Intracanal medicaments and coronal sealing materials influence on root fracture resistance and coronal discoloration: An in vitro study

Immature teeth are more susceptible to fracture, and intracanal medicaments and coronal filling materials used in regenerative endodontics affect their optic and mechanical properties. This study aimed to evaluate the fracture resistance and coronal discoloration of simulated immature teeth following the placement of several intracanal medicaments and coronal sealing materials. Eighty-eight premolars simulating immature teeth were divided into 11 groups (n = 8 each) according to the type of intracanal medicament (triple antibiotic paste [TAP]; double antibiotic pastes [DAP]; calcium hydroxide [Ca(OH)2]) and used coronal barrier materials (mineral trioxide aggregate [MTA] and calcium-enriched mixture [CEM]). A bonding agent was applied in half of the samples in the groups where antibiotic pastes were used (n = 8). After incubating for 3 weeks, the sample’s fracture resistance and color change were evaluated. Data analysis was conducted using multivariate and one-way analysis of variance, Tukey’s honestly significant difference post hoc, and the Kruskal–Wallis tests (α =0.05). The color change after placing the medicaments was comparable among the groups. However, after 3 months, the color change in the TAP-CEM-No-Bonding group was higher than the control, Ca(OH)2-MTA, and DAP-MTA-No-Bonding groups (P < 0.05). The fracture resistance of the TAP-MTA-Bonding, DAP-CEM-Bonding, Ca(OH)2-MTA, and Ca(OH)2-CEM was lower than the control group (P < 0.05). Simultaneous use of DAP-MTA without a dentin bonding agent led to comparable color change and fracture resistance to the control group.