Fracture resistance of immature teeth filled with mineral trioxide aggregate or calcium-enriched mixture cement: An ex vivo study

Background: The ability of mineral trioxide aggregate (MTA) to strengthen the tooth structure has been studied with contradictory results, and there is a lack of data in the case of Calcium-enriched mixture (CEM) cement as a novel endodontic biomaterial. The aim of the present study was to evaluate the reinforcing effect of MTA and CEM cement on simulated immature teeth. Materials and Methods: This ex vivo study was carried out on a total of 46 human maxillary incisors. Access cavities were prepared. Five teeth were randomly selected as negative control. The root length of the remaining teeth was standardized to 9 mm. Rotary files and peeso reamers were used to enlarge the canals. The prepared specimens were randomly assigned into three experimental (n = 12) and a positive control (n = 5) groups. In groups 1 and 2, the canals were filled with MTA or CEM cement, respectively. In group 3, a 5-mm MTA plug was placed, and the remainder of the canal was filled with composite resin. The canals of the positive control were kept unfilled. After 6 months, the teeth were tested for fracture strength in a universal testing machine. The groups were compared using Univariate analysis of variance (ANOVA). Results: There were significant differences between fracture strength of experimental groups with that of both control groups (P<0.05). However, the differences among the three experimental groups were not statistically significant (P>0.05). Conclusion: After 6 months, MTA and CEM cement exhibit distinct reinforcing effect on immature teeth.