Resistance to fracture of simulated external cervical resorption using NeoMTA 2 and Biodentine cements. In Vitro Study

Resistance to fracture of simulated external cervical resorption using NeoMTA 2 and Biodentine cements. In Vitro Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Resistance to fracture of simulated external cervical resorption using NeoMTA 2 and Biodentine cements. In Vitro Study Jimena Alejandra Lama Sarmiento, Maydely Arévalo Cáceres, Lisset Contreras Astete, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6049768/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective The aim of this study is to compare the fracture resistance of simulated 2Cd external resorptions with two different bioceramics cements, NeoMTA 2 and Biodentine. Methodology : Sixty single-rooted mandibular premolars were divided into 4 groups: Control group (healthy teeth); Group 2: teeth with 2Cd cervical resorption class; Group 3: teeth with 2Cd cervical resorption sealed with Biodentine cement; Group 4: teeth with class 2Cd cervical resorption sealed with NeoMTA2 cement. All groups underwent evaluation of compressive forces at 8 and 30 days, measured in Newtons using a Universal machine LG CMT – 5L (Nanchang Howard Technology Co.,Ltd, China). The t-student, Shapiro Wilk and Tukey statistical tests were used using the SPSS 27 Software. Results After 8 days all groups showed a statistical difference (p < 0.05). Group 3 had greater compressive strength capacity than groups 2 and 4, but lower than the control group. At 30 days, groups 3 and 4 did not present a statistical difference, but they had values higher than group 2 (teeth with cervical resorption without repair) and lower than the control group. Conclusions According to the conditions of the study, there was no significant statistical difference in resistance to compressive forces between Biodentine and NeoMTA2 cements at 30 days. Clinical relevance : The use of Biodentine and NeoMTA2 cements as a repair materials are recommended. However, future research is needed to determine the most suitable repair material for resorption cavities with different classifications. Compressive forces Newton Resorption Figures Figure 1 INTRODUCTION The goal of endodontic treatment is to clean, shape and disinfect the root canal system to eliminate or prevent apical periodontitis and tooth loss[1]. However, there are anatomical complexities, such as root resorptions that make disinfection difficult, reducing the success of the treatment. Cervical resorptions may cause progressive loss of dentin and even pulp tissues, weakening the tooth; and depending on their location, they are classified as external or internal. For the diagnosis and adequate treatment of resorptions, clinical examination and complementary exams are needed, such as periapical radiographs and computed tomography images. In 2017, Patel S et al.[2] created a new three-dimensional classification for external cervical resorption, using tomography, considering the height, circumference and proximity to the root canal [3]. Different materials based on calcium silicate known as bioceramic have been suggested for the treatment of this type of conditions. These materials can induce the formation of hydroxyapatite, allowing the repair of affected tissue, helping to prolong tooth stability in the oral cavity [4,5,6] One of the most studied repair cements is Biodentine, which has shown excellent results [3][5–7] [8–12]. Recently, a new hydraulic cement was introduced to the market, NeoMTA2, with properties similar to Biodentine and with dual indication (sealant and repairer). Different authors have carried out studies on the physical, chemical and biological properties of these materials such as: biocompatibility, bioactivity, sealing capacity, radiopacity and solubility[5–7] [8–14]. However, there are any studies that have evaluated the fracture resistance of theeth with external cervical resorptions repaired with NeoMTA2. Therefore, the aim of this research is to determine the fracture resistance in teeth with simulated class 2Cd external cervical resorptions according to Patel S. et al. 2018 and repaired with Biodentine and NeoMTA2 bioceramics cements. MATERIALS AND METHODS Procedure The study was approved by the Institutional Ethics Committee N° 0639-2023-CIEI-UPSJB. For the study, 60 mandibular single-canal premolars were utilized, they were previously stored in saline solution and two periapical radiographs were taken, orthoradial and mesio angulated, applying the Clark technique to assure the presence of a single canal. Subsequently, they were sectioned with a diamond mesh disc mounted (Masterdent) using a low-speed motor (NSK FX 205B2), leaving a standard length of (16 mm.) (Fig. 1 A-B). The working length was determined with a K #10 file (Fig. 1 C) and the root canals were prepared with the RC-Blue-R25/06 and 40/06 system (RCB, Woodpecker, Guilin, China) (Fig. 1 D-E). Irrigation was performed during all root canal preparation with 2.5% Sodium Hypochlorite with a 25 mm Navitip 30G needles (Ultradent, USA) (Fig. 1 F). The final irrigation was done with 2.5% Sodium Hypochlorite and 17% EDTA with ultrasonic activation for three cycles of 20 seconds and the irrigant substances were neutralized with saline solution, always maintaing 2 mm of distance from the working length. The canals were sealed with BioRoot RCS (Septodont, France) manipulated according to the manufacturer's instructions with 