Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Root Reinforcement with an Injectable Pozzolan Based Sealer in Combination with RetroMTA® in Simulated Immature Roots
Bir Enjektabl Pozzolan Bazlı Kanal Patının RetroMTA® ile Kombinasyonu ile Kö̈k Güçlendı̇rilmesi
Gülter Devrim KAKIa, Tuğrul ASLANb
aUşak University Faculty of Dentistry, Department of Endodontics, Uşak, TURKEY
bErciyes University Faculty of Dentistry, Department of Endodontics, Kayseri, TURKEY
Turkiye Klinikleri J Dental Sci. 2020;26(3):378-83
doi: 10.5336/dentalsci.2019-71582
Article Language: EN
Full Text
ABSTRACT
Objective: The aim of this study was to evaluate the effect of an injectable pozzolan-based root canal sealer in combination with RetroMTA on fracture resistance of simulated immature teeth. Material and Methods: Fifty-five mandibular premolars were used. Roots were cut from the cemento-enamel junction and Access cavities were prepared. Working lengths were determined and the canals were instrumented using Reciproc system up to R40 instrument. Peeso reamers (No. 1-6) were used, and the Peeso reamer no. 6 was stepped out from the apex to simulate an incompletely formed root. Specimens were distributed into five groups according to the filling techniques (n=11): Group 1: Negative control, Group 2: EndoSeal MTA, Group 3: RetroMTA, Group 4: Apical plug with RetroMTA + backfill with EndoSeal MTA, Group 5: Apical plug with RetroMTA + backfill with thermoplasticized gutta-percha and EndoSeal MTA. All roots were embedded in the acrylic blocks. A vertical fracture compression test was applied with a universal testing machine at a crosshead speed of 1 mm/min. The fracture loads were recorded for each tooth, and statistical interpretations were made by using SPSS 20.0 (α=0.05). Results: There are statistically significant differences among the groups (p<0.05). The mean values of Group 2 showed the highest results (835±278.53 N). The lowest mean values were in Group 1 (507.663±151.732 N). Conclusions: Considering the results of our study, it can be said that filling the root canals with MTA products in immature teeth contributes positively to the fracture resistance of the roots.

Keywords: MTA; tooth fracture; simulated immature teeth; endodontics
ÖZET
Amaç: Bu çalışmanın amacı, enjekte edilebilir bir pozzolan bazlı kök kanal patının, RetroMTA ile kombinasyon halinde simüle edilmiş apeksi açık dişlerin kırılma direncine etkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmamızda 55 alt küçük azı diş kullanıldı. Dişlerin kronları ve kökleri mine sement birleşiminden ayrıldı ve kök kanal boşlukları şekillendirildi. Çalışma uzunlukları belirlenmiş ve kanallar Reciproc sistemi kullanılarak R40 alete kadar genişletildi. Apeksi açık dişleri simüle edebilmek için, Peeso no.6 ile köklerin dışına çıkıldı. Örnekler, doldurma tekniklerine göre beş gruba dağıtıldı (n = 11): Grup 1: Negatif kontrol, Grup 2: EndoSeal MTA, Grup 3: RetroMTA, Grup 4: RetroMTA+Apikal dolgu, EndoSeal MTA, Grup 5: Termoplastik gutta-percha ve EndoSeal MTA ile RetroMTA + apikal dolgu. Tüm kökler akrilik bloklara gömüldü. Üniversal test cihazı ile 1 mm /dak hızında kompresyon kırma testi uygulandı. Her diş için kırılma yükleri kaydedildi ve SPSS 20,0 (α=0,05) kullanılarak istatistiksel analizler yapıldı. Bulgular: Gruplar arasında istatistiksel olarak anlamlı farklılık olduğu tespit edildi (p<0,05). Grup 2'nin ortalama değerleri en yüksek sonuçları gösterdi (835±278,53 N). En düşük ortalama değerler Grup 1'de tespit edildi (507,663±151,732 N). Sonuç: Çalışmamızın sonuçları göz önüne alındığında immatür dişlerde kök kanallarının MTA içerikli ürünlerle doldurulmasının köklerin kırılma direncine olumlu yönde katkı sağladığı söylenebilir.

