Fracture resistance of teeth obturated with two different types of Mineral Trioxide Aggregate Cements
DOI:
https://doi.org/10.14295/bds.2020.v23i3.2000Abstract
Objective: Endodontically obturated teeth have lower fracture resistance depending on the obturating material and technique. The purpose of this study was therefore to evaluate the influence of ProRoot MTA (Dentsply Sirona, Tulsa Division) and OrthoMTA III (BioMTA, Daejeon, Korea) as an obturating material on the fracture resistance of endodontically treated teeth. Material and Methods: Thirty extracted human maxillary central incisors were decoronated and instrumented using Protaper instruments (size F5). Irrigation was performed with 2.5% sodium hypochlorite between each instrument change followed by 7% maleic acid for one minute. Finally, canals were flushed with 5 ml of PBS solution for one minute. Samples were then divided into three groups. Group I- positive control (no root canal filling); Group II- obturation with ProRoot MTA; Group III- obturation with OrthoMTA III. Ten teeth were randomly selected as a negative control in which no treatment was performed. All the specimens were then subjected to fracture strength testing using universal testing machine. For evaluation of biomineralization, six maxillary central incisors were divided into two groups. Group I obturated with ProRoot MTA and group II obturated with OrthoMTA III. These samples were subjected to SEM analysis. Results: Positive control group demonstrated the least fracture resistance, while OrthoMTA III group showed the highest fracture resistance. There was no significant difference between negative control group and ProRoot MTA groups (p=0.821). OrthoMTA III group showed better tubular biomineralization when compared to ProRoot MTA. Conclusions: Root canals obturated with OrthoMTA III had better fracture resistance and increased tubular biomineralization compared to ProRoot MTA. Since root canals obturated with OrthoMTA III had better fracture resistance, it can be used as a promising obturating material.
Keywords
Biomineralization; Fracture Resistance; OrthoMTA III; ProRoot MTA; Root Canal; Tubular.
References
REFERENCES
Gher ME Jr, Dunlap RM, Anderson MH, Kuhl LV. Clinical survey of fractured teeth. J Am Dent Assoc. 1987;114(5):174-7.
Meister F Jr, Lommel TJ, Gerstein H. Diagnosis and possible causes of vertical root fractures. Oral Surg Oral Med Oral Pathol. 1980;49(3):243-53.
Sornkul E, Stannard JG. Strength of roots before and after endodontic treatment and restoration. J Endod. 1992;18(9):440-3.
Lee KW, Williams MC, Camps JJ, Pashley DH. Adhesion of endodontic sealers to dentin and gutta-percha. J Endod 2002;28(10):684-8.
Lertchirakarn V, Palamara JE, Messer HH. Load and strain during lateral condensation and vertical root fracture. J Endod. 1999;25(2):99-104.
Saw LH, Messer HH. Root strains associated with different obturation techniques. J Endod. 1995;21(6):314-20.
Ross RS, Nicholls JI, Harrington GW. A comparison of strains generated during placement of five endodontic posts. J Endod. 1991;17(9):450-6.
Tay FR, Pashely DH. Monoblocks in root canals- a hypothetical or a tangible goal. J Endod. 2007;33(4):391-8.
Vizgirda PJ, Liewehr FR, Patton WR, McPherson JC, Buxton TB. A comparison of laterally condensed gutta-percha, thermoplasticized gutta-percha, and mineral trioxide aggregate as root canal filling materials. J Endod. 2004;30(2):103-6.
Venturi M, Breschi L. Evaluation of apical filling after warm vertical gutta-percha compaction using different procedures. J Endod. 2004;30(6):436-40.
Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999;25:197-205.
Schmitt D, Lee J, Bogen G. Multifaceted use of ProRoot MTA root canal repair material. Pediatr Dent. 2001;23(4):326-30.
White JD, Lacefield WR, Chavers LS, Eleazer PD. The effect of three commonly used endodontic materials on the strength and hardness of root dentin. J Endod. 2002;28(12):828-30.
Andreasen JO, Munksgaard EC, Bakland LK. Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dent Traumatol. 2006;22(3):154-6.
Bortoluzzi EA, Souza EM, Reis JM, Esberard RM, TanomaruFilho M. Fracture strength of bovine incisors after intraradicular treatment with MTA in an experimental immature tooth model. Int Endod J. 2007;40:684-91.
Hatibovic-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate. Dent Traumatol. 2008;24(3):272-6 doi: 10.1111/j.1600-9657.2007.00541.x..
Chang SW, Baek SH, Yang HC, Seo DG, Hong ST, Han SH, et al. Heavy metal analysis of ortho MTA and ProRoot MTA. J Endod. 2011;37(12):1673-6. Doi:10.1016/j.joen.2011.08.020.
Lee BN, Son HJ, Noh HJ, Koh JT, Chang HS, Hwang IN, et al. Cytotoxicity of newly developed ortho MTA root-end filling materials. J Endod. 2012;38(12):1627-30. doi: 10.1016/j.joen.2012.09.004.
Kum KY, Zhu Q, Safavi K, Gu Y, Bae KS, Chang SW. Analysis of six heavy metals in Ortho mineral trioxide aggregate and ProRoot mineral trioxide aggregate by inductively coupled plasma-optical emission spectrometry. Aust Endod J. 2013;39(3):126-30. doi: 10.1111/j.1747.2012.00349.x.