40/06 cones (Spident, Woodpecker, Korea) and lateral condensation (Fig. 1 G). The simulation of class 2Cd external cervical resorption according to Shanon Patel was reproduced with a high-speed diamond round bur (MDT-018M) with a1.5 mm of diameter. The mesio-disto vestibular face aspect of each tooth was approached. The simulated resorption measured approximately 1.5 mm in depth and 3 mm in height in the corono-apical direction; the total diameter of the drill was used for standardizing the resorption (Fig. 1 H). All canals were patented with #08 k files (Dentsply Maillefer, Switzerland). Cervical resorptions were repaired with Biodentine (Septodont, France) (Fig. 1 I) and NeoMTA2 (Avalon Biomed. USA) (Fig. 1 J), manipulated according to the manufacturer's instructions. The samples were randomly divided into 4 study groups (n = 10/group). Group 1: negative control group (theeth without biomechanical preparation and without simulated resorption) Group 2: teeth with Shanon Patel class 2Cd cervical resorption without repair. Group 3: teeth with Shanon Patel class 2Cd cervical resorption repaired with Biodentine. Group 4: teeth with Shanon Patel class 2Cd cervical resorption repaired with NeoMTA2. After completing the procedure, the samples were kept in an HHD YZITE-6 incubator (Nanchang Howard Technology Co., Ltd., China) at 37°C for 8 and 30 days (Fig. 1 L-M). The samples were immersed in acrylic resin and the periodontal ligament was simulated by fluid silicone, these were submitted to a compression resistance test which was measured with a universal testing machine “LG CMT-5L” (Jinan Liangong Testing Technology Co., Ltd, China) by recording the maximum force in Newton (N) of mm/s, necessary to fracture each root (Fig. 1 N-O). STATISTICAL ANALISIS Statistical analyses were performed on SPSS software, version 26 (Statistical Package for Social Sciences); Student t test was used to compare the average fracture resistance between two groups. For the comparison of the four groups, the F test was applied, after verification of normality Shapiro-Wilk test was assessed; and homogeneity of variances by Levene test. When the comparison was made with the four groups, as a complementary test of the analysis of variance, the data was submitted to Tukey test, which compared the equality of means of the groups in pairs. The statiscal significance amongst the groups were considered with a significance level of p < 0.05. RESULTS Results by Group Group 1: Negative control (healthy teeth), 1989.72 N. Group 2: Positive control (teeth with simulated resorption without repair), 927.78 N. Group 3: Teeth with simulated resorption and repaired with Biodentine. At 8 days 1581.65 N and at 30 days 1656.26 N. Group 4: Teeth with simulated resorption and repaired with NeoMTA2. At 8 days 1421.15 N and at 30 days 1698.37 N. Results between Groups After 8 days, it is observed that all groups showed a significant statistical difference (p < 0.05). Group 1 (healthy teeth) had the greatest capacity to support compressive forces compared to the others. Group 3 (Biodentine) showed higher values (1581.65 N) than Group 4 (Neo MTA2) (1421.15 N). At the end of this period, Group 2 (teeth with unrepaired resorption) was the one that showed the lowest results of resistance to compressive forces (927.78 N) (Table 1). The last experimental period (30 days) it is evident that both cements (Biodentine – Group 3 and Neo MTA 2 – Group 4) did not present a significant statistical difference between them (p > 0.05), meaning that the two cements could support the same load of compressive forces (1656.26 N and 1698.37 N, respectively). On the other hand, the other Groups showed the same behavior as 8 days (Table 2). DISCUSSION External cervical resorption is a type of localized aggressive inflammatory defect that causes extensive loss of tooth structure. This loss can involve dentinal, periodontal and pulp tissues, and can lead to tooth fracture [15,16] The sealing of the lesions with bioceramics cements is one of the main treatment for cervical lesions. Theses biomaterials have physical-chemical properties that can improve the resistance to compressive forces, thus preventing root fractures [15–16]. This is the first study that evaluated the compressive forces of two restorative cements in teeth with simulated external cervical resorptions class 2Cd according to Shanon Patel (2017) [2] in two experimental periods, 8 and 30 days. The results expressed in Table 2 showed the values obtained after 8 days, where all groups have a significant statistical difference (p < 0.05). It is also observed that the Biodentine group (1581.65 N) obtained greater resistance than the NeoMTA2 group (1421.15 N) to compressive forces, which cohoborates with what was reported by Prasanthi et al. ( 2019 ) [17]. Likewise, Olcay et al ( 2022 ) [8] found that Biodentine had better results in compressive strength capacity than ProRoot MTA in the same experimental period. According to a study carried out by Drukteinis et al. (2021) [9], this could be due to the fact that there is a greater release of calcium ions compared to other cements, a product of the interaction of calcium carbonate with the dentinal tissue; which would increase the reaction speed. Camilleri et al. 2013 [18, 20], carried out an investigation of the hydration and bioactivity of radiopacified tricalcium silicate cements, where they observed that the hydration capacity of the Biodentine cement was