The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 25 , ISSUE 1 ( January, 2024 ) > List of Articles


Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study

Michéle Paul Makhlouf, Joe David El Helou, Carla Elias Zogheib, Anne-Christelle Paul Makhlouf, Mariana Elie Karam, Issam Tanios Khalil

Keywords : BioRoot RCS, Calcium silicate-based sealer, K-Sealer, Push-out bond strength, Sealite Ultra, Zinc oxide-based sealer

Citation Information : Makhlouf MP, El Helou JD, Zogheib CE, Makhlouf AP, Karam ME, Khalil IT. Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study. J Contemp Dent Pract 2024; 25 (1):15-19.

DOI: 10.5005/jp-journals-10024-3610

License: CC BY-NC 4.0

Published Online: 17-02-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Aim: The aim of this present study was to compare the dislodgement resistance of calcium silicate-based sealer, zinc oxide sealer, and a new sealer combining both zinc oxide and calcium silicate-based sealer in vitro. Materials and methods: 60 single-rooted human teeth were instrumented with F3 Protaper Gold. All endodontic canals were filled using gutta percha cones using the cold lateral condensation technique in combination using one of the mentioned sealers (n = 20 per group). The teeth were divided into three groups: group A consisted of Sealite® Ultra, group B consisted of K-Sealer®, and group C consisted of BioRoot® RC. After 2 months of incubation (37°C, 100% humidity) and after cutting out 2 mm from the most apical portion of the root apex, six slices of 1 mm thickness were generated. Mechanical dislodgement resistance was examined using a universal pressure-testing machine and the push-out bond strength (POBS) was calculated. Specimens were examined under 20× magnification to define the bond failure mode. Statistical analysis was executed using ANOVA, post hoc Turkey test for pairwise comparisons and Kruskal–Wallis tests. Results: The POBS of BioRoot® was significantly higher than the POBS of the two other sealers with a mean of 10.54 MPa ± 2.10 and 5.73 MPa ± 2.34, respectively (p < 0.001). Sealite® and K-Sealer® showed similar results in the median and coronal part. K-Sealer® revealed highest POBS compared with Sealite® in the apical part (p < 0.05). Conclusion: The POBS of the zinc oxide and calcium silicate-based sealer was significantly lower compared with calcium silicate. Sealite® and K-Sealer® exhibited almost same results. BioRoot showed the highest POBS of all sealers. Clinical significance: The current study was needed to evaluate the bond strength of three different cements to dentinal walls, by evaluating their respective POBS in vitro. The findings of this study may provide guidance for the clinician in the selection of an adequate endodontic sealer that guarantees an enhanced adhesive seal between the Gutta-percha and the dentinal canal walls.

