Fracture Resistance of Teeth with Simulated Perforating Internal Resorption Cavities Repaired with Different Calcium Silicate-based Cements and Backfilling Materials


This study assessed the fracture resistance (FR) of teeth with simulated perforating internal resorption cavities repaired with different calcium silicate-based cements (CSCs) and backfilling materials.

Ninety-six mandibular premolar teeth were used. Twelve of the teeth were assigned as negative control group. Remaining roots were instrumented with rotary files, and standardized internal resorption cavities were prepared on the middle half of roots with burrs. Twelve of the samples were not further interfered and were assigned as a positive control group. The apical 4 mm of the remaining 72 root canals was obturated with single-cone technique and divided into 6 groups according to CSCs used for repairing of cavities and backfilling materials as follows: MTA + MTA, MTA + gutta-percha/sealer, Biodentine + Biodentine, Biodentine + gutta-percha/sealer, MTA Plus + MTA Plus, and MTA Plus + gutta-percha/sealer. Specimens were embedded in acrylic resin and then subjected to fracture testing. The forces when the fracture occurred were analyzed with analysis of variance and Bonferroni tests at P = .05.

No significant difference was found among CSCs irrespective of backfilling materials (P > .05). Groups MTA + gutta-percha/sealer, Biodentine + gutta-percha/sealer, and MTA Plus + gutta-percha/sealer showed significantly lower FR compared with groups MTA + MTA, Biodentine + Biodentine, and MTA Plus + MTA Plus, respectively (P < .05). The highest FR was observed in group Biodentine + Biodentine, and the lowest was in group MTA Plus + gutta-percha/sealer. FR of positive control group was statistically lower than groups completely filled with CSCs (P < .05), whereas FR of negative control group was statistically higher than the groups combined with gutta-percha and sealer (P < .05).

The backfilling with CSCs may be preferable material rather than gutta-percha/sealer combination for the roots with perforated internal resorptions.

J Endod. 2018 May, 44(5):860-863.
Sevinç Aketemur Türker, PhD, Emel Uzunoğlu, PhD, Derya Deniz Sungur, PhD, Vildan Tek, DDS
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NeoMTA Plus is a stainproof, tricalcium silicate-based bioactive cement that can be used universally for vital pulp and other endodontic indications in primary and permanent teeth. NeoMTA Plus is a bioceramic cement that triggers the healing process. With NeoMTA Plus, general dentists, pediatric dentists, and endodontists now have a superior and reasonably priced bioceramic. Dentists praise the multi-use NeoMTA Plus because it mixes more smoothly, is easier to dispense and the unique gel enables more stable placement, washout resistance and faster clinical setting.

New, stain-free light color:

Ideal for pediatric dentistry—won’t discolor teeth
Liquids such as sodium hypochlorite won’t cause discoloration

Multiple indications:

Pulp-capping to base/liner
Pulpotomies to apexification
Sealer to perforation repair
Root-end filling to resorption


Inhibits bacterial growth* *Tested in vitro. Not a disinfectant

Grey MTA Plus is a bioceramic tricalcium silicate-based Dental Cement, which is slightly more radiopaque than (white) MTA. The light silvery color of MTA Plus is visible during placement. Grey MTA Plus is indicated for both Vital Pulp Therapy and Endodontic procedures. General dentists and endodontists praise the multi-use Grey MTA Plus because it mixes more smoothly and is easier to dispense. The unique gel enables more stable placement, washout resistance and faster clinical setting.

Multiple indications:

Pulp-capping to Base/Liner
Pulpotomies to Apexification
Sealer to Perforation Repair
Root-end Filling to Resorption

New, light grey color:

More radiopaque than the leading white MTAs
Visible for precise placement
Inhibits bacterial growth in vitro of Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa.

Better mixing, handling and placement:

Finer powder mixes more easily and smoothly
Dispense as little as 0.1 gm
Unique gel for stable placement
Washout resistant
No special equipment required

Smart, convenient packaging:

Protects fine powder in desiccant-lined bottle
Easy to dispense powder as needed
Dropper-tip gel bottle minimizes waste