Skip to main content
Top
Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Research article

Effect of apexification on occlusal resistance of immature teeth

Authors: WooCheol Lee, Yeon-Jee Yoo

Published in: BMC Oral Health | Issue 1/2020

Login to get access

Abstract

Background

Strain distribution was investigated to assess the occlusal resistance alterations in immature teeth under different occlusal force.

Methods

In vitro apexification models of teeth with a funnel-shaped immature apex were obturated with mineral trioxide aggregate (MTA; ProRoot MTA) using different combinations of core materials (10/group): group 1, full-length orthograde obturation of MTA; group 2, a 5-mm MTA apical plug with a composite core; group 3, a 5-mm MTA apical plug and back-filling with warm gutta-percha. Teeth with calcium hydroxide (CH)-medicated canals and untreated teeth with normal apices were tested as controls. The teeth were arranged between two adjacent normal-apex teeth, embedded in a resin mold with a simulated periodontal ligament space. Strain data were recorded from the 3-unit teeth assembly under static compressive occlusal forces (50, 100, 200, and 300 N). Measurements were repeated 20 times for each condition, and the data were statistically analyzed.

Results

The immature teeth showed altered occlusal force resistance, placing increased strain on adjacent teeth. Teeth with CH-medicated canals showed significantly inferior occlusal resistance under all tested forces (P < 0.05). Application of an MTA plug with deep composite resin core resulted in significantly better stress-bearing capacity especially under forces of 50 and 300 N (P < 0.05).

