Long-Term Fracture Resistance of Simulated Immature Teeth Filled with Various Calcium Silicate-Based Materials

Abstract

Objective. The aim of this in vitro study was to evaluate the long-term fracture resistance of simulated human immature permanent teeth filled with BioAggregate™ (BA), mineral trioxide aggregate (MTA), and EndoSequence® Root Repair Material (ERRM). Material and Methods. 40 teeth, simulated to average root length of 13 ± 1 mm (Cvek's stage 3), were included in the study. The teeth were randomly divided into four groups: Group 1: DiaRoot® BA, Group 2: MTA-Plus™ (MTA-P), Group 3: MTA-Angelus (MTA-A), and Group 4: ERRM. The root canal filling materials were applied according to the manufacturers' instructions. After 24 months of incubation, the roots of the teeth were embedded in acrylic blocks and subjected to fracture testing. The resultant data were analyzed statistically by Kruskal-Wallis and Mann-Whitney U tests. Results. Mean (±SD) failure loads (MPa) were 20.46 ± 2.53 for BA, 18.88 ± 5.13 for MTA-P, 14.12 ± 1.99 for MTA-A, and 17.65 ± 4.28 for ERRM groups. BA group exhibited the highest and MTA-A group showed the lowest resistance to fracture. Significant differences in fracture resistance were found between the groups of BA and MTA-A (p < 0.001), MTA-P and MTA-A (p < 0.05), and ERRM and MTA-A (p < 0.05). Conclusion. Within the limitations of this study, data suggests that BA-filled immature teeth demonstrate higher fracture resistance than other groups at 24 months appearing to be the most promising material tested.

The application of MTA as apical plug for root canal obturation – in vitro study

“…Nowadays, more improved MTA-based sealers (BioRoot TM _ RCS, MTA caps R , iR R , iR-BP PlusMTA-Fillapex R [27], Biodentine TM [27], Bioaggregate R [38], ProRoot MTA R [39]) are more insoluble than original MTA formula in vivo and in vitro. For their safe clinical use further research is required.…”

“…Danas usavršeni endodontski sileri na bazi MTA preskripcije (BioRoot TM _ RCS, MTA caps R , iR R , iR-BP Plus R , MTA-Fillapex R , Biodentine TM , Bioaggregate R , ProRoot MTA R ) pokazuju veću otpornost na rastvaranje nego originalni MTA preparat, što pokazuju kako in vivo, tako i in vitro eksperimenti za retrogradno punjenje kanala korena zuba [27,38,39]. Za njihovu sigurniju primenu u praksi još uvek nedostaju opsežni klinički rezultati.…”

Physico-chemical and biological properties of dental calcium silicate cements - literature review

“…Resistance to fracture in teeth with immature roots filled with Bioaggregate was significantly higher than in those obturated with CH, evaluated 1 year after filling. In addition, there was not significant differences among teeth filled with MTA Angelus (14 ± 2 MPa), ProRoot MTA (19 ± 5 MPa) and Bioaggregate (20 ± 3 MPa) after 1 year [42].…”

Development and evaluation of calcium hydroxide‐coated, pericardium‐based biomembranes for direct pulp capping

“…Calcium silicate cements have been reported to demonstrate better mechanical properties and produce better quality reparative dentine than calcium hydroxide . Calcium silicate cements show good quality in long‐term analyses; for example, long‐term higher fracture resistance at 24 months and resistance to dislodgement from dentin when immersed in phosphate‐buffered saline . These cements induce reparative dentine formation via the release of calcium hydroxide upon hydration, but unlike calcium hydroxide‐alone preparations, long‐term clinical data on the performance of these materials are not yet available.…”

“…5 Calcium silicate cements show good quality in long-term analyses; for example, long-term higher fracture resistance at 24 months and resistance to dislodgement from dentin when immersed in phosphate-buffered saline. 6,7 These cements induce reparative dentine formation via the release of calcium hydroxide upon hydration, 8 but unlike calcium hydroxide-alone preparations, long-term clinical data on the performance of these materials are not yet available. Furthermore, limitations, such as tooth discoloration and the presence of heavy metal ions that might impact the biologic properties of calcium silicate cements in vivo, have been reported.…”