more accelerated than the MTA Angelus, due to the presence of calcium carbonate, chloride of calcium and solubilizing polymers which would allow a faster initial setting that ranges between 6.5 and 16 minutes, the results presented in this study affirm this scientifical allegation. On the other hand, it was observed that after 30 days the NeoMTA 2 group increased its compressive strength capacity equal to the values obtained for group 3, therefore showing that there is no significant statistical difference (p > 0.05) between both groups at the end of the experiment. The late reaction capacity of the NeoMTA2 group compared to the Biodentine group could be by the fact of having a viscous vehicle, the release of calcium and hydroxyl ions tend to be slower [9,10] Finally, after 30 days, group 1 (healthy teeth) reflected the highest values compared to the others (p 0.05); thus, Neo MTA2 cement would be another alternative for the treatment of external cervical resorption cavities, which is a great finding for future clinical applications. However, these two groups (3 and 4) showed values higher than group 2 (tooth pieces with cervical resorption without repairment material), this information demonstrates that only the use of bioceramics repair cements would help to improve the compressive strength capacity in teeth with external cervical resorption. CONCLUSION This in vitro study could point out that both bioceramics cements are capable of withstanding compressive forces of teeth with external cervical resorption after 30 days, this information allows clinical relevance for the treatment of this type of lesions. Declarations CONFLICT OF INTEREST All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. ETHICAL APPROVAL The study was approved by the Institutional Committee on Research Ethics of the San Juan Bautista Private University with the register code N° 0639-2023-CIEI-UPSJB. INFORMED CONSENT Not applicable FUNDING The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Author Contribution Conceptualization, Jimena Lama Sarmiento, Maydeli Arévalo Cáceres, Lisset Contreras Astete and John Paul Torres Navarro ; methodology, Jimena Lama Sarmiento, Maydeli Arévalo Cáceres and Lisset Contreras Astete, formal analysis, Jimena Lama Sarmiento, Maydeli Arévalo Cáceres and Lisset Contreras Astete; investigation, Jimena Lama Sarmiento, Maydeli Arévalo Cáceres and Lisset Contreras Astete; resources, Maydeli Arévalo Cáceres and Lisset Contreras Astete.; writing—original draft preparation, Jimena Lama Sarmiento, Maydeli Arévalo Cáceres and Lisset Contreras Astete ; writing— review and editing, Jimena Lama Sarmiento and Pedro Henrique Chaves Oliveira; supervision, John Paul Torres Navarro; project administration, Jimena Lama Sarmiento and John Paul Torres Navarro. All authors have read and agreed to the published version of the manuscript. References Gluskin AH, Peters CI, Peters OA. Minimally invasive endodontics: challenging prevailing paradigms. Br Dent J. 2014. 10.1038/sj.bdj.2014.201 . Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three-dimensional classification. Int Endod J. 2017. 10.1111/iej.12824 . Topçuoğlu HS, Tuncay Ö, Karataş E, Arslan H, Yeter K, Sealers. J Endod. doi: 10.1016/j.joen.2013.07.034 . Arıcan B, Sesen Uslu Y, Sarıalioğlu Güngör A. Resistance to fracture of simulated external cervical resorption cavities repaired with different materials. Aust Endod J. 2023. 10.1111/aej.12714 . Song W, Sun W, Chen L, Yuan Z. (2020) In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics Front Bioeng Biotechnology 10.3389/fbioe.2020.580954 Almohaimede A. Fracture resistance of roots obturated with bio-ceramic and epoxy resin- based sealers: In vitro study. Turk Endod J. 2020. 10.14744/eej.2019.33042 . Espinosa N, Espinosa I, Rodríguez E, Hernández J, González G. (2014) Resorción radicular externa idiopática múltiple. Presentación de un caso. Gac Méd Espirit doi: http://scielo.sld.cu/scielo.phpscript=sci_arttext &pid=S102502552015000400010&lng=es &nrm = iso. Olcay K, Guneser M, Dincer A, Uyan H. (2022) Compressive strength, surface roughness, and surface microhardness of principle tricalcium silicate-based endodontic cements after universal adhesive application. ;Niger J Clin Pract. 10.4103/njcp.njcp_1287_21 Drukteinis S, Camilleri J. (2021) Bioceramic Materials in Clinical Endodontics . 10.1007/978-3-030-58170-1 Braga RR, About I. How far do calcium release measurements properly reflect its multiple roles in dental tissue mineralization? Clin Oral Investig. 2019;23(1):501. 10.1007/s00784-018-2789 . Molina GFUJ, Brisson GA, Boetto C, Mazzola I, Lascano LB et al. (2021) Resistencia a la compresión de Biodentine®: mezcla manual vs. Mecánica Methodo Investig Apl Cienc Biol 10.22529/me.021.6(2)04 Sen HG, Helvacioglu-Yigit D, Yilmaz A. Radiopacity evaluation of calcium silicate cements. BMC Oral Health. 2023. 10.1186/s12903-023-03182-w . Camilleri J. (2022) Biodentine ™ Microstructure and Composition . In: Imad About, editor Biodentine™ Properties and Clinical Application, 11th end. Springer, pp 1–10. Ha W, Kahler B, Walsh LJ. Classification and Nomanclature of Commercial Hygroscopic Dental Cements. Eur Endod J. 2017;2(1):27. 10.5152/eej.2017.17006 . Fonseca TS, Silva GF, Guerreiro-Tanomaru JM, Sasso-Cerri E, Tanomaru-Filho M, Cerri PS. Mast cells and immunoexpression of FGF-1 and Ki-67 in rat subcutaneous tissue following the implantation of Biodentine and MTA Angelus. Int Endod J. 2018. 