to group I. CONCLUSIONS Within the limitation of this study, there was no significant difference between ESRRM and WMTA regarding their reinforcement of teeth treated with RET. KEY WORDS EndoSequence Root Repair Material, Fracture Strength, Immature Teeth, Mineral Trioxide Aggregate, Regeneration

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Fracture resistance of immature teeth filled with mineral trioxide aggregate, bioaggregate, and biodentine

European Journal of Dentistry ◽

10.4103/1305-7456.178310 ◽

2016 ◽

Vol 10 (02) ◽

pp. 220-224 ◽

Cited By ~ 6

Author(s):

Emre Bayram ◽

Huda Melike Bayram

Keyword(s):

Fracture Resistance ◽

Mineral Trioxide Aggregate ◽

Mean Values ◽

Root Canals ◽

Immature Teeth ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Post Hoc ◽

Group 1

ABSTRACT Objective: The purpose of this study was to evaluate fracture resistance of teeth with immature apices treated with coronal placement of mineral trioxide aggregate (MTA), bioaggregate (BA), and Biodentine. Materials and Methods: Forty-one freshly extracted, single-rooted human premolar teeth were used for the study. At first, the root length was standardized to 9 mm. The crown-down technique was used for the preparation of the root canals using the rotary ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland) of F3 (30). Peeso reamer no. 6 was stepped out from the apex to simulate an incompletely formed root. The prepared roots were randomly assigned to one control (n = 5) and three experimental (n = 12) groups, as described below. Group 1: White MTA (Angelus, Londrina, Brazil) was prepared as per the manufacturer's instructions and compacted into the root canal using MAP system (Dentsply Maillefer, Ballaigues, Switzerland) and condensed by pluggers (Angelus, Londrina, Brazil). Group 2: The canals were filled with DiaRoot-BA (DiaDent Group International, Canada). Group 3: Biodentine (Septodont, Saint Maur des Fosses, France) solution was mixed with the capsule powder and condensed using pluggers. Instron was used to determine the maximum horizontal load to fracture the tooth, placing the tip 3 mm incisal to the cementoenamel junction. Mean values of the fracture strength were compared by ANOVA followed by a post hoc test. P < 0.05 was considered statistically significant. Results: No significant difference was observed among the MTA, BA, and biodentine experimental groups. Conclusion: All the three materials tested, may be used as effective strengthening agents for immature teeth.

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In vitro Comparative Evaluation of the Fracture Resistance of Simulated Immature Teeth reinforced with Different Apical Barriers and Obturation Combination

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1377 ◽

2016 ◽

Vol 7 (3) ◽

pp. 113-118

Author(s):

Neveen A Shaheen ◽

Nahla G El-Din El-Helbawy

Keyword(s):

Fracture Resistance ◽

Comparative Evaluation ◽

Negative Control ◽

Control Group ◽

Root Canals ◽

Immature Teeth ◽

Gutta Percha ◽

Group I ◽

Significant Difference

ABSTRACT Aim This study aimed to assess and compare the fracture resistance of simulated immature teeth reinforced with Biodentine (BD) and mineral trioxide aggregate (MTA) as apical barriers and two root canal backfilling combination (gutta-percha/AH26, MetaSeal). Materials and methods A total of 70 extracted human maxillary incisors were randomly divided into seven groups (n = 10). The positive control group was not instrumented. For the other groups, coronal access was made and root canals were instrumented using the ProTaper, up to F5 followed by six Peeso reamers which were allowed to pass 1 mm beyond the apex to size 6 (1.7 mm) to simulate immature teeth. The apical 4 mm of their root canals was filled with either MTA or BD apical barrier, then backfilled with gutta-percha/AH26 or MetaSeal obturation combination. The negative control group was left unfilled. Composite resin was used to restore the coronal access cavities. The maximum load for fracture of each tooth was recorded utilizing a universal testing machine. Data were analyzed using two-way analysis of variance. Results The noninstrumented group I had the highest fracture resistance and differed significantly (p < 0.05) from the negative control groups. On the contrary, no significant difference was found between BD and MTA groups, regardless of the backfilling combination (p > 0.05). Conclusion There was no difference between MTA and BD apical barriers and the backfilling combination regarding their resistance to root fracture. How to cite this article Shaheen NA, El-Din El-Helbawy NG. In vitro Comparative Evaluation of the Fracture Resistance of Simulated Immature Teeth reinforced with Different Apical Barriers and Obturation Combination. World J Dent 2016;7(3):113-118.

