Root fractures in seniors: Consequences of acute embrittlement of dentin

Abstract

Dentin undergoes irreversible changes in microstructure with aging that involve gradual filling of the tubule lumens with mineral. Known as dental sclerosis, this process begins at the root apex, progresses coronally, and is associated with a degradation in the resistance to fracture of dentin. ObjectiveTo determine i) age-related changes of intertubular dentin with aging, particularly within the root, and ii) the differences in age-related degradation between vital and pulpless (i.e. non-vital) teeth. MethodsWe performed nanoscopic dynamic mechanical analysis (nanoDMA) in scanning mode on the intertubular and peritubular dentin of teeth from young and old adults. The complex, loss and storage moduli, as well as the tan delta parameter were evaluated for teeth with no restorations and teeth with root canal treatment (non-vital). ResultsThere were significant changes in the dynamic moduli of intertubular dentin with age, which were most substantial in the apical third of the root. The storage modulus of the intertubular dentin, which quantifies the purely elastic resistance to deformation, was significantly (p < 0.0005) larger for both the old vital and non-vital teeth than that of the young teeth, over the entire root length. However, the tan delta parameter, which quantifies the relative capacity for viscous deformation, was significantly lower in these two groups (p < 0.005). SignificanceRadicular dentin undergoes an embrittlement with aging, involving reduced capacity for viscous deformation. The extent of degradation is largest in the apical third. Removal of the pulp appears to accelerate the aging process or compound the extent of degradation.