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VOLUME 25 , ISSUE 12 ( December, 2024 ) > List of Articles

ORIGINAL RESEARCH

Push-out Bond Strength of Two Bioceramic Sealers after Using Various Final Irrigation Solutions: An In Vitro Study

Arwa S Alnoury, Mohammad K Abdalwassie, Muhannad W Alawbthani, Lina O Bahanan, Maher S Hajjaj

Keywords : Apple vinegar, Chelating agents, Glycolic acid, Push-out, Root canal

Citation Information : Alnoury AS, Abdalwassie MK, Alawbthani MW, Bahanan LO, Hajjaj MS. Push-out Bond Strength of Two Bioceramic Sealers after Using Various Final Irrigation Solutions: An In Vitro Study. J Contemp Dent Pract 2024; 25 (12):1092-1098.

DOI: 10.5005/jp-journals-10024-3789

License: CC BY-NC 4.0

Published Online: 05-03-2025

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


Abstract

Aim: This study assessed how different final irrigation solutions impact the push-out bond strength (PBS) of EndoSequence Bioceramic (BC) and cerafill BC sealers. Methods: Eighty single-root lower premolars were selected and decoronated. The root canals were then cleaned and shaped chemo-mechanically using ProTaper files up to F5, with 5.25% sodium hypochlorite applied between each file for rinsing. Subsequently, the teeth were categorized into four primary groups of 20 each, distinguished by their final irrigation solution. Group A utilized 17% glycolic acid (GA), group B used a 5% apple vinegar solution, group C employed 17% ethylenediamine tetraacetic acid (EDTA), and group D used saline. Each group was further divided into two subgroups of 10 teeth each, based on the type of BC sealer applied—Cerafill BC sealer for subgroup a, and EndoSequence BC sealer for subgroup b. Two dentin disks were then obtained from the middle third of each root (n = 20) and subjected to the PBS test. Upon completion of this test, the dentin disks were scrutinized under a stereomicroscope to determine the mode of failure for each disk. Results: The use of EndoSequence BC sealer in obturation led to the apple vinegar final irrigation group exhibiting significantly higher PBS than the GA and saline solution groups. Furthermore, when implemented with cerafill BC sealer, the EDTA final irrigation solution group displayed the greatest PBS, showing a significant difference compared with the GA and saline solution groups. Conclusion: Apple vinegar solution could be a potential alternative to EDTA as a chelating agent during root canal treatment, though further research is required. Clinical significance: The EDTA and apple vinegar are effective at removing smear layers, which improves sealer penetration and prevents obturation materials dislodgment.