10.1111/iej.12981 . Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding External Cervical Resorption in Vital Teeth. J Endod. 2016;11. 10.1016/j.joen.2016.06.007 . Heithersay GS. Invasive cervical resorption. Endod Top. 200410.1111/j.1601- 1546.2004.00060.x.}. Prasanthi P, Garlapati R, Nagesh B, Sujana V, Kiran Naik K, Yamini B. Effect of 17% ethylenediaminetetraacetic acid and 0.2% chitosan on pushout bond strength of biodentine and ProRoot mineral trioxide aggregate: An in vitro study. J Conserv Dent. 2019. 10.4103/jcd.jcd_56_19 . Camillieri, MTA Angelus. Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, Biodentine and. Dent Mat. 2013. 10.1016/j.dental.2013.03.007 . Epub 2013 Mar 26. 12. Tables Table 1 and 2 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files tables.pdf Table 1. and Table 2. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6049768","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":421758951,"identity":"dd6c2359-7a3b-4cb5-bd76-5e856254d285","order_by":0,"name":"Jimena Alejandra Lama Sarmiento","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBACxgbmBuaf/2zkDMBcAwtitAA1MbClGRswMIO0SBBpDwPb4cQNYC0MRGhhbj/Y/LmA53D6dvb+oxt+FEgw8Ld3J+C3oyexTXqGRHruzp7DbDd7gA6TOHN2AwFnJbYx8BhY5264kcx2gweoxUAil4CW/ofNH3gSmNMNgFpu/iFKy4zEBmmeA84JIC23ibNlxsM2yZkNaYYbzhw2uy1jIMFD0C+G/cmHP3xssJE3ON747OabPzZy/O29BLQ0oAnw4FUOAvIEVYyCUTAKRsEoAADjXUkaFUXVswAAAABJRU5ErkJggg==","orcid":"","institution":"Universidad Privada San Juan Bautista","correspondingAuthor":true,"prefix":"","firstName":"Jimena","middleName":"Alejandra Lama","lastName":"Sarmiento","suffix":""},{"id":421758953,"identity":"043d816c-8983-4724-a136-e1a52a914e6f","order_by":1,"name":"Maydely Arévalo Cáceres","email":"","orcid":"","institution":"Universidad Privada San Juan Bautista","correspondingAuthor":false,"prefix":"","firstName":"Maydely","middleName":"Arévalo","lastName":"Cáceres","suffix":""},{"id":421758958,"identity":"c4e7cb4a-0ecb-4e22-8048-24d68c5fa6cb","order_by":2,"name":"Lisset Contreras Astete","email":"","orcid":"","institution":"Universidad Privada San Juan Bautista","correspondingAuthor":false,"prefix":"","firstName":"Lisset","middleName":"Contreras","lastName":"Astete","suffix":""},{"id":421758959,"identity":"1429471e-1c4a-42f5-a53b-4dfd47d6a269","order_by":3,"name":"Pedro Henrique Chaves Oliveira","email":"","orcid":"","institution":"São Paulo State University (Unesp)","correspondingAuthor":false,"prefix":"","firstName":"Pedro","middleName":"Henrique Chaves","lastName":"Oliveira","suffix":""},{"id":421758961,"identity":"828344e1-c017-4b15-961b-7e8a76389621","order_by":4,"name":"John Paul Torres Navarro","email":"","orcid":"","institution":"Universidad Privada San Juan Bautista","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Paul Torres","lastName":"Navarro","suffix":""}],"badges":[],"createdAt":"2025-02-17 16:38:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6049768/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6049768/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":78209237,"identity":"2a568c12-2ebe-46c2-ad1e-116f0feabd7d","added_by":"auto","created_at":"2025-03-11 03:20:06","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":413142,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"figurascloi.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6049768/v1/97d9daa15b476f0f8d0907e2.jpg"},{"id":87501444,"identity":"923e0c86-f860-4d68-b8f3-f68c5d588d80","added_by":"auto","created_at":"2025-07-24 13:53:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":871051,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6049768/v1/00954806-6aeb-4dc1-a631-025560a1e4d3.pdf"},{"id":78209236,"identity":"06fea25a-fda8-4fa3-af04-833db8067060","added_by":"auto","created_at":"2025-03-11 03:20:06","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":80245,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eTable 1. and \u0026nbsp;Table 2.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"tables.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6049768/v1/24e748c2ce46ea68315c39f7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Resistance to fracture of simulated external cervical resorption using NeoMTA 2 and Biodentine cements. In Vitro Study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe goal of endodontic treatment is to clean, shape and disinfect the root canal system to eliminate or prevent apical periodontitis and tooth loss[1]. However, there are anatomical complexities, such as root resorptions that make disinfection difficult, reducing the success of the treatment. Cervical resorptions may cause progressive loss of dentin and even pulp tissues, weakening the tooth; and depending on their location, they are classified as external or internal.\u003c/p\u003e \u003cp\u003eFor the diagnosis and adequate treatment of resorptions, clinical examination and complementary exams are needed, such as periapical radiographs and computed tomography images. In 2017, Patel S et al.[2] created a new three-dimensional classification for external cervical resorption, using tomography, considering the height, circumference and proximity to the root canal [3]. Different materials based on calcium silicate known as bioceramic have been suggested for the treatment of this type of conditions. These materials can induce the formation of hydroxyapatite, allowing the repair of affected tissue, helping to prolong tooth stability in the oral cavity [4,5,6]\u003c/p\u003e \u003cp\u003eOne of the most studied repair cements is Biodentine, which has shown excellent results [3][5\u0026ndash;7] [8\u0026ndash;12]. Recently, a new hydraulic cement was introduced to the market, NeoMTA2, with properties similar to Biodentine and with dual indication (sealant and repairer).