RESUMEN
Background: The success of the root-end procedure depends on the regeneration of the functional periodontal attachment system, including the cementum on the resected root-end surface, periodontal ligament (PDL), and alveolar bone. As root end filling materials remain in close contact with live periapical tissues, they may influence the endodontic treatment outcome. Aim: To assess and compare the cytotoxicity and genotoxicity of three root repair materials, mineral trioxide aggregate (MTA), endosequence, and geristore in human-cultured periodontal ligament fibroblasts. Materials and Methods: Cultured human periodontal ligament fibroblasts of the third passage were used in the study. They were placed in contact with the root repair materials. The cytotoxic effect on PDL fibroblasts was determined by (3-(4,5-dimethylthiazol-2-yl)-2,5-tetrazolium bromide) assay after 24 hours and 48 hours intervals. Cell viability was determined using an inverted phase contrast microscope. The genotoxic effect on the periodontal fibroblast cells was determined by comet assay using imaging software. Statistical Analysis Used: Data were analyzed using Tukey's multiple comparison test and Dunnett's multiple test. Results: All the test materials showed higher cytotoxicity and genotoxicity at the 48th hour interval with a statistically significant difference from the control group (P < 0.05). MTA was shown to be least cytotoxic and genotoxic to PDL fibroblasts, followed by endosequence root repair material and geristore at 24 hour and 48 hour intervals. Conclusion: The cytotoxicity and genotoxicity of MTA were the least compared to endosequence and geristore on human-cultured PDL fibroblasts.
RESUMEN
Background: Evaluation of the biomechanical response of tooth with perforation repair is important to attain predictable prognosis. It may remain altered even after perforation repair due to the loss of tooth structure. Aim: The aim of this study is to assess and compare the effect of pulpal floor perforation repair of different sites with biodentine, on the biomechanical response of mandibular molar through 3-dimensional (3D) finite element analysis (FEA). Materials and Methods: Five different 3D models were constructed based on the site of perforation on the pulpal floor using cone-beam computed tomographic images of an extracted mandibular molar. Perforation size was standardized and simulated to be repaired with calcium silicate-based cement. A force of 200 N was applied simulating normal occlusal loads. Static linear FEA was performed using the Ansys FEA software. Tensile stresses were evaluated (Pmax). Statistical Analysis Used: The data were evaluated using the independent t-test (P = 0.05). Results: All the simulated models with perforation repair exhibited higher stress values than their equivalent sites in the control group. The Pmax values of the repaired models were highest in central furcal perforation, followed by buccal furcal perforation. However, there was no statistically significant difference in the stress accumulation among the different repaired perforation sites. Conclusion: The site of the pulpal floor perforation affected the stress distribution and accumulation. Central and buccal furcal perforation repairs on the pulpal floor with calcium silicate-based cement in mandibular molar are likely to have an increased risk of fracture.