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  1. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974;18(2):269–296. PMID: 4522570.
  2. Metzger Z, Zary R, Cohen R, et al. The quality of root canal preparation and root canal obturation in canals treated with rotary versus self-adjusting files: A three-dimensional micro-computed tomographic study. J Endod 2010;36(9):1569–1573. DOI: 10.1016/j.joen.2010.06.003.
  3. Peters OA, Peters CI, Schönenberger K, et al. ProTaper rotary root canal preparation: Assessment of torque and force in relation to canal anatomy. Int Endod J 2003;36(2):93–99. DOI: 10.1046/j.1365-2591.2003.00628.x.
  4. Peters OA, Laib A, Göhring TN, et al. Changes in root canal geometry after preparation assessed by high-resolution computed tomography. J Endod 2001;27(1):1–6. DOI: 10.1097/00004770-200101000-00001.
  5. Rödig T, Hülsmann M, Mühge M, et al. Quality of preparation of oval distal root canals in mandibular molars using nickel-titanium instruments. Int Endod J 2002;35(11):919–928. DOI: 10.1046/j.1365-2591.2002.00599.x.
  6. Naenni N, Thoma K, Zehnder M. Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod 2004;30(11):785–787. DOI: 10.1097/00004770-200411000-00009.
  7. White RR, Goldman M, Lin PS. The influence of the smeared layer upon dentinal tubule penetration by plastic filling materials. J Endod 1984;10(12):558–562. DOI: 10.1016/S0099-2399(84)80100-4.
  8. Violich DR, Chandler NP. The smear layer in endodontics – A review. Int Endod J 2010;43(1):2–15. DOI: 10.1111/j.1365-2591.2009.01627.x.
  9. Marending M, Paqué F, Fischer J, et al. Impact of irrigant sequence on mechanical properties of human root dentin. J Endod 2007;33(11):1325–1328. DOI: 10.1016/j.joen.2007.08.005.
  10. Amaral KF, Rogero MM, Fock RA, et al. Cytotoxicity analysis of EDTA and citric acid applied on murine resident macrophages culture. Int Endod J 2007;40(5):338–343. DOI: 10.1111/j.1365-2591.2007.01220.x.
  11. Aslantas EE, Buzoglu HD, Altundasar E, et al. Effect of EDTA, sodium hypochlorite, and chlorhexidine gluconate with or without surface modifiers on dentin microhardness. J Endod 2014;40(6):876–879. DOI: 10.1016/j.joen.2013.10.041.
  12. Qing Y, Akita Y, Kawano S, et al. Cleaning efficacy and dentin micro-hardness after root canal irrigation with a strong acid electrolytic water. J Endod 2006;32(11):1102–1106. DOI: 10.1016/j.joen.2006. 07.003.
  13. Bello YD, Porsch HF, Farina AP, et al. Glycolic acid as the final irrigant in endodontics: Mechanical and cytotoxic effects. Mater Sci Eng C Mater Biol Appl 2019;100:323–329. DOI: 10.1016/j.msec.2019.03.016.
  14. Bello YD, Farina AP, Souza MA, et al. Glycolic acid: Characterization of a new final irrigant and effects on flexural strength and structural integrity of dentin. Mater Sci Eng C Mater Biol Appl 2020;106:110283. DOI: 10.1016/j.msec.2019.110283.
  15. Candeiro GTM, de Matos IB, da Costa CFE, et al. A comparative scanning electron microscopy evaluation of smear layer removal with apple vinegar and sodium hypochlorite associated with EDTA. J Appl Oral Sci 2011;19(6):639–643. DOI: 10.1590/s1678-77572011000 600016.
  16. Zandim DL, Corrêa FOB, Sampaio JEC, et al. The influence of vinegars on exposure of dentinal tubules: A SEM evaluation. Braz Oral Res 2004;18(1):63–68. DOI: 10.1590/s1806-83242004000100012.
  17. Kataoka M, Sasaki M, Hidalgo AR, et al. Glycolic acid production using ethylene glycol-oxidizing microorganisms. Biosci Biotechnol Biochem 2001;65(10):2265–2270. DOI: 10.1271/bbb.65.2265.
  18. van der Smissen A, Hoffmeister PG, Friedrich N, et al. Artificial extracellular matrices support cell growth and matrix synthesis of human dermal fibroblasts in macroporous 3D scaffolds. J Tissue Eng Regen Med 2017;11(5):1390–1402. DOI: 10.1002/term.2037.
