Resistance to Fracture of Endodontically-treated Teeth with Simulated Cervical Resorption Cavities Restored with Different Restorative Materials: An In Vitro Study
Citation Information :
Rani P, Sinha DJ, Sharma P, Sharma N, Singh I, Mehra D. Resistance to Fracture of Endodontically-treated Teeth with Simulated Cervical Resorption Cavities Restored with Different Restorative Materials: An In Vitro Study. World J Dent 2023; 14 (10):844-850.
Aim: To assess fracture resistance of endodontically treated teeth restored with different restorative materials, namely Biodentine, flowable composite (FC), resin-modified glass ionomer cement (RMGIC), and packable composite (PC), in simulated cervical resorption cavities.
Materials and methods: A total of 75 human maxillary permanent central incisors with one root and a single canal were prepared using ProTaper nickel-titanium rotary files till apical size (F4) was achieved, with subsequent obturation by same size gutta-percha cone and Sealapex root canal sealer. A surveyor was used to simulate resorptive cavity on the labial surface at the intersection of the long axis of the maxillary central incisor and cementoenamel junction (CEJ). Preparations were then divided into and restored with the following restorative materials (n = 15): group I—cavity only (control group), group II—PC, group III—FC, group IV—Biodentine, and group V—RMGICs (light-cured RMGIC). Periodontal ligament simulation was done, and acrylic blocks were used for mounting the teeth. Samples were then assessed for wear resistance and subjected to a Universal Testing Machine for fracture resistance testing, and the collected data were then evaluated using statistical analysis using the analysis of variance (ANOVA) and post hoc Bonferroni tests.
Results: Statistically significant changes were seen in samples with simulated invasive cervical resorption (ICR) lesions in endodontically treated teeth filled with or without adhesive restorative materials (p < 0.001). Biodentine was found to have maximum fracture resistance, followed by those cavities that are restored with FC, RMGIC, and PC, in that order.
Conclusion: All the tested restorative materials performed satisfactorily in simulated cervical resorption cavities.
Clinical significance: The current study provides clinically relevant knowledge about the different adhesive restorative materials available in terms of wear and fracture resistance of endodontically treated teeth, providing in-depth insight regarding the effective and efficient management of cervical resorption cases.
Kutty KNS, Mohamed SC. Invasive cervical resorption: a review. Inter J Med Health Res 2017;3(6):47–50. DOI: 10.2117/j.med.2017.03.047
Heithersay GS. Management of tooth resorption. Aust Dent J 2007;52(1 Suppl):S105–S121. DOI: 10.1111/j.1834-7819.2007.tb00519.x
Patel S, Foschi F, Mannocci F, et al. External cervical resorption: a three-dimensional classification. Int Endod J 2018;51(2):206–214. DOI: 10.1111/iej.12824
Karunakar P, Soloman RV, Anusha B, et al. Endodontic management of invasive cervical resorption: report of two cases. J Conserv Dent 2018;21(5):578–581. DOI: 10.4103/JCD.JCD_119_18
Bolli RV, Margasahayam SV, Shenoy VU, et al. A comparative evaluation of the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials: an in vitro study. J Conserv Dent 2020;23(2):174–179. DOI: 10.4103/JCD.JCD_345_19
Domingos Pires M, Cordeiro J, Vasconcelos I, et al. Effect of different manipulations on the physical, chemical and microstructural characteristics of Biodentine. Dent Mater 2021;37(7):e399–e406. DOI: 10.1016/j.dental.2021.03.021