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An in vitro comparative Evaluation of Fracture Strength of Roots Instrumentated with Self-adjusting File and Reciproc Reciprocating File, with and without Obturation

10.5005/jp-journals-10060-0005 ◽

2017 ◽

Vol 1 (1) ◽

pp. 20-25

Author(s):

Pooja Kabra

Keyword(s):

Fracture Strength ◽

Comparative Evaluation ◽

Group Iv ◽

Control Group ◽

Group V ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Group Ii

ABSTRACT Aim The purpose of this study was to evaluate the fracture strength of roots instrumented with the self-adjusting file (SAF; ReDent-Nova, Ra'anana, Israel) and the Reciproc reciprocating file and that were and were not obturated using the warm vertical lateral compaction technique. Materials and methods In total, 75 mandibular premolar teeth were sectioned at or below the cementoenamel junction to obtain roots 13 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameters and weight. They were distributed into four experimental groups and one control group (n = 15): No instrumentation (group I), instrumentation with SAF files but no obturation (group II), instrumentation with SAF files and obturated with warm vertical lateral compaction (group III), instrumentation with Reciproc File but no obturation (group IV), and instrumentation with Reciproc File and obturated with warm vertical lateral compaction (group V). AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) was used along with gutta-percha points. One week later, a vertical load was applied to the specimen's canal until fracture occurred. Data were statistically analyzed using one-way analysis of variance (p = 0.05). Results The mean fracture load was 312.83 N for group I, 297.35 N for group II, 359.15 N for group III, 231.51 N for group IV, and 275.81 N for group V. Conclusion The fracture resistances exhibited a statistically significant difference between all the groups. Teeth instrumented by SAF exhibited a better fracture resistance. How to cite this article Tyagi S, Choudhary E, Kabra P, Chauhan R. An in vitro comparative Evaluation of Fracture Strength of Roots Instrumentated with Self-adjusting File and Reciproc Reciprocating File, with and without Obturation. Int J Clin Dent Res 2017;1(1):20-25.

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Antibacterial Effect of New Bioceramic Pulp Capping Material on the Main Cariogenic Bacteria

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1854 ◽

2016 ◽

Vol 17 (5) ◽

pp. 349-353 ◽

Cited By ~ 6

Author(s):

Fahiem MM Elshamy ◽

Husham Elraih ◽

Iti Gupta ◽

Faisal AI Idris

Keyword(s):

Antibacterial Activity ◽

Antibacterial Effect ◽

Antibacterial Properties ◽

Mineral Trioxide Aggregate ◽

Mutans Streptococci ◽

Repair Material ◽

Cariogenic Bacteria ◽

Pulp Capping ◽

Root Repair ◽

Significant Difference

ABSTRACT Background The purpose of this research was to assess the antibacterial activity of a new bioceramic pulp capping material (endosequence root repair material [ERRM]) against the main cariogenic bacteria: Salivary mutans streptococci (MS) and lactobacilli and compare the results with mineral trioxide aggregate (MTA) and calcium hydroxide (Dycal). Materials and methods The isolation of MS group bacteria and Lactobacillus (LB) spp. from stimulated saliva was performed with in-office caries risk test bacteria dip slide test. Endosequence root repair material, MTA (ProRoot MTA), and Dycal were used as pulp capping materials. Mutans Streptococci and LB were scattered on the agar dishes with a swab. The pulp capping materials under study were placed in the wells and prepared in the agar, immediately after mixing. The dishes were incubated for 24 hours at 37°C. The growth inhibition zones were recorded and compared for every material and bacterial strain. One-way analysis of variance test was done to compare the development of growth inhibition of selected bacteria against testing materials. Post hoc Tukey honest significant difference was conducted to compare each material group. Results All the three selected pulp capping materials were found to inhibit the bacteria LB and MS. The antibacterial activity of ERRM and ProRoot MTA was significantly better than the Dycal. Against MS, ERRM and MTA showed no statistically significant difference. Mineral trioxide aggregate showed significantly better inhibitory activity against LB. Conclusion Endosequence root repair material and MTA had superior antibacterial properties against the main cariogenic bacteria: MS and LB compared with Dycal. Clinical significance A pulp-capping agent having good antibacterial properties can have better success rate in maintaining the vitality of the tooth while treating deep carious lesions in patients. How to cite this article Elshamy FMM, Singh G, Elraih H, Gupta I, AI Idris F. Antibacterial Effect of New Bioceramic Pulp Capping Material on the Main Cariogenic Bacteria. J Contemp Dent Pract 2016;17(5):349-353.