\u003c/p\u003e \u003cp\u003eDifferent authors have carried out studies on the physical, chemical and biological properties of these materials such as: biocompatibility, bioactivity, sealing capacity, radiopacity and solubility[5\u0026ndash;7] [8\u0026ndash;14]. However, there are any studies that have evaluated the fracture resistance of theeth with external cervical resorptions repaired with NeoMTA2. Therefore, the aim of this research is to determine the fracture resistance in teeth with simulated class 2Cd external cervical resorptions according to Patel S. et al. 2018 and repaired with Biodentine and NeoMTA2 bioceramics cements.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cp\u003eThe study was approved by the Institutional Ethics Committee N\u0026deg; 0639-2023-CIEI-UPSJB. For the study, 60 mandibular single-canal premolars were utilized, they were previously stored in saline solution and two periapical radiographs were taken, orthoradial and mesio angulated, applying the Clark technique to assure the presence of a single canal. Subsequently, they were sectioned with a diamond mesh disc mounted (Masterdent) using a low-speed motor (NSK FX 205B2), leaving a standard length of (16 mm.) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA-B). The working length was determined with a K #10 file (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC) and the root canals were prepared with the RC-Blue-R25/06 and 40/06 system (RCB, Woodpecker, Guilin, China) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eD-E). Irrigation was performed during all root canal preparation with 2.5% Sodium Hypochlorite with a 25 mm Navitip 30G needles (Ultradent, USA) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eF). The final irrigation was done with 2.5% Sodium Hypochlorite and 17% EDTA with ultrasonic activation for three cycles of 20 seconds and the irrigant substances were neutralized with saline solution, always maintaing 2 mm of distance from the working length. The canals were sealed with BioRoot RCS (Septodont, France) manipulated according to the manufacturer's instructions with 40/06 cones (Spident, Woodpecker, Korea) and lateral condensation (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eG). The simulation of class 2Cd external cervical resorption according to Shanon Patel was reproduced with a high-speed diamond round bur (MDT-018M) with a1.5 mm of diameter. The mesio-disto vestibular face aspect of each tooth was approached. The simulated resorption measured approximately 1.5 mm in depth and 3 mm in height in the corono-apical direction; the total diameter of the drill was used for standardizing the resorption (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eH). All canals were patented with #08 k files (Dentsply Maillefer, Switzerland). Cervical resorptions were repaired with Biodentine (Septodont, France) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eI) and NeoMTA2 (Avalon Biomed. USA) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eJ), manipulated according to the manufacturer's instructions. The samples were randomly divided into 4 study groups (n\u0026thinsp;=\u0026thinsp;10/group).\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eGroup 1: negative control group (theeth without biomechanical preparation and without simulated resorption)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eGroup 2: teeth with Shanon Patel class 2Cd cervical resorption without repair.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eGroup 3: teeth with Shanon Patel class 2Cd cervical resorption repaired with Biodentine.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eGroup 4: teeth with Shanon Patel class 2Cd cervical resorption repaired with NeoMTA2.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003cp\u003eAfter completing the procedure, the samples were kept in an HHD YZITE-6 incubator (Nanchang\u003c/p\u003e \u003cp\u003eHoward Technology Co., Ltd., China) at 37\u0026deg;C for 8 and 30 days (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eL-M). The samples were\u003c/p\u003e \u003cp\u003eimmersed in acrylic resin and the periodontal ligament was simulated by fluid silicone, these were submitted to a compression resistance test which was measured with a universal testing machine \u0026ldquo;LG CMT-5L\u0026rdquo; (Jinan Liangong Testing Technology Co., Ltd, China) by recording the maximum force in Newton (N) of mm/s, necessary to fracture each root (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eN-O).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSTATISTICAL ANALISIS\u003c/h3\u003e\n\u003cp\u003eStatistical analyses were performed on SPSS software, version 26 (Statistical Package for Social Sciences); Student t test was used to compare the average fracture resistance between two groups. For the comparison of the four groups, the F test was applied, after verification of normality Shapiro-Wilk test was assessed; and homogeneity of variances by Levene test. When the comparison was made with the four groups, as a complementary test of the analysis of variance, the data was submitted to Tukey test, which compared the equality of means of the groups in pairs. The statiscal significance amongst the groups were considered with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eResults by Group\u003c/p\u003e \u003cp\u003eGroup 1: Negative control (healthy teeth), 1989.72 N.