Abstract
Amaç: Rejeneratif endodontik tedavi görmüş
vakalarda kök kırıklarının en önemli nedenlerinden biri travmadır. Bu
çalışmanın amacı, bariyer materyali olarak farklı kalınlıklarda yerleştirilen
Biodentine’in gelişimi tamamlanmamış dişlerin kırılma dayanımına etkisini
incelemektir.
Gereç ve Yöntem: Gelişimi tamamlanmamış diş simulasyonu
için, 65 adet üst santral dişin kök kanalları Peeso reamerlar ile genişletildi.
On dişte giriş kavitesi açılmadı ve bunlar negatif kontrol grubu olarak
ayrıldı. Giriş kavitesi açılmış 55 dişin, 10 tanesi pozitif kontrol olarak
ayrıldı ve bu dişlerin kök kanalına kalsiyum hidroksit yerleştirildi. Kök
kanallarına yerleştirilen Biodentine’in kalınlığına göre 45 diş rastgele olacak
şekilde 3 gruba ayrıldı (n=15); Grup 1: 2-3 mm kalınlıkta koronal bariyer, Grup
2: 5-6 mm kalınlıkta koronal bariyer, Grup 3: tüm kanalın dolumu. Bekleme
süresi sonrası, kırılma dayanımı analizi universal test cihazı ile
gerçekleştirildi. Tek yönlü varyans analizi ve Tukey testleri ile istatistiksel
analiz yapıldı.
Bulgular: Pozitif kontrol, Grup 1 ve Grup 2
arasında anlamlı fark yoktu (P > 0.05). Negatif kontrol ve Grup 3
en yüksek kırılma dayanımı değerlerini gösterdi (P < 0.05) ve bu iki grup arasında anlamlı fark yoktu (P > 0.05). Tüm kırıklar dişlerin servikal
kısmında yatay veya eğik olarak meydana geldi.
Sonuçlar: Biodentine koronal bariyer olarak
kullanıldığında dişlerin kırılma dayanımı üzerinde güçlendirici bir etkisi
olmadı. Kök kanalı tamamen Biodentine ile doldurulduğunda en iyi güçlendirme
etkisi oluştu. Koronal bariyer kalınlığının gelişimi tamamlanmamış dişlerin
kırılma dayanımına herhangi bir etkisi olmadı.
References
- 1. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013;39:S30-43.2. Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol 2002;18:134-137.3. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999;25:197-205.4. Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod 2012;38:1330-1336.5. Silujjai J, Linsuwanont P. Treatment outcomes of apexification or revascularization in nonvital immature permanent teeth: a retrospective study. J Endod 2017;43:238-245.6. Lin J, Zeng Q, Wei X, Zhao W, Cui M, Gu J, Lu J, Yang M, Ling J. Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis: a prospective randomized controlled study. J Endod 2017;43:1821-1827.7. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196-200.8. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 2001;17:185-187.9. Chueh LH, Huang GT. Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift. J Endod 2006;32:1205-1213.10. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod 2008;34:876-887.11. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod 2010;36:536-541.12. Bukhari S, Kohli MR, Setzer F, Karabucak B. Outcome of revascularization procedure: a retrospective case series. J Endod 2016;42:1752-1759.13. Bakhtiar H, Esmaeili S, Fakhr Tabatabayi S, Ellini MR, Nekoofar MH, Dummer PM. Second-generation platelet concentrate (platelet-rich fibrin) as a scaffold in regenerative endodontics: a case series. J Endod 2017;43:401-408.14. Al-Jundi SH. Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study. Dent Traumatol 2004;20:1-5.15. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod 2013;39:319-326.16. Cicek E, Yilmaz N, Kocak MM, Saglam BC, Kocak S, Bilgin B. Effect of mineral trioxide aggregate apical plug thickness on fracture resistance of immature teeth. J Endod 2017;43:1697-1700.17. Uzunoglu E, Eymirli A, Uyanik MO, Nagas E, Cehreli ZC. Fracture resistance of simulated immature teeth after internal bleaching procedures. Aust Endod J 2017.18. Chan T, Kucukkaya Eren S, Wong R, Parashos P. In vitro fracture strength and patterns in root-filled teeth restored with different base materials. Aust Dent J 2018;63:99-108.19. Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J 2016;49:926-936.20. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 2011;37:562-567.21. Chen MY, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45:294-305.22. Chaniotis A. Treatment options for failing regenerative endodontic procedures: report of 3 cases. J Endod 2017;43:1472-1478.23. Topcuoglu G, Topcuoglu HS. Regenerative endodontic therapy in a single visit using platelet-rich plasma and Biodentine in necrotic and asymptomatic immature molar teeth: a report of 3 cases. J Endod 2016;42:1344-1346.24. Bortoluzzi EA, Niu LN, Palani CD, El-Awady AR, Hammond BD, Pei DD, Tian FC, Cutler CW, Pashley DH, Tay FR. Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularization. Dent Mater 2015;31:1510-1522.25. Ulusoy OI, Nayir Y, Darendeliler-Yaman S. Effect of different root canal sealers on fracture strength of simulated immature roots. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:544-547.26. Tanalp J, Dikbas I, Malkondu O, Ersev H, Gungor T, Bayirli G. Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts. Dent Traumatol 2012;28:457-464.27. Hemalatha H, Sandeep M, Kulkarni S, Yakub SS. Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements--an in vitro study. Dent Traumatol 2009;25:433-438.28. Ari H, Erdemir A, Belli S. Evaluation of the effect of endodontic irrigation solutions on the microhardness and the roughness of root canal dentin. J Endod 2004;30:792-795.29. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod 2010;36:105-109.30. 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;28:828-830.31. 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;22:154-156.32. Karapinar-Kazandag M, Basrani B, Tom-Kun Yamagishi V, Azarpazhooh A, Friedman S. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol 2016;32:146-152.33. Linsuwanont P, Kulvitit S, Santiwong B. Reinforcement of simulated immature permanent teeth after mineral trioxide aggregate apexification. J Endod 2018;44:163-167.34. Natale LC, Rodrigues MC, Xavier TA, Simoes A, de Souza DN, Braga RR. Ion release and mechanical properties of calcium silicate and calcium hydroxide materials used for pulp capping. Int Endod J 2015;48:89-94.35. 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;32:116-120.
Abstract
Objectives: Secondary trauma is one of the main
causes of root fracture in regenerative endodontic cases. The aim of this study was to compare the influence of
placing Biodentine as a barrier material at different thicknesses on the
fracture strength of simulated immature teeth.
Materials and Methods: The root canals of 65 human maxillary
central incisors were instrumented using Peeso reamers to simulate immature
teeth. Ten teeth were assigned to the negative control group and received no
access cavity preparation. The access cavities of the remaining 55 teeth were
prepared. Among them, the root canals of 10 teeth were filled with calcium
hydroxide to serve as the positive control. Forty-five teeth were randomly distributed
into 3 groups (n=15); Group 1: 2-3 mm thick coronal plug, Group 2: 5-6 mm thick
coronal plug, Group 3: complete obturation. After the storage period, fracture
testing was performed using a universal testing machine. One-way analysis of
variance and Tukey tests were used to analyze the data.
Results: No significant difference was found among
the positive control, group 1 and group 2 (P
> 0.05). The negative control and group 3 presented the highest fracture strength
values (P < 0.05), while there was
no significant difference between them (P
> 0.05). All fractures occurred through the cervical region of the root
horizontally or obliquely.
Conclusions: No significant reinforcement effect was
obtained when Biodentine was used as a coronal plug. The complete root canal
obturation of simulated immature teeth using Biodentine provided the best
reinforcement effect. The coronal plug thickness had no influence on the
fracture strength of immature teeth.
