Biomechanical Effects of Bonding Pericervical Dentin in Maxillary Premolars

Pericervical dentin (PCD) loss may increase root fracture propensity in root-filled teeth. This study evaluated the impacts of bonding PCD with composite resin (CR) on radicular microstrain distribution and load at failure of root-filled maxillary premolars.

Ten single-canal maxillary premolars decoronated 2 mm coronal to the cementoenamel junction (CEJ) had canals enlarged with ProTaper Universal instruments (Dentsply Tulsa Dental Specialties, Tulsa, OK) to F3. They were root filled with gutta-percha (GP) to the CEJ and restored with Cavit (3M Deutschland GmbH, Neuss, Germany) (GP group, n = 5) or 6 mm apical to the CEJ and restored with bonded CR to simulate bonding of PCD (bonded PCD group, n = 5). Digital moiré interferometry was used to evaluate pre- and postoperative whole-field microstrain distribution in the root dentin under physiologically relevant loads (10-50 N). Another 30 premolars, similarly treated as groups 1 and 2 or left untreated as controls (n = 10/group), were subjected to cyclic loads (1.2 million cycles, 45 N, 4 Hz) followed by uniaxial compressive load to failure. Mechanical data were analyzed with 1-way analysis of variance and the post hoc Tukey test at a 5% level of significance.

Microstrain distribution showed bending and compressive patterns at the coronal and apical root dentin, respectively. In the GP group, microstrain distribution was unaltered. In the bonded-PCD group, different microstrain distribution suggested stiffening at the PCD. The load at failure did not differ significantly for the GP, bonded PCD, and control groups (P > .05).

CR bonding of PCD might impact the biomechanical responses in maxillary premolar roots at low-level continuous loads. The effect of this impact on root fracture loads when subjected to cyclic load warrants further investigation.