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Biomechanical Characterization of Immature Roots Following Regenerative Endodontic Treatment and MTA Apexification: A
Ali Nosrat1, Alireza Kolahdouzan2, Rajeshwari Hadagalu Revana Siddappa3
1Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland; Private Practice in Endodontics, Centreville Endodontics, Centreville, Virginia.
Introduction:
This clinical investigation aims to determine and compare the volume, hardness, and elastic modulus of immature roots following regenerative endodontic treatment (RET) and mineral trioxide aggregate (MTA) apexification.
Methods:
A total of six volunteers aged between 9 and 14 years participated in the study, each providing a pair of mandibular or maxillary premolars with normal pulp and periapex planned for extraction due to orthodontic reasons. After full pulpectomy, each pair received either an MTA obturation or RET using blood clot as scaffold, followed by permanent restoration. Teeth were extracted ∼6.5 months later. Micro-computed tomographic images of teeth were taken for volumetric analyses and roots were subjected to nanoindentation physical testing.
Results:
Root volumes ranged from 168 mm3-236 mm3 (202.5 ± 31.07) in the MTA group and 178 mm3-251 mm3 (223 ± 28.09) in the RET group (P < .05). The median values of hardness in all regions (apical and middle) and all sites (periphery to canal lumen) ranged from 0.56-1.04 giga pascal (GPa) in the MTA group and 0.32-0.65 GPa in the RET group (P < .05). The median values of elastic modulus in all regions (apical and middle) and all sites (periphery to canal lumen) ranged from 10.4-22.9 GPa in the MTA group and 4.8-12.1 GPa in the RET groups (P < .05). Except the hardness in apical third in the MTA group, the values of hardness and elastic modulus increased from periphery towards lumen in all other regions in both groups (P < .05).
Conclusions:
After a period of 6.5 months RET resulted in increased root volumes, with the root structure indicative of newly formed hard tissue, which exhibited lower hardness and elastic modulus compared to those treated with MTA apexification.