  1. Holland R, Gomes JE Filho, Cintra LTA, et al. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017;25(5):465–476. DOI: 10.1590/1678-7757-2016-0464.
  2. Komabayashi T, Colmenar D, Cvach N, et al. Comprehensive review of current endodontic sealers. Dent Mater J 2020;39(5):703–720. DOI: 10.4012/dmj.2019-288.
  3. Eltair M, Pitchika V, Hickel R, et al. Evaluation of the interface between gutta-percha and two types of sealers using scanning electron microscopy (SEM). Clin Oral Investig 2018;22(4):1631–1639. DOI: 10.1007/s00784-017-2216-x.
  4. Viapiana R, Moinzadeh AT, Camilleri L, et al. Porosity and sealing ability of root fillings with gutta-percha and BioRoot RCS or AH Plus sealers. Evaluation by three ex vivo methods. Int Endod J 2016;49(8):774–782. DOI: 10.1111/iej.12513.
  5. Song W, Li S, Tang Q, et al. In vitro biocompatibility and bioactivity of calcium silicatebased bioceramics in endodontics (Review). Int J Mol Med 2021;48(1):128. DOI: 10.3892/ijmm.2021.4961.
  6. Akhtar H, Naz F, Hasan A, et al. Exploring the most effective apical seal for contemporary bioceramic and conventional endodontic sealers using three obturation techniques. Medicina (Kaunas) 2023;59(3):567. Published on: 14 March 2023. DOI: 10.3390/medicina59030567.
  7. Alsubait S, Alsaad N, Alahmari S, et al. The effect of intracanal medicaments used in endodontics on the dislocation resistance of two calcium silicate-based filling materials. BMC Oral Health 2020;20(1):57. DOI: 10.1186/s12903-020-1044-6.
  8. Donnermeyer D, Urban K, Bürklein S, et al. Physico-chemical investigation of endodontic sealers exposed to simulated intracanal heat application: epoxy resins and zinc oxide-eugenols. Int Endod J 2020;53(5):690–697. DOI: 10.1111/iej.13267.
  9. Vula V, Stavileci M, Ajeti N, et al. Evaluation of apical leakage after root canal obturation with glass ionomer, resin, and zinc oxide eugenol sealers combined with thermafil. Med Sci Monit Basic Res 2022;28:e936675. DOI: 10.12659/MSMBR.936675.
  10. Li J, Bergeron BE, Chao J, et al. Micro-computed tomography evaluation of root canal filling quality with apical negative pressure. J Dent 2020;100:103431. DOI: 10.1016/j.jdent.2020.103431.
  11. Alipour M, Faraji Gavgani L, Ghasemi N. Push-out bond strength of the calcium silicate-based endodontic cements in the presence of blood: A systematic review and meta-analysis of in vitro studies. Clin Exp Dent Res 2022;8(2):571–582. DOI: 10.1002/cre2.546.
  12. Hardan L, Mancino D, Bourgi R, et al. Bond strength of adhesive systems to calcium silicate-based materials: A systematic review and meta-analysis of in vitro studies. Gels 2022;8(5):311. DOI: 10.3390/gels8050311.
  13. Manoj A, Kavitha R, Karuveettil V, et al. Comparative evaluation of shear bond strength of calcium silicate-based liners to resin-modified glass ionomer cement in resin composite restorations – A systematic review and meta-analysis. Evid Based Dent 2022. DOI: 10.1038/s41432-022-0825-y.
  14. Tohidkhah S, Ahmadi E, Abbasi M, et al. Effect of Bioinductive Cavity Liners on Shear Bond Strength of Dental Composite to Dentin. Biomed Res Int 2022;2022:3283211. DOI: 10.1155/2022/3283211.
  15. Retana-Lobo C, Tanomaru-Filho M, Guerreiro-Tanomaru JM, et al. Push-out bond strength, characterization, and ion release of premixed and powder-liquid bioceramic sealers with or without gutta-percha. Scanning 2021;2021:6617930. DOI: 10.1155/2021/6617930.
  16. Sfeir G, Bukiet F, Hage W, et al. Impact of final irrigation protocol on the push-out bond strength of two types of endodontic sealers. Materials (Basel) 2023;16(5):1761. DOI: 10.3390/ma16051761.
  17. Kurup D, Nagpal AK, Shetty S, et al. Data on the push-out bond strength of three different root canal treatment sealers. Bioinformation 2021;17(1):67–72. DOI: 10.6026/97320630017067.
  18. Camilleri J. Sealers and warm gutta-percha obturation techniques. J Endod 2015;41(1):72–78. DOI: 10.1016/j.joen.2014.06.007.