Anahtar Kelimeler: MTA; diş kırığı; simüle edilmiş immatür dişler; endodonti
REFERENCES:
  1. Andersson L. Epidemiology of traumatic dental injuries. J Endod. 2013;39(3 Suppl):S2-5. [Crossref]  [PubMed] 
  2. Bortoluzzi EA, Souza EM, Reis JMSN, Esberard RM, Tanomaru-Filho M. Fracture strength of bovine incisors after intra-radicular treatment with MTA in an experimental immature tooth model. Int Endod J. 2007;40(9):684-91. [Crossref]  [PubMed] 
  3. Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol. 1992;8(2):45-55. [Crossref]  [PubMed] 
  4. Wilkinson KL, Beeson TJ, Kirkpatrick TC. Fracture resistance of simulated immature teeth filled with resilon, gutta-percha, or composite. J Endod. 2007;33(4):480-3. [Crossref]  [PubMed] 
  5. Bystrom A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol. 1985;1(5):170-5. [Crossref]  [PubMed] 
  6. Frank AL. Therapy for the divergent pulpless tooth by continued apical formation. J Am Dent Assoc. 1966;72(1):87-93. [Crossref]  [PubMed] 
  7. Damle SG, Bhattal H, Loomba A. Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste. J Clin Pediatr Dent. 2012;36(3):263-8. [Crossref]  [PubMed] 
  8. Shabahang S. Treatment options: apexogenesis and apexification. J Endod. 2013;39(3 Suppl):S26-9. [Crossref]  [PubMed] 
  9. Felippe WT, Felippe MCS, Rocha MJC. The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formation. Int Endod J. 2006;39(1):2-9. [Crossref]  [PubMed] 
  10. Maroto M, Barbería E, Planells P, Vera V. Treatment of a non-vital immature incisor with mineral trioxide aggregate (MTA). Dent Traumatol. 2003;19(3):165-9. [Crossref]  [PubMed] 
  11. Villa P, Fernández R. Apexification of a replanted tooth using mineral trioxide aggregate. Dent Traumatol. 2005;21(5):306-8. [Crossref]  [PubMed] 
  12. Iqbal Z, Qureshi AH. Monoblock obturation technique for non-vital immature permanent maxillary incisors using mineral trioxide aggregate: results from case series. J Coll Physicians Surg Pak. 2014;24(1):56-9.
  13. Choi Y, Park SJ, Lee SH, Hwang YC, Yu MK, Min KS, et al. Biological effects and washout resistance of a newly developed fast-setting pozzolan cement. J Endod. 2013;39(4):467-72. [Crossref]  [PubMed] 
  14. Park SJ, Heo SM, Hong SO, Hwang YC, Lee KW, Min KS, et al. Odontogenic effect of a fast-setting pozzolan-based pulp capping material. J Endod. 2014;40(8):1124-31. [Crossref]  [PubMed] 
  15. Song M, Yoon TS, Kim SY, Kim E. Cytotoxicity of newly developed pozzolan cement and other root-end filling materials on human periodontal ligament cell. Restor Dent Endod. 2014;39(1):39-44. [Crossref]  [PubMed]  [PMC] 
  16. de Souza LC, Yadlapati M, Dorn SO, Silva R, Letra A. Analysis of radiopacity, pH and cytotoxicity of a new bioceramic material. J Appl Oral Sci. 2015;23(4):383-9. [Crossref]  [PubMed]  [PMC] 
  17. Girish K, Mandava J, Chandra RR, Ravikumar K, Anwarullah A, Athaluri M, et al. Effect of obturating materials on fracture resistance of simulated immature teeth. J Conserv Dent. 2017;20(2):115-9. [Crossref]  [PubMed]  [PMC] 
  18. Desai S, Chandler N. The restoration of permanent immature anterior teeth, root filled using MTA: a review. J Dent. 2009;37(9):652-7. [Crossref]  [PubMed] 
  19. Topçuoğlu HS, Kesim B, Düzgün S, Tuncay Ö, Demirbuga S, Topçuoğlu G, et al. The effect of various backfilling techniques on the fracture resistance of simulated immature teeth performed apical plug with biodentine. Int J Paediatr Dent. 2015;25(4):248-54. [Crossref]  [PubMed] 
  20. Bayram E, Bayram HM. Fracture resistance of immature teeth filled with mineral trioxide aggregate, bioaggregate, and biodentine. Eur J Dent. 2016;10(2):220-4. [Crossref]  [PubMed]  [PMC] 
  21. Steinig TH, Regan JD, Gutmann JL. The use and predictable placement of mineral trioxide aggregate in one-visit apexification cases. Aust Endod J. 2003;29(1):34-42. [Crossref]  [PubMed] 
  22. Lawley GR, Schindler WG, 3rd Walker WA, Kolodrubetz D. Evaluation of ultrasonically placed MTA and fracture resistance with intracanal composite resin in a model of apexification. J Endod. 2004;30(3):167-72. [Crossref]  [PubMed] 
  23. Pene JR, Nicholls JI, Harrington GW. Evaluation of fiber-composite laminate in the restoration of immature, nonvital maxillary central incisors. J Endod. 2001;27(1):18-22. [Crossref]  [PubMed] 
  24. Elnaghy AM, Elsaka SE. Fracture resistance of simulated immature teeth filled with biodentine and white mineral trioxide aggregate - an in vitro study. Dent Traumatol. 2016;32(2):116-20. [Crossref]  [PubMed] 
  25. Hatibović-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO, et al. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate. Dent Traumatol. 2008;24(3):272-6. [Crossref]  [PubMed] 
  26. Han L, Okiji T. Bioactivity evaluation of three calcium silicate-based endodontic materials. Int Endod J. 2013;46(9):808-14. [Crossref]  [PubMed] 
  27. EL-Ma'ita AM, Qualtrough AJE, Watts DC. Resistance to vertical fracture of MTA-filled roots. Dent Traumatol. 2014;30(1):36-42. [Crossref]  [PubMed] 
  28. Możyńska J, Metlerski M, Lipski M, Nowicka A. Tooth discoloration induced by different calcium silicate-based cements: a systematic review of in vitro studies. J Endod. 2017;43(10):1593-601. [Crossref]  [PubMed] 
  29. Belli S, Eraslan O, Eskitascioglu G, Karbhari V. Monoblocks in root canals: a finite elemental stress analysis study. Int Endod J. 2011;44(9):817-26. [Crossref]  [PubMed] 

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