Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide

Background: The aim of this in vitro study was to assess the long-term fracture resistance of human immature permanent teeth filled with BioAggregate (BA), mineral trioxide aggregate (MTA) and calcium hydroxide (CH). Materials and methods: The study consisted of single rooted premolar teeth with immature root formation extracted for orthodontic reasons. A total of 28 immature premolars with average root length of 10.7 mm and apical diameter of 3 mm were included in the study. The pulps were extirpated and the canals were prepared using an apical approach. The teeth were randomly assigned to four groups: Group I: DiaRoot (R) BA (DiaDent, Burnaby, BC, Canada), Group II: Angelus MTA (MTA-A; Angelus, Londrina, Brazil), Group III: ProRoot (R) MTA (MTA-PR; Dentsply, Tulsa, OK, USA), Group IV: CH (Sultan Chemists Inc., Englewood, NJ, USA). The teeth were placed in saline solution at 4 degrees C for 1 year. The root of each tooth was then embedded in an acrylic resin block. All specimens were loaded at a crosshead speed of 1 mm min-1 in an Instron testing machine and the peak loads up to fracture were recorded. Data were analysed statistically by Kruskal-Wallis and Mann-Whitney U-tests. Results: Mean (+/- SD) failure loads (MPa) were: 37.69 +/- 14.43 for BA group, 32.94 +/- 8.15 for MTA-A group, 28.74 +/- 9.49 for MTA-PR group and 23.18 +/- 8.48 for CH group. The BA group exhibited the highest fracture resistance and the CH group showed the lowest resistance to fracture. Significant differences (P < 0.05) in fracture resistance were found between the DiaRoot-BA and CH groups, and also between the MTA-A and CH groups. Conclusion: Within the limitations of this study, data suggest that DiaRoot-BA-filled immature teeth demonstrate higher fracture resistance than other groups at 1 year. Considering the long-term risk of cervical root fracture associated with immature teeth, the use of DiaRoot-BA as a root canal filling material appears to be the most advantageous of the materials tested.