\u003c/p\u003e \u003cp\u003eGroup 2: Positive control (teeth with simulated resorption without repair), 927.78 N.\u003c/p\u003e \u003cp\u003eGroup 3: Teeth with simulated resorption and repaired with Biodentine. At 8 days 1581.65 N and at 30 days 1656.26 N.\u003c/p\u003e \u003cp\u003eGroup 4: Teeth with simulated resorption and repaired with NeoMTA2. At 8 days 1421.15 N and at 30 days 1698.37 N.\u003c/p\u003e\n\u003ch3\u003eResults between Groups\u003c/h3\u003e\n\u003cp\u003eAfter 8 days, it is observed that all groups showed a significant statistical difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Group 1 (healthy teeth) had the greatest capacity to support compressive forces compared to the others. Group 3 (Biodentine) showed higher values (1581.65 N) than Group 4 (Neo MTA2) (1421.15 N). At the end of this period, Group 2 (teeth with unrepaired resorption)\u003c/p\u003e \u003cp\u003ewas the one that showed the lowest results of resistance to compressive forces (927.78 N) (Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003eThe last experimental period (30 days) it is evident that both cements (Biodentine \u0026ndash; Group 3 and Neo MTA 2 \u0026ndash; Group 4) did not present a significant statistical difference between them (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), meaning that the two cements could support the same load of compressive forces (1656.26 N and 1698.37 N, respectively). On the other hand, the other Groups showed the same behavior as 8 days (Table\u0026nbsp;2).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eExternal cervical resorption is a type of localized aggressive inflammatory defect that causes extensive loss of tooth structure. This loss can involve dentinal, periodontal and pulp tissues, and can lead to tooth fracture [15,16]\u003c/p\u003e \u003cp\u003eThe sealing of the lesions with bioceramics cements is one of the main treatment for cervical lesions. Theses biomaterials have physical-chemical properties that can improve the resistance to compressive forces, thus preventing root fractures [15\u0026ndash;16]. This is the first study that evaluated the compressive forces of two restorative cements in teeth with simulated external cervical resorptions class 2Cd according to Shanon Patel (2017) [2] in two experimental periods, 8 and 30 days.\u003c/p\u003e \u003cp\u003eThe results expressed in Table\u0026nbsp;2 showed the values obtained after 8 days, where all groups have a significant statistical difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). It is also observed that the Biodentine group (1581.65 N) obtained greater resistance than the NeoMTA2 group (1421.15 N) to compressive forces, which cohoborates with what was reported by Prasanthi et al. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) [17]. Likewise, Olcay et al (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) [8] found that Biodentine had better results in compressive strength capacity than ProRoot MTA in the same experimental period. According to a study carried out by Drukteinis et al. (2021) [9], this could be due to the fact that there is a greater release of calcium ions compared to other cements, a product of the interaction of calcium carbonate with the dentinal tissue; which would increase the reaction speed.\u003c/p\u003e \u003cp\u003eCamilleri et al. 2013 [18, 20], carried out an investigation of the hydration and bioactivity of radiopacified tricalcium silicate cements, where they observed that the hydration capacity of the Biodentine cement was more accelerated than the MTA Angelus, due to the presence of calcium carbonate, chloride of calcium and solubilizing polymers which would allow a faster initial setting that ranges between 6.5 and 16 minutes, the results presented in this study affirm this scientifical allegation. On the other hand, it was observed that after 30 days the NeoMTA 2 group increased its compressive strength capacity equal to the values obtained for group 3, therefore showing that there is no significant statistical difference (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) between both groups at the end of the experiment. The late reaction capacity of the NeoMTA2 group compared to the Biodentine group could be by the fact of having a viscous vehicle, the release of calcium and hydroxyl ions tend to be slower [9,10]\u003c/p\u003e \u003cp\u003eFinally, after 30 days, group 1 (healthy teeth) reflected the highest values compared to the others (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while groups 3 and 4 had no significant statistical difference between them (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05); thus, Neo MTA2 cement would be another alternative for the treatment of external cervical resorption cavities, which is a great finding for future clinical applications. However, these two groups (3 and 4) showed values higher than group 2 (tooth pieces with cervical resorption without repairment material), this information demonstrates that only the use of bioceramics repair cements would help to improve the compressive strength capacity in teeth with external cervical resorption.