Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

Ensieh Grayli; Abbas Dashtban; Leyla Shadan; Naser Behnampour; Elham Afshari

doi:10.1186/s12903-021-01641-w

Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

BMC Oral Health. 2021 May 28;21(1):280. doi: 10.1186/s12903-021-01641-w.

Authors

Ensieh Grayli¹, Abbas Dashtban², Leyla Shadan³, Naser Behnampour⁴, Elham Afshari⁵

Affiliations

¹ Department of Edndodontics, Gorgan School of Dentistry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
² Gorgan School of Dentistry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
³ Department of Prosthodontics, Gorgan School of Dentistry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
⁴ Department of Biostatics and Epidemiology, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
⁵ Department of Pediatric Dentistry, Gorgan School of Dentistry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran. dr.afshari@goums.ac.ir.

Abstract

Background: Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different apical plug materials (MTA and Calcium enriched mixture cement) at varied thicknesses on fracture resistance of teeth restored with cast metal posts.

Methods: A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups (n = 8) according to apical plug (control group: No plug, group MTA5: 5 mm MTA plug, group CEM5: 5 mm CEM plug, group MTA3: 3 mm MTA plug, group CEM3: 3 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using One-way ANOVA and Dunnett's T3 tests with significance level at P value < 0.05.

Results: The analysis showed a significant difference of fracture resistance between groups (P value < 0.05). The mean fracture resistance of samples in control group was significantly lower than MTA5 (P value = 0.003). There was no significant difference between other groups (P value > 0.05).

Conclusions: Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 3 mm MTA apical plug or either 3 or 5 mm CEM apical plug.

Keywords: Bioceramics; CEM; Cast metal; Endodontic post; Fracture resistance; MTA.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Gutta-Percha
Humans
Root Canal Filling Materials*
Root Canal Obturation
Tooth Apex
Tooth Fractures* / prevention & control

Substances

Gutta-Percha
Root Canal Filling Materials