Effects of Intracanal Medicaments and Coronal Barrier Materials Used in Regenerative Endodontics on the Fracture Resistance of Simulated Immature Teeth

Objective: Immature teeth are more susceptible to fracture because of their fragile roots. Intracanal medicaments and coronal filling materials used in regenerative endodontics affect the fracture resistance of immature teeth. This study evaluated the fracture resistance of simulated immature teeth coronally filled with mineral trioxide aggregate (MTA) and EndoSequence (ES) BC Root Repair Material following the intracanal placement of several antibiotic pastes. Materials and Methods: Sixty maxillary central incisors simulating immature teeth were divided into six randomized groups (n=10/group) according to the type of antibiotic pastes [triple antibiotic paste (TAP; a mixture of metronidazole, ciprofloxacin and minocycline); modified triple antibiotic paste (mTAP: metronidazole, ciprofloxacin and cefaclor); or augmentin] and used coronal barrier materials (MTA; or ES). After 21 days of storage, the antibiotic pastes were removed, and the coronal-barrier materials were placed. The samples were submitted to the fracture tests. The data were analyzed using t-test and one-way ANOVA tests. The significance level was set at a<0.05. Results: Fracture resistance was significantly lower for the mTAP-MTA group than the other MTA groups (p<0.05) and for the mTAP-ES group (p<0.05). No significant differences were observed for the other pair-wise comparisons (p>0.05). Conclusion: Immature teeth coronally filled with MTA were more prone to fracture than ES after intracanal placement of mTAP. Before coronal MTA filling, the placement of mTAP decreased the fracture resistance of immature teeth compared with other medicaments. The teeth coronally filled with ES presented with similar fracture strength regardless of the application of intracanal medicament.