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis in vitro study could point out that both bioceramics cements are capable of withstanding compressive forces of teeth with external cervical resorption after 30 days, this information allows clinical relevance for the treatment of this type of lesions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCONFLICT OF INTEREST\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors certify that they have no affiliations with or involvement in any organization or \u0026nbsp;entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eETHICAL APPROVAL\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Institutional Committee on Research Ethics of the San Juan Bautista Private University with the register code N\u0026deg; 0639-2023-CIEI-UPSJB.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eINFORMED CONSENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualization, Jimena Lama Sarmiento, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres, Lisset Contreras Astete and John Paul Torres Navarro ; methodology, Jimena Lama Sarmiento, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres and Lisset Contreras Astete, formal analysis, Jimena Lama Sarmiento, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres and Lisset Contreras Astete; investigation, Jimena Lama Sarmiento, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres and Lisset Contreras Astete; resources, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres and Lisset Contreras Astete.; writing\u0026mdash;original draft preparation, Jimena Lama Sarmiento, Maydeli Ar\u0026eacute;valo C\u0026aacute;ceres and Lisset Contreras Astete ; writing\u0026mdash; review and editing, Jimena Lama Sarmiento and Pedro Henrique Chaves Oliveira; supervision, John Paul Torres Navarro; project administration, Jimena Lama Sarmiento and John Paul Torres Navarro. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGluskin AH, Peters CI, Peters OA. Minimally invasive endodontics: challenging prevailing paradigms. Br Dent J. 2014. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/sj.bdj.2014.201\u003c/span\u003e\u003cspan address=\"10.1038/sj.bdj.2014.201\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three-dimensional classification. Int Endod J. 2017. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/iej.12824\u003c/span\u003e\u003cspan address=\"10.1111/iej.12824\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTop\u0026ccedil;uoğlu HS, Tuncay \u0026Ouml;, Karataş E, Arslan H, Yeter K, Sealers. J Endod. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.joen.2013.07.034\u003c/span\u003e\u003cspan address=\"10.1016/j.joen.2013.07.034\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArıcan B, Sesen Uslu Y, Sarıalioğlu G\u0026uuml;ng\u0026ouml;r A. Resistance to fracture of simulated external cervical resorption cavities repaired with different materials. Aust Endod J. 2023. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/aej.12714\u003c/span\u003e\u003cspan address=\"10.1111/aej.12714\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong W, Sun W, Chen L, Yuan Z. (2020) In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics \u003cem\u003eFront Bioeng Biotechnology\u003c/em\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fbioe.2020.580954\u003c/span\u003e\u003cspan address=\"10.3389/fbioe.2020.580954\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlmohaimede A. Fracture resistance of roots obturated with bio-ceramic and epoxy resin- based sealers: In vitro study. Turk Endod J. 2020. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.14744/eej.2019.33042\u003c/span\u003e\u003cspan address=\"10.14744/eej.2019.33042\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEspinosa N, Espinosa I, Rodr\u0026iacute;guez E, Hern\u0026aacute;ndez J, Gonz\u0026aacute;lez G. (2014) Resorci\u0026oacute;n radicular externa idiop\u0026aacute;tica m\u0026uacute;ltiple. Presentaci\u0026oacute;n de un caso. Gac M\u0026eacute;d Espirit doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://scielo.sld.cu/scielo.phpscript=sci_arttext\u003c/span\u003e\u003cspan address=\"http://scielo.sld.cu/scielo.phpscript=sci_arttext\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u0026amp;pid=S102502552015000400010\u0026amp;lng=es \u0026amp;nrm\u0026thinsp;=\u0026thinsp;iso.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlcay K, Guneser M, Dincer A, Uyan H. (2022) Compressive strength, surface roughness, and surface microhardness of principle tricalcium silicate-based endodontic cements after \u003c/span\u003e\u003cspan\u003euniversal adhesive application. ;Niger J Clin Pract. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/njcp.njcp_1287_21\u003c/span\u003e\u003cspan address=\"10.4103/njcp.njcp_1287_21\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDrukteinis S, Camilleri J. (2021) \u003cem\u003eBioceramic Materials in Clinical Endodontics\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/978-3-030-58170-1\u003c/span\u003e\u003cspan address=\"10.1007/978-3-030-58170-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraga RR, About I. How far do calcium release measurements properly reflect its multiple roles in dental tissue mineralization? Clin Oral Investig. 2019;23(1):501. