The long-term effect of calcium hydroxide application on dentin fracture strength of endodontically treated teeth.

OBJECTIVE The aim of this in vitro study was to evaluate the long-term effect of calcium hydroxide (CH) on the microtensile fracture strength (MTFS) of endodontically treated human teeth. MATERIALS AND METHODS A total of 105 caries-free extracted human mandibular incisors were used. The teeth were divided into seven experimental groups of 15 teeth each. The root canals of all the teeth were rotary instrumented. The teeth in the control group were immediately obturated and tested for MTFS. The rest of the teeth were vertically compacted with CH and a sterile saline solution mixture and sealed with temporary filling. The teeth were stored in a moist environment for 30, 90, 180, 270, 360, and 540 days. On scheduled dates, the root canals were obturated and then the teeth were tested for MTFS with an Instron testing machine. The Kruscal-Wallis test and a post hoc Dunn's multiple comparison test was utilized. The statistical significance level was established at P < 0.05. RESULTS The introduction of CH into the root canals seems to decrease the MTFS of teeth statistically significantly through the 180th, 270th, 360th, and 540th days, respectively, compared with the control group. The results clearly indicated that there are statistically significant differences between group 2 and group 7 (P < 0.001) and between group 3 and group 7 (P < 0.05). There were no statistically significant differences between the rest of the groups (P > 0.05). CONCLUSIONS The results indicate that long-term CH treatments can significantly reduce the strength of the teeth, causing an increase in fracture risk.

[1]  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.

[2]  C. Sedgley,et al.  Effects of intracanal mineral trioxide aggregate and calcium hydroxide during four weeks on pH changes in simulated root surface resorption defects: an in vitro study using matched pairs of human teeth. , 2011, Journal of endodontics.

[3]  Brett Rosenberg,et al.  The effect of calcium hydroxide root filling on dentin fracture strength. , 2007, Dental traumatology : official publication of International Association for Dental Traumatology.

[4]  J. Andreasen,et al.  Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. , 2006, Dental traumatology : official publication of International Association for Dental Traumatology.

[5]  J. Hellstein,et al.  A quantitative assessment of efficacy of various calcium hydroxide removal techniques. , 2006, Journal of endodontics.

[6]  D. Ørstavik,et al.  Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing. , 2005, Journal of endodontics.

[7]  C. Stavrianos,et al.  The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: an in vitro study. , 2004, Journal of endodontics.

[8]  D. Millett,et al.  Resin-modified glass ionomer, modified composite or conventional glass ionomer for band cementation?--an in vitro evaluation. , 2003, European journal of orthodontics.

[9]  P. Eleazer,et al.  The effect of three commonly used endodontic materials on the strength and hardness of root dentin. , 2002, Journal of endodontics.

[10]  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.

[11]  P. Hörsted-Bindslev,et al.  A laboratory study evaluating the release of hydroxyl ions from various calcium hydroxide products in narrow root canal-like tubes. , 2000, International endodontic journal.

[12]  M. Torabinejad,et al.  Treatment of teeth with open apices using mineral trioxide aggregate. , 2000, Practical periodontics and aesthetic dentistry : PPAD.

[13]  J. Siqueira,et al.  Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. , 1999, International endodontic journal.

[14]  Z. Fuss,et al.  Prevalence of vertical root fractures in extracted endodontically treated teeth. , 1999, International endodontic journal.

[15]  J. Palamara,et al.  Load and strain during lateral condensation and vertical root fracture. , 1999, Journal of endodontics.

[16]  M. Torabinejad,et al.  A comparative study of root-end induction using osteogenic protein-1, calcium hydroxide, and mineral trioxide aggregate in dogs. , 1999, Journal of endodontics.

[17]  J F Siqueira,et al.  Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria. , 1996, Journal of endodontics.

[18]  D. Pashley,et al.  Relationship between surface area for adhesion and tensile bond strength--evaluation of a micro-tensile bond test. , 1994, Dental materials : official publication of the Academy of Dental Materials.

[19]  M. Iwaku,et al.  Histological observations of hard tissue barrier formation in amputated dental pulp capped with alpha-tricalcium phosphate containing calcium hydroxide. , 1994, Endodontics & dental traumatology.

[20]  K. Safavi,et al.  Effect of calcium hydroxide on bacterial lipopolysaccharide. , 1993, Journal of endodontics.

[21]  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.

[22]  T. Bayer,et al.  Prognosis of root-fractured permanent incisors--prediction of healing modalities. , 1989, Endodontics & dental traumatology.

[23]  L. Tronstad,et al.  Root resorption--etiology, terminology and clinical manifestations. , 1988, Endodontics & dental traumatology.

[24]  H. Worthington,et al.  The closure of open apices in non-vital immature incisor teeth , 1988, British Dental Journal.

[25]  R. Holland,et al.  Ability of a new calcium hydroxide root canal filling material to induce hard tissue formation. , 1985, Journal of endodontics.

[26]  F. J. Fisher,et al.  Calcium hydroxide base materials. An investigation into the relationship between chemical structure and antibacterial properties , 1978, British Dental Journal.

[27]  G. Heithersay,et al.  Calcium hydroxide in the treatment of pulpless teeth with associated pathology. , 1975, Journal of the British Endodontic Society.

[28]  A. L. Frank,et al.  Nonsurgical therapy for the perforative defect of internal resorption. , 1973, Journal of the American Dental Association.

[29]  M. Cvek Treatment of non-vital permanent incisors with calcium hydroxide. II. Effect on external root resorption in luxated teeth compared with effect of root filling with guttapucha. A follow-up. , 1973, Odontologisk revy.

[30]  G. D. Kennedy,et al.  The hollow tube controversy. , 1969, Journal of the British Endodontic Society.

[31]  A. L. Frank,et al.  Therapy for the divergent pulpless tooth by continued apical formation. , 1966, Journal of the American Dental Association.