A comparative evaluation of the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials: An in vitro study

Aim:

The aim of the study was to compare the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities, restored with different restorative materials, namely, conventional glass-ionomer cement (CGIC), resin-modified glass-ionomer cement (RMGIC), flowable composite (FC), and giomer.

Methods:

Sixty extracted human permanent maxillary central incisor teeth were assigned to six groups,which were, Group 1 (intact teeth, control), Group 2 (teeth with biomechanical preparation and resorption cavity), Group 3 (CGIC), Group 4 (RMGIC), Group 5 (FC), and Group 6 (giomer). Except for Group 1, other groups were subjected to endodontic treatment. Teeth of Group 2 were left unobturated and teeth of Groups 3–6 were obturated. A simulated resorption cavity was prepared labially in the specimens belonging to Groups 2–6 and restored with respective restorative materials. The specimens were subjected to compressive load until failure in an Instron testing machine and the load at failure was recorded in Newtons.

Statistical Analysis:

The data obtained were statistically analyzed using one-way ANOVA, pair-wise comparison was made with Tukey's multiple comparison test, and P < 0.05 was considered statistically significant.

Results:

There was a statistically significant difference in the fracture resistance of intact teeth and endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials. Among the restored teeth, there was no significant difference.

Conclusion:

Intact teeth were found to have the highest resistance to fracture followed by those restored with giomer, FC, RMGIC, and CGIC in that order.

Endodontic management of invasive cervical resorption: Report of two cases

Invasive cervical resorption of the tooth is a relatively rare and uncommon phenomenon where the etiology remains idiopathic and unclear, and if not treated may lead to ultimate loss of tooth structure. Advancements in digital imaging have made the clinician to diagnose the pathological changes with great precision. Proper diagnosis and management of this condition is key to the successful outcome. The aim of this article was to elaborate two case reports of invasive cervical root resorption with surgical management using biocompatible restorative material.

Surgical repair of invasive cervical root resorption with calcium-enriched mixture cement: a case report

Invasive cervical resorption (ICR) occurs in the cervical area of the teeth due to the formation of a soft tissue that progressively resorbs dentin. The disease is asymptomatic unless the pulp is exposed. This article presents a case involving a mandibular canine that was treated with a calcium-enriched mixture (CEM) cement. After a full mucoperiosteal flap was performed, the soft tissue was curetted away and the cavity filled with CEM biomaterial. One week later, the supragingival surface of the CEM was polished and covered with composite resin. At a 1-year follow-up visit, the pulp was healthy and the gingival probing depth decreased from >3 mm to 1 mm, showing attachment gain. As a biocompatible material, CEM has proven its ability in dentinogenesis, cementogenesis, and osteogenesis; it may prove to be a suitable biomaterial for treating ICR cases.

Failure of treatment of impacted canines associated with invasive cervical root resorption

OBJECTIVES

To propose invasive cervical root resorption (ICRR) as an unrecognized and/or overlooked etiologic factor in the failure of response of an impacted tooth to orthodontic traction and to underline the importance of cone beam computerized tomography (CBCT) for early and accurate diagnosis of ICRR.

MATERIALS AND METHODS

Fourteen patients (age 13-21 years) with impacted canines (15 canines) that had failed to respond to orthodontic forces and that exhibited ICRR formed the case series for this investigation. The initial diagnosis, treatment, clinical and radiographic expression of failure, and adverse effects on adjacent teeth were analyzed.

RESULTS

Initial diagnosis had been performed on plane radiographs. The orthodontist was absent during surgery in 11 patients. Nine canines had been exposed by open procedures. ICRR was not related to the severity of impaction. Its diagnosis was made on existing radiographs, new films, and/or new CBCT. The severity of the lesions was Class 3 or 4, and the teeth were finally extracted. Loss of anchorage characterized 11 patients. Apical resorption of the roots of adjacent teeth was diagnosed in 9 patients.

CONCLUSIONS

ICRR is a frequently undiagnosed or unrecognized cause of failure of orthodontic resolution of impacted canines and should be distinguished from replacement resorption. CBCT should be used for its early detection and accurate assessment of potential damage to adjacent anchor teeth.