Conclusions

The pattern of occlusal force distribution in immature teeth differed according to the canal obturation materials used for apexification. Immature teeth with an MTA apical plug showed more favorable occlusal force resistance than those with CH-medicated canals.
Literature
1.
go back to reference Sheehy EC, Roberts GJ. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. Brit Dent J. 1997;183:241–6.CrossRef Sheehy EC, Roberts GJ. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. Brit Dent J. 1997;183:241–6.CrossRef
2.
3.
go back to reference White JD, Lacefield WR, Chavers LS, Eleazer PD. The effect of three commonly used endodontic materials on the strength and hardness of root dentin. J Endod. 2002;28:828–30.CrossRef White JD, Lacefield WR, Chavers LS, Eleazer PD. The effect of three commonly used endodontic materials on the strength and hardness of root dentin. J Endod. 2002;28:828–30.CrossRef
4.
go back to reference Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol. 1992;8:45–55.CrossRef Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol. 1992;8:45–55.CrossRef
5.
go back to reference Hatibovic-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate. Dent Traumatol. 2008;24:272–6.CrossRef Hatibovic-Kofman S, Raimundo L, Zheng L, Chong L, Friedman M, Andreasen JO. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate. Dent Traumatol. 2008;24:272–6.CrossRef
6.
go back to reference Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18:134–7.CrossRef Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18:134–7.CrossRef
7.
go back to reference Carvalho CA, Valera MC, Oliveira LD, Camargo CH. Structural resistance in immature teeth using root reinforcements in vitro. Dent Traumatol. 2005;21:155–9.CrossRef Carvalho CA, Valera MC, Oliveira LD, Camargo CH. Structural resistance in immature teeth using root reinforcements in vitro. Dent Traumatol. 2005;21:155–9.CrossRef
8.
go back to reference Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review–part III: clinical applications, drawbacks, and mechanism of action. J Endod. 2010a;36:400–13.CrossRef Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review–part III: clinical applications, drawbacks, and mechanism of action. J Endod. 2010a;36:400–13.CrossRef
9.
go back to reference Morse DR, O’Larnic J, Yesilsoy C. Apexification: review of the literature. Quintessence Int. 1990;21:589–98.PubMed Morse DR, O’Larnic J, Yesilsoy C. Apexification: review of the literature. Quintessence Int. 1990;21:589–98.PubMed
10.
go back to reference Hong ST, Bae KS, Baek SH, Kum KY, Lee W. Microleakage of accelerated mineral trioxide aggregate and Portland cement in an in vitro apexification model. J Endod. 2008;34:56–8.CrossRef Hong ST, Bae KS, Baek SH, Kum KY, Lee W. Microleakage of accelerated mineral trioxide aggregate and Portland cement in an in vitro apexification model. J Endod. 2008;34:56–8.CrossRef
11.
go back to reference Bogen G, Kuttler S. Mineral trioxide aggregate obturation: a review and case series. J Endod. 2009;35:777–90.CrossRef Bogen G, Kuttler S. Mineral trioxide aggregate obturation: a review and case series. J Endod. 2009;35:777–90.CrossRef
12.
go back to reference Cho YE, Park EJ, Koak JY, Kim SK, Heo SJ, Park JM. Strain gauge analysis of occlusal forces on implant prostheses at various occlusal heights. Int J Oral Maxillofac Implants. 2014;29:1034–41.CrossRef Cho YE, Park EJ, Koak JY, Kim SK, Heo SJ, Park JM. Strain gauge analysis of occlusal forces on implant prostheses at various occlusal heights. Int J Oral Maxillofac Implants. 2014;29:1034–41.CrossRef
13.
go back to reference Elnaghy AM, Elsaka SE. Fracture resistance of simulated immature teeth filled with Biodentine and white mineral trioxide aggregate - an invitro study. Dent Traumatol. 2016;32:116–20.CrossRef Elnaghy AM, Elsaka SE. Fracture resistance of simulated immature teeth filled with Biodentine and white mineral trioxide aggregate - an invitro study. Dent Traumatol. 2016;32:116–20.CrossRef
14.
go back to reference Karapinar-Kazandag M, Basrani B, Yamagishi VTK, Azarpazhooh A, Friedman S. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol. 2016;32:146–52.CrossRef Karapinar-Kazandag M, Basrani B, Yamagishi VTK, Azarpazhooh A, Friedman S. Fracture resistance of simulated immature tooth roots reinforced with MTA or restorative materials. Dent Traumatol. 2016;32:146–52.CrossRef
15.
go back to reference Sivieri-Araujo G, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Bortoluzzi EA, Jorge EG, Reis JM. Fracture resistance of simulated immature teeth after different intra-radicular treatments. Braz Dent J. 2015;26:211–5.CrossRef Sivieri-Araujo G, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Bortoluzzi EA, Jorge EG, Reis JM. Fracture resistance of simulated immature teeth after different intra-radicular treatments. Braz Dent J. 2015;26:211–5.CrossRef
16.
go back to reference Brito-Junior M, Pereira RD, Verissimo C, Soares CJ, Faria-e-Silva AL, Camilo CC, et al. Fracture resistance and stress distribution of simulated immature teeth after apexification with mineral trioxide aggregate. Int Endod J. 2014;47:958–66.CrossRef Brito-Junior M, Pereira RD, Verissimo C, Soares CJ, Faria-e-Silva AL, Camilo CC, et al. Fracture resistance and stress distribution of simulated immature teeth after apexification with mineral trioxide aggregate. Int Endod J. 2014;47:958–66.CrossRef
17.
go back to reference Rezaei SM, Heidarifar H, Arezodar FF, Azary A, Mokhtarykhoee S. Influence of connector width on the stress distribution of posterior bridges under loading. J Dent (Tehran). 2011;8:67–74. Rezaei SM, Heidarifar H, Arezodar FF, Azary A, Mokhtarykhoee S. Influence of connector width on the stress distribution of posterior bridges under loading. J Dent (Tehran). 2011;8:67–74.
18.
