Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study.

Murtuza S Zhabuawala

doi:10.5005/jp-journals-10005-1464

Abstract

AimTo evaluate the fracture resistance of simulated immature teeth with an apical plug of biodentine followed by composite resin vs total obturation with biodentine tested immediately and after 3 months of aging and also to find out the chemical composition of dentin in contact with these materials.Materials and methodsExtracted human maxillary central incisors with simulated immature apex with radicular dentin thickness (RDT) of 1 to 1.5 mm selected and divided into three groups of 20 each. Group I (control)—4 mm biodentine apically and thermoplasticized gutta-percha. Group II—4 mm biodentine apically and composite resin. Group III—complete obturation with biodentine. About 10 samples from each group were tested immediately and remaining 10 stored in phosphate buffered solution (PBS) and tested after 3 months for fracture resistance and chemical analysis of dentin.ResultsNo significant difference in fracture resistance between the groups was observed when tested immediately. After 3 months of aging, only biodentine group showed a significant reduction in fracture resistance with increased Ca/P ratio of root dentine.ConclusionBiodentine group has shown drastic reduction in fracture resistance after 3 months of aging, and hence, cannot be recommended as a reinforcement material in immature teeth with thin dentin walls.How to cite this article: Zhabuawala MS, Nadig RR, Pai VS, Gowda Y, Aswathanarayana RM. Reinforcing Effects of Calcium Silicate-based Cement and Dual Cure Composite Resin in Simulated Immature Teeth with an Open Apex: An in vitro Study. Int J Clin Pediatr Dent 2017;10(4):351-357.

Highlights

Dental impact injuries are commonly associated with children between 8- and 12-years-old developing maxillary anterior teeth.[1,2,3] These injuries often lead to pulpal necrosis leading to incomplete root development with an open apex, thin dentinal walls, and wide funnelshaped canal.[4]
Higher mean fracture resistance was recorded in paracore group followed by Biodentine and gutta-percha group respectively
Higher mean fracture resistance was recorded in paracore group followed by gutta-percha and Biodentine group respectively

Summary

Introduction

Dental impact injuries are commonly associated with children between 8- and 12-years-old developing maxillary anterior teeth.[1,2,3] These injuries often lead to pulpal necrosis leading to incomplete root development with an open apex, thin dentinal walls, and wide funnelshaped canal.[4] Management of such cases is a significant challenge both endodontically and restoratively due to lack of adequate apical constriction and presence of thin dentinal walls.[5] The traditional approach to the treatment of non-vital teeth with incompletely developed roots has been apexification using calcium hydroxide.4,6Andreasen et al[7] showed that immature roots which had calcium hydroxide placed within the root canals of immature teeth over 1 year had 50% reduction in strength because of proteolytic reaction. Garcia-Godoy and Murray[8] stated that regenerative endodontic treatment is not recommended for patients younger than 7 years or older than 16 years

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