Hasani Z, Khodadadi E, Ezoji F, et al. Effect of mechanical load cycling on microleakage of restorative glass ionomers compared to flowable composite resin in class V cavities. Front Dent 2019;16(2):136–143. DOI: 10.18502/fid.v16i2.1365
Rees JS, Jacobsen PH. The effect of interfacial failure around a class V composite restoration analysed by the finite element method. J Oral Rehabil 2000;27(2):111–116. DOI: 10.1046/j.1365-2842.2000.00493.x
Dietschi D, Monasevic M, Krejci I, et al. Marginal and internal adaptation of class II restorations after immediate or delayed composite placement. J Dent 2002;30(5-6):259–269. DOI: 10.1016/s0300-5712(02)00041-6
Rathi A, Chowdhry P, Kaushik M, et al. Effect of different periodontal ligament simulating materials on the incidence of dentinal cracks during root canal preparation. J Dent Res Dent Clin Dent Prospects 2018;12(3):196–200. DOI: 10.15171/joddd.2018.030
Apicella MJ, Loushine RJ, West LA, et al. A comparison of root fracture resistance using two root canal sealers. Int Endod J 1999;32(5): 376–380. DOI: 10.1046/j.1365-2591.1999.00240.x
Cobankara FK, Unlu N, Cetin AR, et al. The effect of different restoration techniques on the fracture resistance of endodontically-treated molars. Oper Dent 2008;33(5):526–533. DOI: 10.2341/07-132
Rotondi O, Waldon P, Kim SG. The disease process, diagnosis and treatment of invasive cervical resorption: a review Dent J (Basel) 2020;8(3):64. DOI: 10.3390/dj8030064
ProTaper Universal. System_Brochure_EN.
Jung JH, Park SH. Comparison of polymerization shrinkage, physical properties, and marginal adaptation of flowable and restorative bulk fill resin-based composites. Oper Dent 2017;42(4):375–386. DOI: 10.2341/16-254-L
Xie H, Zhang F, Wu Y, et al. Dentine bond strength and microleakage of flowable composite, compomer and glass ionomer cement. Aust Dent J 2008;53(4):325–331. DOI: 10.1111/j.1834-7819.2008.00074.x
Bilgi PS, Shah NC, Patel PP, et al. Comparison of fracture resistance of endodontically treated teeth restored with nanohybrid, silorane, and fiber reinforced composite: an in vitro study. J Conserv Dent 2016;19(4):364–367. DOI: 10.4103/0972-0707.186458
Tyas MJ. The class V lesion—aetiology and restoration. Aust Dent J 1995;40(3):167–170. DOI: 10.1111/j.1834-7819.1995.tb05631.x
Attar N, Turgut MD, Güngör HC. The effect of flowable resin composites as gingival increments on the microleakage of posterior resin composites. Oper Dent 2004;29(2):162–167. DOI: 10.2341/1559-2863-29-2-1
McCarthy MF, Hondrum SO. Mechanical and bond strength properties of light-cured and chemically cured glass ionomer cements. Am J Orthod Dentofacial Orthop 1994;105(2):135–141. DOI: 10.1016/S0889-5406(94)70109-1
Schwartz RS, Robbins JW, Rindler E. Management of invasive cervical resorption: observations from three private practices and a report of three cases. J Endod 2010;36(10):1721–1730. DOI: 10.1016/j.joen.2010.06.011
Franco EB, Benetti AR, Ishikiriama SK, et al. 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions. Oper Dent 2006;31(4):403–408. DOI: 10.2341/05-87
Baranwal AK. Management of external invasive cervical resorption of tooth with Biodentine: a case report. J Conserv Dent 2016;19(3): 296–299. DOI: 10.4103/0972-0707.181952
Priyalakshmi S, Ranjan M. Review on Biodentine—a bioactive dentin substitute. J Dent Med Sci 2014;13(1):13–17. DOI: 10.9790/0853-13131317
Soares CJ, Pizi EC, Fonseca RB, et al. Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res 2005;19(1):11–16. DOI: 10.1590/s1806-83242005000100003
DeLong R, Pintado M, Douglas WH. Measurement of change in surface contour by computer graphics. Dent Mater 1985;1(1):27–30. DOI: 10.1016/S0109-5641(85)80061-0