Abstract
BackgroundStrain distribution was investigated to assess the occlusal resistance alterations in immature teeth under different occlusal force.MethodsIn vitro apexification models of teeth with a funnel-shaped immature apex were obturated with mineral trioxide aggregate (MTA; ProRoot MTA) using different combinations of core materials (10/group): group 1, full-length orthograde obturation of MTA; group 2, a 5-mm MTA apical plug with a composite core; group 3, a 5-mm MTA apical plug and back-filling with warm gutta-percha. Teeth with calcium hydroxide (CH)-medicated canals and untreated teeth with normal apices were tested as controls. The teeth were arranged between two adjacent normal-apex teeth, embedded in a resin mold with a simulated periodontal ligament space. Strain data were recorded from the 3-unit teeth assembly under static compressive occlusal forces (50, 100, 200, and 300 N). Measurements were repeated 20 times for each condition, and the data were statistically analyzed.ResultsThe immature teeth showed altered occlusal force resistance, placing increased strain on adjacent teeth. Teeth with CH-medicated canals showed significantly inferior occlusal resistance under all tested forces (P < 0.05). Application of an MTA plug with deep composite resin core resulted in significantly better stress-bearing capacity especially under forces of 50 and 300 N (P < 0.05).ConclusionsThe pattern of occlusal force distribution in immature teeth differed according to the canal obturation materials used for apexification. Immature teeth with an MTA apical plug showed more favorable occlusal force resistance than those with CH-medicated canals.
Highlights
Strain distribution was investigated to assess the occlusal resistance alterations in immature teeth under different occlusal force
Concerns exist regarding the use of calcium hydroxide (CH) or mineral trioxide aggregate (MTA) as an intracanal medicament in apexification treatment, since these patients are usually relatively young
Each summed occlusal force calculated from the three strain gauges was smaller than the applied occlusal forces, indicating stress absorption from tooth-supporting structures with a quadratic trendline (R2 = 0.95) in association with increasing occlusal force (Table 1)
Summary
Strain distribution was investigated to assess the occlusal resistance alterations in immature teeth under different occlusal force. Regenerative endodontic procedures enable continued root growth, in both length and width, in immature teeth with pulp necrosis and apical periodontitis. Immature teeth with completely destroyed apical papillae or previous unsuccessful endodontic interventions fail to complete further root formation. The conventional approach induces the formation of an apical barrier through long-term CH treatment [1, 2]. This treatment strategy involves multiple visits for medication changes and root canal irrigation over a prolonged period, which may lead to the loss of temporary dressings and re-infection.
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