Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts.

BACKGROUND   The purpose of this study was to compare the fracture resistances of immature teeth treated with MTA along with root canal obturation methods using AH Plus, MetaSEAL, MTA Fillapex sealers + lateral compaction technique, and Unicore quartz fiber posts. MATERIALS AND METHODS   Fifty single-rooted maxillary anterior teeth were divided into five groups. The crowns were dissected and root canals were enlarged. #6 Peeso reamers were allowed to protrude 1 mm. beyond the apex to simulate immature teeth. The apical 4-5 mm of each tooth was filled using Angelus white MTA. The remaining portions of canals were obturated as follows: Group 1: No backfilling (control), Group 2: AH Plus + gutta-percha, lateral compaction, Group 3: MetaSEAL + gutta-percha, lateral compaction, Group 4: MTA Fillapex + gutta-percha, lateral compaction, Group 5: UniCore Fiber posts luted using PermaFlo DC. The specimens were embedded into self-curing acrylic poured into identical cylinders which were mounted on a jig providing a 45° angle. A compressive load increasing at 1 mm min(-1) was applied and the maximum load at which fracture occurred was recorded. Statistical analysis was performed using Kruskal-Wallis and Dunn's multiple tests. RESULTS   The highest fracture resistance was obtained with Group 5 (Fiber posts) whereas Group 4 (MTA Fillapex) yielded the lowest values. The mean fracture resistance value of Group 2 (AH Plus) was significantly higher than Group 4 (MTA Fillapex) (P = 0.001). The mean fracture value of Group 5 (Fiber posts) was significantly higher than Group 2 (AH Plus), Group 3 (MetaSEAL), and Group 4 (MTA Fillapex) (P = 0.02, 0.004, and 0.0001, respectively). CONCLUSION   Within the limitations of this study, UniCore quartz fiber posts provided the highest resistance. This methodology may specifically be advantageous for teeth with arrest of development at early stages, as these teeth are more susceptible to fracture owing to their excessively weak dentinal walls.

[1]  Y. Shigetani,et al.  Immunohistochemical analysis of subcutaneous tissue reactions to methacrylate resin-based root canal sealers. , 2011, International endodontic journal.

[2]  E. Tuna,et al.  Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide. , 2011, Dental traumatology : official publication of International Association for Dental Traumatology.

[3]  A. Nosrat,et al.  Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. , 2011, Journal of endodontics.

[4]  M. Gandolfi,et al.  Dynamic sealing ability of MTA root canal sealer. , 2011, International endodontic journal.

[5]  H. Ari,et al.  Sealing ability of Hybrid Root SEAL (MetaSEAL) in conjunction with different obturation techniques. , 2010, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[6]  R. Verbeeck,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. , 2010, Dental traumatology : official publication of International Association for Dental Traumatology.

[7]  M. Trope.  Treatment of the immature tooth with a non-vital pulp and apical periodontitis. , 2010, Dental clinics of North America.

[8]  J. Ferracane,et al.  Comparison of push-out bond strengths of Resilon with three different sealers. , 2010, Journal of endodontics.

[9]  N. Chandler,et al.  The restoration of permanent immature anterior teeth, root filled using MTA: a review. , 2009, Journal of dentistry.

[10]  S. Kulkarni,et al.  Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements--an in vitro study. , 2009, Dental traumatology : official publication of International Association for Dental Traumatology.

[11]  E. Ozcan,et al.  A comparative evaluation of sealing ability of a new, self-etching, dual-curable sealer: hybrid root SEAL (MetaSEAL). , 2008, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[12]  T. Oliveira,et al.  Mineral trioxide aggregate as an alternative treatment for intruded permanent teeth with root resorption and incomplete apex formation. , 2008, Dental traumatology : official publication of International Association for Dental Traumatology.

[13]  F. Tay,et al.  Resistance of a 4-META-containing, methacrylate-based sealer to dislocation in root canals. , 2008, Journal of endodontics.

[14]  M. Tanomaru-Filho,et al.  Fracture strength of bovine incisors after intra-radicular treatment with MTA in an experimental immature tooth model. , 2007, International endodontic journal.

[15]  R. Schwartz.  Adhesive dentistry and endodontics. Part 2: bonding in the root canal system-the promise and the problems: a review. , 2006, Journal of endodontics.

[16]  I. G. Moraes,et al.  Use of MTA and intracanal post reinforcement in a horizontally fractured tooth: a case report. , 2006, Dental traumatology : official publication of International Association for Dental Traumatology.

[17]  S. Schwartz,et al.  Reinforcement of immature roots with a new resin filling material. , 2006, Journal of endodontics.

[18]  Murilo Pereira de Melo,et al.  Evaluation of fracture resistance of endodontically treated teeth restored with prefabricated posts and composites with varying quantities of remaining coronal tooth structure. , 2005, Journal of applied oral science : revista FOB.

[19]  M. Valera,et al.  Structural resistance in immature teeth using root reinforcements in vitro. , 2005, Dental traumatology : official publication of International Association for Dental Traumatology.

[20]  M. Trope,et al.  Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? , 2004, Journal of endodontics.

[21]  D. Kolodrubetz,et al.  Evaluation of ultrasonically placed MTA and fracture resistance with intracanal composite resin in a model of apexification. , 2004, Journal of endodontics.

[22]  P. Planells,et al.  Treatment of a non-vital immature incisor with mineral trioxide aggregate (MTA). , 2003, Dental traumatology : official publication of International Association for Dental Traumatology.

[23]  J. Andreasen,et al.  Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. , 2002, Dental traumatology : official publication of International Association for Dental Traumatology.

[24]  D. Clement,et al.  Mineral trioxide aggregate: a new material for endodontics. , 1999, Journal of the American Dental Association.

[25]  M. Torabinejad,et al.  Cytotoxicity of four root end filling materials. , 1995, Journal of endodontics.

[26]  M. Torabinejad,et al.  Comparative investigation of marginal adaptation of mineral trioxide aggregate and other commonly used root-end filling materials. , 1995, Journal of endodontics.

[27]  M. Cvek.  Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. , 1992, Endodontics & dental traumatology.

[28]  L. Tronstad,et al.  Resistance to fracture of restored endodontically treated teeth. , 1985, Endodontics & dental traumatology.