References
- 1. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013;39:S30-43.2. Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol 2002;18:134-137.3. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999;25:197-205.4. Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod 2012;38:1330-1336.5. Silujjai J, Linsuwanont P. Treatment outcomes of apexification or revascularization in nonvital immature permanent teeth: a retrospective study. J Endod 2017;43:238-245.6. Lin J, Zeng Q, Wei X, Zhao W, Cui M, Gu J, Lu J, Yang M, Ling J. Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis: a prospective randomized controlled study. J Endod 2017;43:1821-1827.7. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196-200.8. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 2001;17:185-187.9. Chueh LH, Huang GT. Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift. J Endod 2006;32:1205-1213.10. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod 2008;34:876-887.11. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod 2010;36:536-541.12. Bukhari S, Kohli MR, Setzer F, Karabucak B. Outcome of revascularization procedure: a retrospective case series. J Endod 2016;42:1752-1759.13. Bakhtiar H, Esmaeili S, Fakhr Tabatabayi S, Ellini MR, Nekoofar MH, Dummer PM. Second-generation platelet concentrate (platelet-rich fibrin) as a scaffold in regenerative endodontics: a case series. J Endod 2017;43:401-408.14. Al-Jundi SH. Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study. Dent Traumatol 2004;20:1-5.15. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod 2013;39:319-326.16. Cicek E, Yilmaz N, Kocak MM, Saglam BC, Kocak S, Bilgin B. Effect of mineral trioxide aggregate apical plug thickness on fracture resistance of immature teeth. J Endod 2017;43:1697-1700.17. Uzunoglu E, Eymirli A, Uyanik MO, Nagas E, Cehreli ZC. Fracture resistance of simulated immature teeth after internal bleaching procedures. Aust Endod J 2017.18. Chan T, Kucukkaya Eren S, Wong R, Parashos P. In vitro fracture strength and patterns in root-filled teeth restored with different base materials. Aust Dent J 2018;63:99-108.19. Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J 2016;49:926-936.20. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 2011;37:562-567.21. Chen MY, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45:294-305.22. Chaniotis A. Treatment options for failing regenerative endodontic procedures: report of 3 cases. J Endod 2017;43:1472-1478.23. Topcuoglu G, Topcuoglu HS. Regenerative endodontic therapy in a single visit using platelet-rich plasma and Biodentine in necrotic and asymptomatic immature molar teeth: a report of 3 cases. J Endod 2016;42:1344-1346.24. Bortoluzzi EA, Niu LN, Palani CD, El-Awady AR, Hammond BD, Pei DD, Tian FC, Cutler CW, Pashley DH, Tay FR. Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularization. Dent Mater 2015;31:1510-1522.25. Ulusoy OI, Nayir Y, Darendeliler-Yaman S. Effect of different root canal sealers on fracture strength of simulated immature roots. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:544-547.26. Tanalp J, Dikbas I, Malkondu O, Ersev H, Gungor T, Bayirli G. Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts. Dent Traumatol 2012;28:457-464.27. Hemalatha H, Sandeep M, Kulkarni S, Yakub SS. Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements--an in vitro study. Dent Traumatol 2009;25:433-438.28. Ari H, Erdemir A, Belli S. Evaluation of the effect of endodontic irrigation solutions on the microhardness and the roughness of root canal dentin. J Endod 2004;30:792-795.29. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod 2010;36:105-109.30. 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;28:828-830.31. 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;22:154-156.32. Karapinar-Kazandag M, Basrani B, Tom-Kun Yamagishi V, Azarpazhooh A, Friedman S. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol 2016;32:146-152.33. Linsuwanont P, Kulvitit S, Santiwong B. Reinforcement of simulated immature permanent teeth after mineral trioxide aggregate apexification. J Endod 2018;44:163-167.34. Natale LC, Rodrigues MC, Xavier TA, Simoes A, de Souza DN, Braga RR. Ion release and mechanical properties of calcium silicate and calcium hydroxide materials used for pulp capping. Int Endod J 2015;48:89-94.35. 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;32:116-120.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | October 17, 2018 |
| Submission Date | June 11, 2018 |
| Published in Issue | Year 2018Volume: 21 Issue: 3 |
Cited By
Reinforcement effect of intra-orifice barrier materials in teeth treated with regenerative endodontic procedure: Research article
Journal of Dental Research, Dental Clinics, Dental Prospects
Sevinç Aktemur Türker
https://doi.org/10.34172/joddd.2021.019
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