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Biocompatibility of NeoMTA Plus® versus MTA Angelus as delayed furcation perforation repair materials in a dog model

BMC Oral Health ◽

10.1186/s12903-021-01552-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Khaled M. Abboud ◽

Ashraf M. Abu-Seida ◽

Ehab E. Hassanien ◽

Hossam M. Tawfik

Keyword(s):

Cell Count ◽

Inflammatory Cell ◽

Fibrous Tissue ◽

Mineral Trioxide Aggregate ◽

Control Group ◽

Filling Material ◽

Group I ◽

Repair Materials ◽

Significant Difference ◽

Group Ii

Abstract Background The biocompatibility of NeoMTA Plus® (Avlon BioMed Inc., Bradenton, Fl) as a furcal perforation repair material is not fully understood. This study compares the biocompatibility of Mineral Trioxide Aggregate (MTA Angelus) and NeoMTA Plus® as delayed furcation perforation repair materials. Methods Pulpotomy and root canal obturation were performed in 72 premolars in six mongrel dogs and then a standardized furcal perforation was performed. The coronal access was left open for three weeks. After curetting, cleaning and drying of the perforations, these teeth were divided into three equal groups (N = 24 teeth/ 2 dogs each) according to the material used for perforation repair; group I: NeoMTA Plus®, group II: MTA Angelus and group III: no material (positive control). The coronal access cavities were sealed with a filling material. The inflammatory cell count and qualitative pathology (presence of calcific bridge, configuration of fibrous tissue formed, examination of tissue surrounding the furcation area, histology of intraradicular bone and the inflammatory nature of tissues) were carried out after one week (subgroup A, N = 8 teeth), one month (subgroup B, N = 8 teeth) and three months (subgroup C, N = 8 teeth). The inflammatory cell count was expressed as mean ± SD and statistically analyzed. P-value < 0.05 was considered significant. Results In all subgroups, the control group exhibited the highest number of inflammatory cell count, followed by MTA Angelus group and the least inflammatory cell count was shown by NeoMTA Plus® group. There was a significant difference in the inflammatory cell count between the NeoMTA Plus® and MTA Angelus after one week (P < 0.05) while no significant differences were recorded between them after one month and three months (P > 0.05). In contrast to group II, there was no significant differences in inflammatory cell count between the subgroups in groups I and III (P > 0.05). NeoMTA Plus® exhibited better qualitative pathological features than MTA Angelus after one week and nearly similar features after one month and three months of repair. Conclusion NeoMTA Plus® has a better early biocompatibility than MTA Angelus after one week of delayed furcation perforation repair and a similar late biocompatibility after one month and three months.

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Comparative Study of Sealing Ability of Different Filling Materials for Root End: An In Vitro Evaluation

Dental Journal of Advance Studies ◽

10.1055/s-0040-1716926 ◽

2020 ◽

Author(s):

Shagun Bhatia ◽

Ankush Jain ◽

Himanshu Sood ◽

Kanu Jain

Keyword(s):

Mineral Trioxide Aggregate ◽

Apical Region ◽

Filling Material ◽

Depth Of Penetration ◽

Sealing Ability ◽

India Ink ◽

Group I ◽

Retrograde Filling ◽

Significant Difference

Abstract Introduction Failure in surgical endodontic techniques can occur most commonly due to improper seal in the apical region. The root-end filling material used should not allow the contamination of the periapical tissue. The aim of the present study was to compare the ability of white mineral trioxide aggregate (MTA), white Portland cement (PC) and intermediate restorative material (IRM) for sealing root-end by dye leakage test. Materials and Methods 120 teeth with single root were prepared through instruments. Following obturation, the apex was cut, and a cavity was made. Then, the teeth were divided into four groups (Group I: MTA, Group II: white PC, Group III: IRM, Group IV: control). Cavities made at apex in the first three groups were then filled with the respective materials. Exposure to the dye, India Ink, was then done for a time period of 72 hours. The depth of penetration of dye inside the whole root was then evaluated with a magnification of 16X under stereomicroscope in vitro. Result MTA showed statistically significant difference in sealing ability (p < 0.05) as compared with other materials. Conclusion MTA cement showed better sealing ability. It is an ideal retrograde filling material, because it is a biocompatible material and has a good marginal adaptation as compared with PC which, in turn, showed better sealing ability than IRM.

