Effect of Intracanal Medicament and Gutta Percha on Fracture Resistance of Simulated Immature Teeth Reinforced with MTA and Fibre-Post: A Comparative in-Vitro Study

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Megha Patel, Rupal Vadher, Chhaya Patel, Rohan Bhatt, Kaushal Joshi, Makwani Disha


Background: Traumatized immature teeth pose a treatment dilemma for practitioners due to inadequate natural apical constriction and thin root walls that are prone to shatter hence it becomes necessary to reinforce it with suitable post and apical plug so as to provide adequate strength. Variable factors like intracanal medicament, obturating materials, reinforcement of canals etc. plays an imperative role in success of the treatment.

Aim: To evaluate and compare the effect of intracanal medicament and apical plug on fracture resistance of immature teeth restored with fiber post.

Methodology: 40 single rooted maxillary incisors were included in study. To achieve a final length of 15±1, teeth were sectioned 2 mm above and 13 mm beneath the CEJ for standardization. Access opening was done and Pro Taper rotary files up to#F3 were used to prepare canals. Peeso reamer #5 was used for simulation of immature apex to obtain a standard internal diameter of 1.5 mm. These teeth were then divided in two groups: Group A(n=20): with intracanal medicament Ca(OH)2 and Group B(n=20) no intracanal medicament, which further were split into Group A1(n=10): 5mm MTA Apical plug+ Rely X fiber post; Group A2(n=10): 3mm MTA Apical plug +2mm GP + Rely X fiber post; Group B1(n=10) and Group B2(n= 10) same as Group A1 and Group A2 respectively but without intracanal medicament. Specimens were then subjected to fracture testing in Universal Testing Machine. The fracture resistance and fracture pattern were statistically analysed using ANOVA and post hoc Tukey test.

Results: The mean fracture resistance was more for specimens without intracanal medicament placement and those with placement of gutta-percha on MTA apical plug. Maximum fracture resistance was found in Group B2 (2351.287±220.402).  and minimum in Group A1 1475.154±232.922 and was statistically significant (p<0.001). Most common fracture pattern observed was above CEJ. (p> 0.05)

Conclusion: Use of intracanal medicament Ca(OH)2 diminishes fracture resistance of reinforced immature teeth over the period of time. Furthermore, use of gutta percha along with MTA in apical plug can act as shock absorber, thereby favours the prognosis.

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