背景和目的根孔是根管系统和外部支持组织之间的连接。条形穿孔(SP),发生在一条长条的根管内,会恶化治疗牙齿的预后,降低其机械阻力,并损害牙齿结构。所提出的处理SP的方法之一是用生物材料如硅酸钙水泥将其密封。因此,这项体外研究旨在评估由于SP引起的摩尔结构损伤,这需要研究抗断裂性,以及三氧化矿物骨料(MTA)的能力,生物陶瓷,和富含钙的混合物(CEM)来修复这个穿孔。材料和方法75颗磨牙被测量为25号尺寸,锥度为4%,用次氯酸钠和乙二胺四乙酸(EDTA)灌溉,干,然后随机分为五组(G1-G5):在G1,根管填充古塔胶和密封剂(阴性对照样品),而其余组(G2-G5)在提取的磨牙的中根使用GatesGlidden钻进行了手动模拟SP,并填充古塔胶和封胶剂直至其穿孔区域;在G2中,SP填充古塔胶和封胶剂(阳性对照样品);G3使用MTA修复SP;G4使用生物陶瓷腻子;G5使用CEM。使用万能试验机在冠尖方向上进行了磨牙的抗断裂性测试。单因素方差分析和Bonferroni检验用于研究牙齿抗断裂性平均值差异的显著性,其中统计显著性设置为0.05。结果ANOVA检验显示,各组之间的抗骨折性(牛顿)值之间存在统计学差异(p=0.000)。Bonferroni检验显示G2的抗断裂平均值小于其他四个研究组(656.53N;p=0.000),G5小于G1、G3和G4(794.40N,1083.73N,1025.20N,和1034.20N,分别;在每个成对比较中p=0.000)。结论SP降低了牙髓治疗磨牙的骨折阻力。使用MTA和生物陶瓷腻子恢复的SP比用CEM处理的SP更好,与没有SP的磨牙相似。此外,MTA和生物陶瓷腻子将经牙髓治疗的牙齿的抗骨折性提高到与无SP的磨牙相似的水平。
Background and aims A root perforation is a connection between the root canal system and the external supportive tissues. Strip perforation (SP), occurring within root canals in a strip, can worsen the prognosis of a treated tooth, reduce its mechanical resistance, and impair the tooth structure. One of the suggested methods to treat SP is to seal it with a bio-material such as calcium silicate cement. Therefore, this in vitro study aimed to assess the molar structure impairment due to SP, which requires studying the fracture resistance, and the ability of mineral trioxide aggregate (MTA), bioceramic, and calcium-enriched mixture (CEM) to repair this perforation. Materials and methods Seventy-five molars were instrumented to size #25 and taper 4%, irrigated with sodium hypochlorite and ethylenediaminetetraacetic acid (EDTA), dried, and then divided randomly into five groups (G1-G5): in G1, root canals were filled with gutta-percha and sealer (negative control sample), whereas the rest of the groups (G2-G5) had a manual simulated SP made with Gates Glidden drill at the mesial root of the extracted molar, and filled with gutta-percha and sealer up to their perforation area; in G2, SP was filled with gutta-percha and sealer (positive control sample); G3 used MTA to repair the SP; G4 used bioceramic putty; and G5 used CEM. Fracture resistance tests of the molars were conducted in the crown-apical direction using a universal testing machine. One-way ANOVA test and Bonferroni test were used to study the significance of the differences in the mean values of the tooth fracture resistance, where statistical significance was set at 0.05. Results The ANOVA test showed that there were statistically significant differences between the fracture resistance (in newtons) values among groups (p = 0.000). The Bonferroni test showed that G2 had a smaller fracture resistance mean than the other four study groups (656.53 N; p = 0.000), and that of G5 was smaller than G1, G3, and G4 (794.40 N, 1083.73 N, 1025.20 N, and 1034.20 N, respectively; p = 0.000 in each pairwise comparison). Conclusion SP reduced the fracture resistance of endodontically treated molars. SP restored using MTA and bioceramic putty was better than that treated with CEM and similar to molars without SP. Moreover, MTA and bioceramic putty enhanced the fracture resistance of endodontically treated teeth to levels similar to molars without SP.