Comparative evaluation of fracture resistance of simulated immature teeth and its effect on single visit apexification versus complete obturation using MTA and biodentine

Darak, Pawan; Likhitkar, Manoj; Goenka, Shachi; Kumar, Abhinav; Madale, Priyanka; Kelode, Ashwini

doi:10.4103/jfmpc.jfmpc_1145_19

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…In the present study, the effect of type and thickness of apical plug materials (MTA vs CEM/ 3 mm vs 5 mm) on fracture resistance of endodontically treated immature teeth restored with cast metal posts was assessed. Several studies have shown that a full canal obturation or an apical plugging by bio-ceramics, increases the fracture resistance of either mature or simulated immature teeth compared to the roots which were instrumented but were not filled, or were filled only with gutta-percha and sealer [ 8 , 39 , 40 ]. Full canal obturation by bio-ceramics is not indicated when placement of an endodontic post is the treatment plan, because further removal of the material for post-space preparation might not be easy [ 41 ], and also the material is more expensive than gutta-percha and sealer.…”

Section: Discussionmentioning

confidence: 99%

Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

et al. 2021

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Background Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different apical plug materials (MTA and Calcium enriched mixture cement) at varied thicknesses on fracture resistance of teeth restored with cast metal posts. Methods A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups (n = 8) according to apical plug (control group: No plug, group MTA5: 5 mm MTA plug, group CEM5: 5 mm CEM plug, group MTA3: 3 mm MTA plug, group CEM3: 3 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using One-way ANOVA and Dunnett’s T3 tests with significance level at P value < 0.05. Results The analysis showed a significant difference of fracture resistance between groups (P value < 0.05). The mean fracture resistance of samples in control group was significantly lower than MTA5 (P value = 0.003). There was no significant difference between other groups (P value > 0.05). Conclusions Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 3 mm MTA apical plug or either 3 or 5 mm CEM apical plug.

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Section: Discussionmentioning

confidence: 99%

Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

et al. 2021

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“…But researcher only looked at one study in which CHPP tips were used on a tooth for 24 months, and the tooth's apex closed. Due to this, the two authors cited below, Tirmazi and Darak reported that clinical studies are needed with a larger sample size and a longer follow-up time [12,13]. Ulusoy explored whether bone repair and reabsorption of MTA could occur after MTA was released from periradicular tissues, or if MTA could remain inactive and obstruct the healing process.…”

Section: Resultsmentioning

confidence: 99%

Comparison between Calcium Hydroxide and MTA When Used for Apexification: A Systematic Review

Alyahya¹,

AlMuhaya²,

Alqahtani³

et al. 2022

Pharmacophore

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Apexification is a way to treat young permanent teeth whose roots have stopped growing and developing because the pulp has died. Its goal is to make the root end close without the canal wall getting thicker or the root getting longer. There are two ways to do it: first, with a lengthy operation that employs a calcium hydroxide dressing to allow the body to produce a strong tissue barrier; or second, with a recent short-term procedure that creates an artificial plug at the top of the tooth using MTA or similar bioceramic material. Using the PubMed, Medline, and ScienceDirect databases, a thorough evaluation of the literature spanning 2010 to 2022 was conducted. "Calcium hydroxide," "MTA," and "apexification" were the keywords utilized. The selection of the searched articles was further explained using the PRISMA flowchart. The quality of the included studies was evaluated using the Cochrane risk of bias assessment technique. A total of 7 studies were included in this systematic review, out of which all studies concluded that MTA was a better choice for apexification as compared to calcium hydroxide. MTA was found to be superior to conduct the procedure of apexification successfully as compared to calcium hydroxide. Therefore, it can be used as a material of choice by endodontists in their practice.

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“…Several studies have shown that a full canal obturation or an apical plugging by bio-ceramics, increases the fracture resistance of either mature or simulated immature teeth compared to the roots which were instrumented but were not lled, or were lled only with gutta-percha and sealer. (8,19,20) Full canal obturation by bio-ceramics is not indicated when placement of an endodontic post is the treatment plan, because further removal of the material for post-space preparation might not be easy (21), and also the material is more expensive than gutta-percha and sealer. Therefore, in such cases, MTA or CEM are used as apical plugs and the rest of the root canal is lled with gutta-percha and sealer.…”

Section: Resultsmentioning

confidence: 99%

MTA versus CEM root-end fillings effect on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

Grayli¹,

Dashtban²,

Shadan³

et al. 2021

Preprint

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Background: Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different root-end filling materials (MTA and CEM) on fracture resistance of teeth restored with cast metal posts.Methods: A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups according to apical plug (Group 1: No plug, Group 2: 5 mm MTA plug, Group 3: 5 mm CEM plug, Group 4: 2 mm MTA plug, Group 5: 2 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using SPSS 16.0 with significance level at P value < 0.05. Results The analysis showed a significant difference of fracture resistance between groups (p-value<0.05). The mean fracture resistance of samples in group 1 was significantly lower than group 2 (p-value=0.003). there was no significant difference between other groups (p-value>0.05).Conclusions: Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 2 mm MTA apical plug or either 2 or 5 mm CEM apical plug.

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Comparative evaluation of fracture resistance of simulated immature teeth and its effect on single visit apexification versus complete obturation using MTA and biodentine

Cited by 11 publications

References 20 publications

Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

Comparison between Calcium Hydroxide and MTA When Used for Apexification: A Systematic Review

MTA versus CEM root-end fillings effect on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

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