Fracture Resistance of Root Canal Dentin Using Resin Versus Bioceramic-Based Sealers with Different Disinfection Protocols

Abstract

Root canal treatment decreases the fracture resistance of the teeth. The success in the endodontic treatment depends on cleaning, shaping and disinfection of the root canals. Endodontically treated teeth are not more brittle than unrestored teeth; however, they are weaker. Tooth structure becomes weak due to several factors and causes. Restorative factors can lead to tooth structure loss, for example; trauma, caries, previous restorations, heavy obturation forces and techniques due to the excessive forces and wedging effect of the spreader during lateral condensation, post preparation, endodontic access and root canal instrumentation. All these treatment steps generate heavy apical forces causing tooth fracture. Dentine factors, as loss of water in the pulp tissues after mechanical steps and extirpation, decrease mechanical properties of tooth. Age factors, such as crack propagation in sclerotic and dehydrated dentin in elder people, occur rapidly. Chemical factors, like endodontic irrigations and medicaments, play a role in the chemomechanical preparation of the root. In addition to their antibacterial action and lubrication during instrumentation, they can affect the sealing ability and adhesion of root filling materials. This is because the smear layer and debris prevent adhesion of sealer to canal walls if no copious irrigation is done.