Yoo JS, Chang SW, Oh SR, Perinpanayagam H, Lim SM, Yoo YJ, et al. Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: a scanning electron microscopy study. Int J Oral Sci. 2014;6(4):227-32. doi: 10.1038/ijos.2014.30.
Yoo JS, Chang SW, Oh SR, Perinpanayagam H, Lim SM, Yoo YJ, et al. Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: a scanning electron microscopy study. Int J Oral Sci. 2014;6(4):227-32. doi: 10.1038/ijos.2014.30.
El Briak-benabdeslam H, Ginebra MP, Vert M, Boudeville P. Wet or dry mechanochemical synthesis of calcium phosphates? Influence of the water content on DCPD–CaO reaction kinetics. Acta Biomater. 2008,4(2):378-86.
Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31(2):97-100.
Bozeman TB, Lemon RR, Eleazer PD. Elemental analysis of crystal precipitate from gray and white MTA. J Endod. 2006;32(5):425-8.
Soares CJ, Pizi EC, Fonseca RB, Martins LR. Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res. 2005;19(1):11-6.
Hammad M, Qualtrough A, Silikas N. Effect of new obturating materials on vertical root fracture resistance of endodontically treated teeth. J Endod. 2007;33(6):732-6.
Hatibovic-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO. Fracture resistance and histological findings of immature teeth treated with mineral Trioxide aggregate. Dent Traumatol. 2008;24(3):272-6. doi: 10.1111/j.1600-9657.2007.00541.X.
Bortoluzzi EA, Souza EM, Reis JM, 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.
Kruzic JJ, Nalla RK, Kinney JH, Ritchie RO. Crack blunting, crack bridging and resistance-curve fracture mechanics in dentin: effect of hydration. Biomaterials 2003;24(28):5209-21.
Pashley DH. Dentin permeability. In: Spangberg LSW, editor. Experimental endodontics. Boca Raton: CRS Press; 1990. p. 19-49.
Hirata K, Nakashima M, Sekine I, Mukouyama Y, Kimura K. Dentinal fluid movement associated with loading of restorations. J Dent Res. 1991;70(6):975-8.
Kinney JH, Balooch M, Marshall GW, Marshall SJ. Atomic-force microscopic study of dimensional changes in human dentine during drying. Arch Oral Biol. 1993;38(11):1003-7.
Kishen A, Asundi A. Experimental investigation on the role of water in the mechanical behavior of structural dentine. J Biomed Mater Res A. 2005;73(2):192-200.
van der Graaf ER, ten Bosch JJ. The uptake of water by freeze-dried human dentine sections. Arch Oral Biol. 1990;35(9):731-9.
Jameson MW, Hood JA, Tidmarsh BG. The effects of dehydration and on some mechanical properties of human dentine. J Biomech. 1993;26(9):1055-65.
Kishen A, Rafique A. Investigations on the dynamics of water in the macrostructural dentine. J Biomed Opt. 2006;11(5):054018.
Kishen A, Vedantam S. Hydromechanics in dentine: role of dentinal tubules and hydrostatic pressure on mechanical stress–strain distribution. Dent Mater. 2007;23(10):1296-306.
Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18(3):134-7.
Huang SC, Naka K, Chujo Y. Effect of molecular weights of poly(acrylic acid) on crystallization of calcium carbonate by the delayed addition method. Polym J. 2008; 40:154-62.
Ha WN, Kahler B, Walsh LJ. The influence of particle size and curing conditions on testing mineral trioxide aggregate cement. Acta Biomater Odontol Scand. 2016,2(1):130-7. doi: 10.1080/23337931.2016.1239181.
Rees JS. An investigation into the importance of the periodontal ligament and alveolar bone as supporting structures in finite element studies. J Oral Rehab. 2001;28(5):425-32.
Soares CJ, Pizi EC, Fonseca RB, Martins LRM. Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res. 2005;19(1):11-6.
Yoshida N, Koga Y, Peng CL, Tanaka E, Kobayashi K. In vivo measurement of the elastic modulus of the human periodontal ligament. Med Eng Phys. 2001;23(8):567-72.
Gower LB. Biomimetic model systems for investigating the amorphous precursor pathway and its role in biomineralization. Chem Rev. 2008;108(11):4551-627.doi: 10.1021/cr800443h.
Hammad M, Qualtrough A, Silikas N. Effect of new obturating materials on vertical root fracture resistance of endodontically treated teeth. J Endod. 2007;33(6):732-6.
Andreasen JO, Munksgaard EC, Bakland LK. Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dent Traumatol. 2006;22(3):154-6.
Hatibovi_c-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO. Fracture resistance and histological findings of immature teeth treated with mineral Trioxide aggregate. Dent Traumatol. 2008;24(3):272-6. doi:10.1111/j.1600-9657.2007.00541.X.
Bortoluzzi EA, Souza EM, Reis JM, 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.
Madarati AA, Qualtrough AJ, Watts DC. Effect of retained fractured instruments on tooth resistance to vertical fracture with or without attempt at removal. Int Endod J. 2010;43(11):1047-53. doi: 10.1111/j.1365-2591.2010.01783.x.
Zehnder M. Root canal irrigants. J Endod. 2006;32(5):389-98.
Ballal NV, Kandian S, Mala K, Bhat KS, Acharya S. Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: A scanning electron microscopic study. J Endod. 2009;35(11):1573-6. doi: 10.1016/j.joen.2009.07.021.
Ulusoy OI, Görgül G. Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. Aust Endod J. 2013;39(2):66-72. doi: 10.1111/j.1747-4477.2010.00291.x.
