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Fracture resistance of human roots filled with mineral trioxide aggregate mixed with phosphate‐buffered saline, with and without calcium hydroxide pre‐medication
Author(s) -
ŻukGrajewska E.,
Saunders W. P.,
Chadwick R. G.
Publication year - 2021
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.13426
Subject(s) - mineral trioxide aggregate , calcium hydroxide , saline , dentistry , root canal , hydroxide , significant difference , nuclear chemistry , materials science , chemistry , medicine , inorganic chemistry
Aim To compare the fracture strength of extracted human roots with apical plugs of mineral trioxide aggregate (MTA) mixed with either Ca‐ and Mg‐free phosphate‐buffered saline (PBS) or water, with and without calcium hydroxide (CH) canal pre‐medication. Methodology A total of 180 single‐rooted human teeth were prepared to resemble immature roots and divided into groups ( n = 20). The negative control received canal irrigation only, and the positive control received intracanal treatment with CH for either two or twelve weeks. MTA mixed with water was used in Group 1: (i) without CH pre‐medication – MTA(W); (ii) after 2 weeks CH pre‐medication – 2/52CH + MTA(W); and (iii) after 12‐week CH pre‐medication – 12/52 CH + MTA(W). MTA mixed with PBS was used in Group 2: (i) without CH pre‐medication – MTA(PBS); (ii) after 2‐week CH pre‐medication – 2/52CH + MTA(PBS); and (iii) after 12‐week CH pre‐medication – 12/52 CH + MTA(PBS). A compressive force was applied to each root until the point of fracture. The results were analysed by the Kruskal–Wallis and Dunn’s multiple comparisons tests ( P < 0.05). Results There was no significant difference between groups MTA(W), MTA(PBS) and 2/52CH + MTA(PBS), and all three groups were significantly ( P < 0.01, P < 0.05 and P < 0.05, respectively) more resistant to fracture than the negative control. Within Group 1, the samples that received two‐ ( P < 0.01) and twelve‐week ( P < 0.001) CH pre‐treatment were more prone to fracture than those which did not. No difference was found amongst the control groups. The roots of the MTA(PBS) group had a higher dependability ( P < 0.05) than the MTA(W) group when compared by the Weibull modulus. The difference was also present when a 2‐week CH pre‐medication was used. Conclusions Mineral trioxide aggregate mixed with Ca‐ and Mg‐free phosphate‐buffered saline had a significant strengthening effect on the fracture resistance of structurally weak roots, even when short‐term calcium hydroxide pre‐medication had been used. MTA mixed with water lost its strengthening effect on human roots when 2‐ or 12‐week CH pre‐treatment had been used. Use of CH dressing for up to 12 weeks had no negative effect on fracture resistance of human roots.