go back to reference Fontijn-Tekamp FA, Slagter AP, Van Der Bilt A, Van THMA, Witter DJ, Kalk W, et al. Biting and chewing in overdentures, full dentures, and natural dentitions. J Dent Res. 2000;79:1519–24.CrossRef Fontijn-Tekamp FA, Slagter AP, Van Der Bilt A, Van THMA, Witter DJ, Kalk W, et al. Biting and chewing in overdentures, full dentures, and natural dentitions. J Dent Res. 2000;79:1519–24.CrossRef
19.
go back to reference Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review–part I: chemical, physical, and antibacterial properties. J Endod. 2010b;36:16–27.CrossRef Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review–part I: chemical, physical, and antibacterial properties. J Endod. 2010b;36:16–27.CrossRef
20.
go back to reference Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller RN. Calcium phosphate phase transformation produced by the interaction of the portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid. J Endod. 2007;33:1347–51.CrossRef Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller RN. Calcium phosphate phase transformation produced by the interaction of the portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid. J Endod. 2007;33:1347–51.CrossRef
21.
go back to reference Han L, Okiji T, Okawa S. Morphological and chemical analysis of different precipitates on mineral trioxide aggregate immersed in different fluids. Dent Mater J. 2010;29:512–7.CrossRef Han L, Okiji T, Okawa S. Morphological and chemical analysis of different precipitates on mineral trioxide aggregate immersed in different fluids. Dent Mater J. 2010;29:512–7.CrossRef
22.
go back to reference Reyes-Carmona JF, Felippe MS, Felippe WT. Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid. J Endod. 2009;35:731–6.CrossRef Reyes-Carmona JF, Felippe MS, Felippe WT. Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid. J Endod. 2009;35:731–6.CrossRef
23.
go back to reference Gandolfi MG, Taddei P, Tinti A, Prati C. Apatite-forming ability (bioactivity) of ProRoot MTA. Int Endod J. 2010;43:917–29.CrossRef Gandolfi MG, Taddei P, Tinti A, Prati C. Apatite-forming ability (bioactivity) of ProRoot MTA. Int Endod J. 2010;43:917–29.CrossRef
24.
go back to reference Bird DC, Komabayashi T, Guo L, Opperman LA, Spears R. In vitro evaluation of dentinal tubule penetration and biomineralization ability of a new root-end filling material. J Endod. 2012;38:1093–6.CrossRef Bird DC, Komabayashi T, Guo L, Opperman LA, Spears R. In vitro evaluation of dentinal tubule penetration and biomineralization ability of a new root-end filling material. J Endod. 2012;38:1093–6.CrossRef
25.
go back to reference Yoo YJ, Baek SH, Kum KY, Shon WJ, Woo KM, Lee W. Dynamic intratubular biomineralization following root canal obturation with pozzolan-based mineral trioxide aggregate sealer cement. Scanning. 2016;38:50–6.CrossRef Yoo YJ, Baek SH, Kum KY, Shon WJ, Woo KM, Lee W. Dynamic intratubular biomineralization following root canal obturation with pozzolan-based mineral trioxide aggregate sealer cement. Scanning. 2016;38:50–6.CrossRef
26.
go back to reference Huiskes R, Ruimerman R, van Lenthe GH, Janssen JD. Effects of mechanical forces on maintenance and adaptation of form in trabecular bone. Nature. 2000;405:704–6.CrossRef Huiskes R, Ruimerman R, van Lenthe GH, Janssen JD. Effects of mechanical forces on maintenance and adaptation of form in trabecular bone. Nature. 2000;405:704–6.CrossRef
27.
go back to reference Kerner J, Huiskes R, van Lenthe GH, Weinans H, van Rietbergen B, Engh CA, et al. Correlation between pre-operative periprosthetic bone density and post-operative bone loss in THA can be explained by strain-adaptive remodelling. J Biomech. 1999;32:695–703.CrossRef Kerner J, Huiskes R, van Lenthe GH, Weinans H, van Rietbergen B, Engh CA, et al. Correlation between pre-operative periprosthetic bone density and post-operative bone loss in THA can be explained by strain-adaptive remodelling. J Biomech. 1999;32:695–703.CrossRef
28.
go back to reference Brown IW, Ring PA. Osteolytic changes in the upper femoral shaft following porous-coated hip replacement. J Bone Joint Surg. 1985;67:218–21.CrossRef Brown IW, Ring PA. Osteolytic changes in the upper femoral shaft following porous-coated hip replacement. J Bone Joint Surg. 1985;67:218–21.CrossRef
29.
go back to reference Hayashi S, Nakakura-Ohshima K, Ohshima H, Noda T, Honma S, Wakisaka S, et al. The development of terminal Schwann cells associated with periodontal Ruffini endings in the rat incisor ligament. Brain Res. 2000;858:167–71.CrossRef Hayashi S, Nakakura-Ohshima K, Ohshima H, Noda T, Honma S, Wakisaka S, et al. The development of terminal Schwann cells associated with periodontal Ruffini endings in the rat incisor ligament. Brain Res. 2000;858:167–71.CrossRef
30.
go back to reference Shi L, Atsumi Y, Kodama Y, Honma S, Wakisaka S. Requirement of proper occlusal force for morphological maturation of neural components of periodontal Ruffini endings of the rat incisor. Arch Oral Biol. 2006;51:681–8.CrossRef Shi L, Atsumi Y, Kodama Y, Honma S, Wakisaka S. Requirement of proper occlusal force for morphological maturation of neural components of periodontal Ruffini endings of the rat incisor. Arch Oral Biol. 2006;51:681–8.CrossRef
31.
go back to reference Shi L, Kodama Y, Atsumi Y, Honma S, Wakisaka S. Requirement of occlusal force for maintenance of the terminal morphology of the periodontal Ruffini endings. Arch Histol Cytol. 2005;68:289–99.CrossRef Shi L, Kodama Y, Atsumi Y, Honma S, Wakisaka S. Requirement of occlusal force for maintenance of the terminal morphology of the periodontal Ruffini endings. Arch Histol Cytol. 2005;68:289–99.CrossRef
32.
go back to reference Craig RG, Johnson DW, Peyton FA. compressive properties of enamel, dental cements, and gold. J Dent Res. 1961;40:936–45.CrossRef Craig RG, Johnson DW, Peyton FA. compressive properties of enamel, dental cements, and gold. J Dent Res. 1961;40:936–45.CrossRef
Metadata
Title
Effect of apexification on occlusal resistance of immature teeth
Authors
WooCheol Lee
Yeon-Jee Yoo
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01317-x

Other articles of this Issue 1/2020

BMC Oral Health 1/2020 Go to the issue