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00784-018-2789\u003c/span\u003e\u003cspan address=\"10.1007/s00784-018-2789\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMolina GFUJ, Brisson GA, Boetto C, Mazzola I, Lascano LB et al. \u003cem\u003e(2021)\u003c/em\u003e Resistencia a la compresi\u0026oacute;n de Biodentine\u0026reg;: mezcla manual vs. Mec\u0026aacute;nica Methodo Investig Apl Cienc Biol \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.22529/me.021.6(2)04\u003c/span\u003e\u003cspan address=\"10.22529/me.021.6(2)04\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSen HG, Helvacioglu-Yigit D, Yilmaz A. Radiopacity evaluation of calcium silicate cements. BMC Oral Health. 2023. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12903-023-03182-w\u003c/span\u003e\u003cspan address=\"10.1186/s12903-023-03182-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCamilleri J. (2022) \u003cem\u003eBiodentine \u0026trade; Microstructure and Composition\u003c/em\u003e. In: Imad About, editor Biodentine\u0026trade; Properties and Clinical Application, 11th end. Springer, pp 1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHa W, Kahler B, Walsh LJ. Classification and Nomanclature of Commercial Hygroscopic Dental Cements. Eur Endod J. 2017;2(1):27. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5152/eej.2017.17006\u003c/span\u003e\u003cspan address=\"10.5152/eej.2017.17006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFonseca TS, Silva GF, Guerreiro-Tanomaru JM, Sasso-Cerri E, Tanomaru-Filho M, Cerri PS. Mast cells and immunoexpression of FGF-1 and Ki-67 in rat subcutaneous tissue following the implantation of Biodentine and MTA Angelus. Int Endod J. 2018. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/iej.12981\u003c/span\u003e\u003cspan address=\"10.1111/iej.12981\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding External Cervical Resorption in Vital Teeth. J Endod. 2016;11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.joen.2016.06.007\u003c/span\u003e\u003cspan address=\"10.1016/j.joen.2016.06.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeithersay GS. Invasive cervical resorption. Endod Top. 200410.1111/j.1601- 1546.2004.00060.x.}.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrasanthi P, Garlapati R, Nagesh B, Sujana V, Kiran Naik K, Yamini B. Effect of 17% ethylenediaminetetraacetic acid and 0.2% chitosan on pushout bond strength of biodentine and ProRoot mineral trioxide aggregate: An in vitro study. J Conserv Dent. 2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jcd.jcd_56_19\u003c/span\u003e\u003cspan address=\"10.4103/jcd.jcd_56_19\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCamillieri, MTA Angelus. Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, Biodentine and. Dent Mat. 2013. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.dental.2013.03.007\u003c/span\u003e\u003cspan address=\"10.1016/j.dental.2013.03.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2013 Mar 26. 12.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 and 2 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Compressive forces, Newton, Resorption","lastPublishedDoi":"10.21203/rs.3.rs-6049768/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6049768/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe aim of this study is to compare the fracture resistance of simulated 2Cd external resorptions with two different bioceramics cements, NeoMTA 2 and Biodentine.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e: Sixty single-rooted mandibular premolars were divided into 4 groups: Control group (healthy teeth); Group 2: teeth with 2Cd cervical resorption class; Group 3: teeth with 2Cd cervical resorption sealed with Biodentine cement; Group 4: teeth with class 2Cd cervical resorption sealed with NeoMTA2 cement. All groups underwent evaluation of compressive forces at 8 and 30 days, measured in Newtons using a Universal machine LG CMT – 5L (Nanchang Howard Technology Co.,Ltd, China). The t-student, Shapiro Wilk and Tukey statistical tests were used using the SPSS 27 Software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter 8 days all groups showed a statistical difference (p \u0026lt; 0.05). Group 3 had greater compressive strength capacity than groups 2 and 4, but lower than the control group. At 30 days, groups 3 and 4 did not present a statistical difference, but they had values higher than group 2 (teeth with cervical resorption without repair) and lower than the control group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the conditions of the study, there was no significant statistical difference in resistance to compressive forces between Biodentine and NeoMTA2 cements at 30 days. \u003cstrong\u003eClinical relevance\u003c/strong\u003e: The use of Biodentine and NeoMTA2 cements as a repair materials are recommended. However, future research is needed to determine the most suitable repair material for resorption cavities with different classifications.\u003c/p\u003e","manuscriptTitle":"Resistance to fracture of simulated external cervical resorption using NeoMTA 2 and Biodentine cements. In Vitro Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-11 03:20:02","doi":"10.21203/rs.3.rs-6049768/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73e36301-30f6-43b0-9c88-a448bd93b207","owner":[],"postedDate":"March 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-24T13:53:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-11 03:20:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6049768","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6049768","identity":"rs-6049768","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}