  19. Ali N, Saha SG, Vijayvargiya P, et al. Comparative evaluation of push-out bond strength of gutta-percha using different sealers with lateral condensation and thermoplasticized obturation technique: An in vitro study. J Conserv Dent 2019;22(6):593–597. DOI: 10.4103/JCD.JCD_553_18.
  20. Donnermeyer D, Dornseifer P, Schäfer E, et al. The push-out bond strength of calcium silicate-based endodontic sealers. Head Face Med 2018;14(1):13. DOI: 10.1186/s13005-018-0170-8.
  21. De-Deus G, Souza EM, Silva EJNL, et al. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384–445. DOI: 10.1111/iej.13713. Epub 2022 Mar 13. PMID: 35226760.
  22. Baranwal HC, Mittal N, Garg R, et al. Comparative evaluation of retreatability of bioceramic sealer (BioRoot RCS) and epoxy resin (AH Plus) sealer with two different retreatment files: An in vitro study. J Conserv Dent 2021;24(1):88–93. DOI: 10.4103/jcd.jcd_657_20.
  23. De Bem IA, de Oliveira RA, Weissheimer T, et al. Effect of ultrasonic activation of endodontic sealers on intratubular penetration and bond strength to root dentin. J Endod 2020;46(9):1302–1308. DOI: 10.1016/j.joen.2020.06.014.
  24. Neelakantan P, Ahmed HMA, Wong MCM, et al. Effect of root canal irrigation protocols on the dislocation resistance of mineral trioxide aggregate-based materials: A systematic review of laboratory studies. Int Endod J 2018;51(8):847–861. DOI: 10.1111/iej.12898.
  25. Srivastava A, Yadav DS, Rao M, et al. Evaluation of push-out bond strength of BioRoot RCS and AH Plus after using different irrigants: An in vitro study. J Conserv Dent 2020;23(1):26–31. DOI: 10.4103/JCD.JCD_223_20.
  26. Milanovic I, Milovanovic P, Antonijevic D, et al. Immediate and long-term porosity of calcium silicate-based sealers. J Endod 2020;46(4):515–523. DOI: 10.1016/j.joen.2020.01.007.
  27. Uzunoglu-Özyürek E, Erdoğan Ö, Aktemur Türker S. Effect of calcium hydroxide dressing on the dentinal tubule penetration of 2 different root canal sealers: A confocal laser scanning microscopic study. J Endod 2018;44(6):1018–1023. DOI: 10.1016/j.joen.2018.02.016.
  28. Ballal NV, Ulusoy Öİ, Chhaparwal S, et al. Effect of novel chelating agents on the push-out bond strength of calcium silicate cements to the simulated root-end cavities. Microsc Res Tech 2018;81(2): 214–219. DOI: 10.1002/jemt.22969.
  29. Badawy RE, Mohamed DA. Evaluation of new bioceramic endodontic sealers: An in vitro study. Dent Med Probl 2022;59(1):85–92. DOI: 10.17219/dmp/133954.
  30. Gokturk H, Ozkocak I, Buyukgebiz F. Effect of different chelating agents on the bond strength of a silicone-based root canal sealer to root dentin. J Conserv Dent 2020;23(2):158–162. DOI: 10.4103/JCD.JCD_81_19.
  31. Augusto CM, Cunha Neto MA, Pinto KP, et al. Influence of the use of chelating agents as final irrigant on the push-out bond strength of epoxy resin-based root canal sealers: A systematic review. Aust Endod J 2022;48(2):347–363. DOI: 10.1111/aej.12563.
  32. Khalil I, Naaman A, Camilleri J. Properties of tricalcium silicate sealers. J Endod 2016;42(10):1529–1535. DOI: 10.1016/j.joen.2016.06.002.
  33. Aminoshariae A, Primus C, Kulild JC. Tricalcium silicate cement sealers: Do the potential benefits of bioactivity justify the drawbacks? J Am Dent Assoc 2022;153(8):750–760. DOI: 10.1016/j.adaj.2022.01.004.
  34. Chakar S, Changotade S, Osta N, et al. Cytotoxic evaluation of a new ceramic-based root canal sealer on human fibroblasts. Eur J Dent 2017;11(2):141–148. DOI: 10.4103/ejd.ejd_2_17.
  35. Kim JH, Cho SY, Choi Y, et al. Clinical efficacy of sealer-based obturation Using calcium silicate sealers: A randomized clinical Trial. J Endod 2022;48(2):144–151.
  36. Carvalho CN, Grazziotin-Soares R, de Miranda Candeiro GT, et al. Micro Push-out bond strength and bioactivity analysis of a bioceramic root canal sealer. Iran Endod J 2017 Summer;12(3):343–348. DOI: 10.22037/iej.v12i3.16091.
  37. Milani AS, Kuzegari S, Zand V, et al. Ability of calcium silicate and epoxy resin-based sealers to fill the artificial lateral canals in the presence or absence of smear layer. Maedica (Bucur) 2021;16(3): 458–462. DOI: 10.26574/maedica.2021.16.3.458.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.