Effect of Diabetes on Tubular Density and Push-out Bond Strength of Mineral Trioxide Aggregate to Dentin
Journal of Endodontics
Introduction: This study compared the tubular density and push-out bond strength of mineral trioxide aggregate (MTA) to dentin in diabetic and nondiabetic patients. Methods: Ten extracted single-rooted human teeth from diabetic and nondiabetic patients (n = 5 in each group) were decoronated, prepared up to a #5 Gates-Glidden drill, and sectioned horizontally at the midroot area to prepare 3 dentin slices, each measuring 2 mm in thickness (1 slice for the push-out test and 2 slices for the tubular density test). MTA was prepared and packed into the root canal space followed by incubation for 3 days. The push-out bond strength values were determined using a universal testing machine. Specimens were viewed under a stereomicroscope and a scanning electron microscope to determine the failure types at the cement-dentin interface. Ten slice specimens in each group were evaluated under SEM at 3 different sites to determine the tubular density. Comparisons were performed using the Mann-Whitney U test (P < .05). Results: Diabetic patients exhibited significantly lower push-out bond strength of MTA to root canal dentin (P < .05). The pattern of failure at the MTA-dentin interface was different between the 2 groups. The tubular density was significantly higher in diabetic patients (P < .05). Conclusions: The dentin in diabetic patients exhibited different physicochemical properties. The failure patterns and modes in diabetic patients might be explained by the changes in the push-out bond strength, the calcification mechanism of the dentin-pulp complex, a higher dentinal tubule density, and less peritubular dentin. These differences could explain the higher failure rate of root canal treatment in these patients.
Saghiri, M. A.,
Morgano, S. M.
Effect of Diabetes on Tubular Density and Push-out Bond Strength of Mineral Trioxide Aggregate to Dentin.
Journal of Endodontics, 46(11), 1584–1591.