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12-Year Follow-Up of Regenerative Endodontic Treatment of Immature Permanent Upper Incisors with Acute Abscess

Brazilian Dental Journal ◽

10.1590/0103-6440202003663 ◽

2020 ◽

Vol 31 (6) ◽

pp. 680-684

Author(s):

Claudio Maniglia-Ferreira ◽

Eduardo Diogo Gurgel Filho ◽

Fabio de Almeida Gomes ◽

Sthefanny Amaral Reis ◽

Fernanda Geraldo Pappen

Keyword(s):

Clinical Success ◽

Glass Ionomer Cement ◽

Mineral Trioxide Aggregate ◽

Endodontic Treatment ◽

Treatment Access ◽

Root Canals ◽

Immature Teeth ◽

The Right ◽

Regenerative Endodontic Treatment

Abstract This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.

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A Confocal Laser Scanning Microscopic Study Evaluating the Sealing Ability of Mineral Trioxide Aggregate, Biodentine and Anew Pulp Capping Agent-Theracal

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672009 ◽

2015 ◽

Vol 03 (01) ◽

pp. 020-025 ◽

Cited By ~ 3

Author(s):

Sameer Makkar ◽

Harpreet Kaur ◽

Anurag Aggarwal ◽

Ruchi Vashisht

Keyword(s):

Laser Scanning ◽

Mineral Trioxide Aggregate ◽

Confocal Laser Scanning ◽

Confocal Laser ◽

Capping Agent ◽

Capping Agents ◽

Pulp Capping ◽

Sealing Ability ◽

Group I ◽

Significant Difference

Abstract Aims and Objectives: Viability and health of the pulpal tissue after an exposure can be stimulated with biocompatible pulp capping materials. Mineral trioxide aggregate(MTA), though biocompatible with excellent sealing ability, has clinical disadvantages like poor handling properties and long setting time. New pulp capping agents- Biodentine and Theracal have proven to overcome MTA’s shortcomings. This study aimed to comparatively evaluate the sealing ability of Mineral Trioxide Aggregate(Angelus), Biodentine (Septodont) and Theracal(Bisco) when used as pulp capping agents. Materials and Methods: Occlusal cavities were prepared in extracted human third molars. The cavities were divided into 3 groups containing 12 samples each. Pulp capping in samples of group I, II and III was done with MTA, Biodentine and Theracal respectively. All samples were kept in a damp environment for 24 hrs. In each tooth, the root was cut just below the cementum-enamel junction. An aqueous 0.25% solution of Rhodamine-B was put in the open pulp chambers of all the samples and placed upside-down in a damp environment. The dye was left for 3 hrs to permeate toward the interface. After being stained, all samples were rinsed with distilled water and sectioned vertically. A Confocal Laser Scanning Microscope was used to image the samples. Results: No significant difference was found in interfacial microleakage between MTA and Biodentine. Theracal exhibited less interfacial microleakage than the two. Conclusion: Biodentine and MTA exhibit an efficient and durable protection of pulp. Theracal exhibits better sealing ability as a pulp capping agent than MTA and Biodentine.

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Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study

International Journal of Clinical Pediatric Dentistry ◽

10.5005/jp-journals-10005-1464 ◽

2017 ◽

Vol 10 (4) ◽

pp. 351-357

Author(s):

Murtuza S Zhabuawala

Keyword(s):

Calcium Silicate ◽

Fracture Resistance ◽

Composite Resin ◽

In Vitro Study ◽

Group Iii ◽

Immature Teeth ◽

Group I ◽

Significant Difference ◽

Reinforcing Effects

ABSTRACT Aim To evaluate the fracture resistance of simulated immature teeth with an apical plug of biodentine followed by composite resin vs total obturation with biodentine tested immediately and after 3 months of aging and also to find out the chemical composition of dentin in contact with these materials. Materials and methods Extracted human maxillary central incisors with simulated immature apex with radicular dentin thickness (RDT) of 1 to 1.5 mm selected and divided into three groups of 20 each. Group I (control)—4 mm biodentine apically and thermoplasticized gutta-percha. Group II—4 mm biodentine apically and composite resin. Group III—complete obturation with biodentine. About 10 samples from each group were tested immediately and remaining 10 stored in phosphate buffered solution (PBS) and tested after 3 months for fracture resistance and chemical analysis of dentin. Results No significant difference in fracture resistance between the groups was observed when tested immediately. After 3 months of aging, only biodentine group showed a significant reduction in fracture resistance with increased Ca/P ratio of root dentine. Conclusion Biodentine group has shown drastic reduction in fracture resistance after 3 months of aging, and hence, cannot be recommended as a reinforcement material in immature teeth with thin dentin walls. How to cite this article Zhabuawala MS, Nadig RR, Pai VS, Gowda Y, Aswathanarayana RM. Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study. Int J Clin Pediatr Dent 2017;10(4):351-357.

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