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Impact of Biodentine Placement on Fracture Resistance and its Influence on Discoloration with Different Scaffolds
Evren Sarıyılmaz1, Öznur Sarıyılmaz1, Burak Çarıkçıoğlu2
1Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
Introduction:
This study aimed to investigate the fracture resistance of teeth that underwent ex vivo regenerative endodontic treatment using Biodentine placed either above or below the cemento-enamel junction (CEJ). Additionally, it examined the impact of different placement approaches, in combination with various scaffold materials (blood, platelet-rich fibrin [PRF], injectable PRF [i-PRF]), on tooth discoloration over time.
Methods:
Thirty-nine human maxillary incisors were divided into three groups. The control group consisted of intact teeth. In the two experimental groups, regenerative endodontic procedures were simulated, and Biodentine was placed above or below the CEJ. Fracture resistance was evaluated after thermal and mechanical aging using a chewing simulator. In the discoloration test, 96 human maxillary incisor teeth were selected. Roots were sectioned 10 mm apical to the CEJ and canal enlargement was performed Gates-Glidden burs. Teeth were grouped according to the placement level of Biodentine (above or below CEJ) and the type of scaffold materials used (blood, PRF, i-PRF, distilled water). Discoloration was assessed by using a spectrophotometer at baseline, 1 week, 1 month, and 6 months. Data were analyzed using one-way analysis of variance followed by Tukey post hoc tests independent t-tests were used to evaluate the effect of placement location on color change.
Results:
The fracture resistance of intact teeth was significantly higher than that of the group in which Biodentine was placed below the CEJ. Blood and blood-derived products resulted in greater discoloration compared to distilled water, whereas PRF induced less discoloration than blood. Furthermore, the placement of Biodentine above the CEJ led to significantly less discoloration at specific time points compared to its placement below the CEJ.
Conclusions:
Positioning Biodentine above the CEJ may offer clinical advantages by potentially improving structural integrity while minimizing aesthetic concerns. When PRF is used as the scaffold material and Biodentine is placed coronally, tooth discoloration is minimized.
