A comparative evaluation of the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials: An in vitro study

Abstract

Aim: The aim of the study was to compare the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities, restored with different restorative materials, namely, conventional glass-ionomer cement (CGIC), resin-modified glass-ionomer cement (RMGIC), flowable composite (FC), and giomer. Methods: Sixty extracted human permanent maxillary central incisor teeth were assigned to six groups,which were, Group 1 (intact teeth, control), Group 2 (teeth with biomechanical preparation and resorption cavity), Group 3 (CGIC), Group 4 (RMGIC), Group 5 (FC), and Group 6 (giomer). Except for Group 1, other groups were subjected to endodontic treatment. Teeth of Group 2 were left unobturated and teeth of Groups 3–6 were obturated. A simulated resorption cavity was prepared labially in the specimens belonging to Groups 2–6 and restored with respective restorative materials. The specimens were subjected to compressive load until failure in an Instron testing machine and the load at failure was recorded in Newtons. Statistical Analysis: The data obtained were statistically analyzed using one-way ANOVA, pair-wise comparison was made with Tukey's multiple comparison test, and P < 0.05 was considered statistically significant. Results: There was a statistically significant difference in the fracture resistance of intact teeth and endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials. Among the restored teeth, there was no significant difference. Conclusion: Intact teeth were found to have the highest resistance to fracture followed by those restored with giomer, FC, RMGIC, and CGIC in that order.

Comparison of Reverse Sandwich Restorations Versus Composite Fillings for the Restoration of External Cervical Resorptions: An In-Vitro Study

“…To overcome this potential problem, we calculated the mean fracture resistance of several samples for each group. Since ECR defects are often diagnosed at a more advanced stage due to their asymptomatic nature ( 8 ), endodontic therapy is often part of the treatment plan, leading to the decision to perform root canal treatment on all specimens in the study.…”

“…In a similar in-vitro study ( 8 ), the authors compared the fracture resistance to oblique loading on simulated ECR defects in maxillary central incisors restored with Giomer, RMGIC, conventional GIC and flowable resin composite. Although they concluded that Giomer showed significantly better results compared to the other materials, a major limitation of the study was the absence of periodontal ligament simulation.…”

“…G*Power 3.1 (Heinrich-Heine-University, Düsseldorf, Germany) was used to calculate the needed sample size. Calculations were based on Bolli et al ( 8 ), who compared the fracture resistance of root canal treated teeth with artificial cervical resorption cavities after restoration with various restorative materials. Parameters were set to α=0.05 and 90% power and considering an effect size of 0.48, a total of 47 specimens were indicated as required for observing significant differences.…”

“…The ideal requirements of a restorative material are to seal the defect, reinforce root integrity, resist fracture against masticatory forces, and demonstrate biocompatibility towards the surrounding tissues, all directly affecting the longevity of a tooth with ECR. Adhesive materials have shown to reinforce roots affected by ECR, albeit to a varying degree ( 8 ), but unfortunately, they often cause irritation to gingival and subgingival issues. Non-adhesive materials are unable to strengthen a root to the same extent ( 6 ).…”

“…Various materials have been tested regarding their ability to provide fracture resistance, including RMGIC, resin composites, flowable composites, Giomer, Biodentin, or Mineral Trioxide Aggregate (MTA) ( 6 , 8 ). However, there is limited knowledge regarding root reinforcement for ECR defects after restoration with RSR, and how masticatory forces may affect its marginal integrity.…”