  19. Cecchin D, Farina AP, Vidal C, et al. A novel enamel and dentin etching protocol using α-hydroxy glycolic acid: Surface property, etching pattern, and bond strength studies. Oper Dent 2018;43(1):101–110. DOI: 10.2341/16-136-L.
  20. Caligiani A, Acquotti D, Palla G, et al. Identification and quantification of the main organic components of vinegars by high resolution 1H NMR spectroscopy. Anal Chim Acta 2007;585(1):110–119. DOI: 10.1016/j.aca.2006.12.016.
  21. Estrela C, Holland R, Bernabé PFE, et al. Antimicrobial potential of medicaments used in healing process in dogs’ teeth with apical periodontitis. Braz Dent J 2004;15(3):181–185. DOI: 10.1590/s0103-64402004000300003.
  22. Kuçi A, Alaçam T, Yavaş O, et al. Sealer penetration into dentinal tubules in the presence or absence of smear layer: A confocal laser scanning microscopic study. J Endod 2014;40(10):1627–1631. DOI: 10.1016/j.joen.2014.03.019.
  23. Sagsen B, Ustün Y, Demirbuga S, et al. Push-out bond strength of two new calcium silicate-based endodontic sealers to root canal dentine. Int Endod J 2011;44(12):1088–1091. DOI: 10.1111/j.1365-2591.2011.01925.x.
  24. Hata G, Kawazoe S, Toda T, et al. Sealing ability of Thermafil with and without sealer. J Endod 1992;18(7):322–326. DOI: 10.1016/s0099-2399(06)80481-4.
  25. Zeid STA, Alnoury A. Characterisation of the bioactivity and the solubility of a new root canal sealer. Int Dent J 2023;73(5):760–769. DOI: 10.1016/j.identj.2023.04.003.
  26. Brasseler. Endosequence BC sealer [Internet]. Brasseler [cited 2024 May 8]. Available from: https://brasselerusadental.com/products/endosequence-bc-sealer.
  27. Donnermeyer D, Bürklein S, Dammaschke T, et al. Endodontic sealers based on calcium silicates: A systematic review. Odontology 2019;107(4):421–436. DOI: 10.1007/s10266-018-0400-3.
  28. Giacomino CM, Wealleans JA, Kuhn N, et al. Comparative biocompatibility and osteogenic potential of two bioceramic sealers. J Endod 2019;45(1):51–56. DOI: 10.1016/j.joen.2018.08.007.
  29. Edrees HY, Zeid STHA, Atta HM, et al. Induction of osteogenic differentiation of mesenchymal stem cells by bioceramic root repair material. Materials (Basel) 2019;12(14):2311. DOI: 10.3390/ma12142311.
  30. Zhang H, Shen Y, Ruse ND, et al. Antibacterial activity of endodontic sealers by modified direct contact test against Enterococcus faecalis. J Endod 2009;35(7):1051–1055. DOI: 10.1016/j.joen.2009.04.022.
  31. Ersahan S, Aydin C. Dislocation resistance of iRoot SP, a calcium silicate-based sealer, from radicular dentine. J Endod 2010;36(12):2000–2002. DOI: 10.1016/j.joen.2010.08.037.
  32. Nagas E, Uyanik MO, Eymirli A, et al. Dentin moisture conditions affect the adhesion of root canal sealers. J Endod 2012;38(2):240–244. DOI: 10.1016/j.joen.2011.09.027.
  33. Prevest DenPro. Bioceramic root canal filling and sealing material [Internet]. 2024 [cited 2024 May 8]. Available from: https://www.pre-vestdenpro.com/product/cerafill-rcs.
  34. Lin GSS, Ghani NRNA, Noorani TY, et al. Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: An in-vitro study. Odontology 2021;109(1):149–156. DOI: 10.1007/s10266-020-00535-7.
  35. Küçükekenci FF. The effect of different acidic irrigation solutions on the push-out bond strength of root canal filling. J Dent Res Dent Clin Dent Prospects 2023;17(1):18–22. DOI: 10.34172/joddd.2023.36920.
  36. Veeramachaneni C, Aravelli S, Dundigalla S. Comparative evaluation of push-out bond strength of bioceramic and epoxy sealers after using various final irrigants: An in vitro study. J Conserv Dent 2022;25(2):145–150. DOI: 10.4103/jcd.jcd_10_22.
  37. Gundogar M, Sezgin GP, Erkan E, et al. The influence of the irrigant QMix on the push-out bond strength of a bioceramic endodontic sealer. Eur Oral Res 2019;52(2):64–68. DOI: 10.26650/eor.2018.446.
  38. Secilmis A, Dilber E, Gokmen F, et al. Effects of storage solutions on mineral contents of dentin. J Dent Sci 2011;6(4):189–194. DOI: 10.1016/j.jds.2011.09.001.
  39. Ali AMM, Raab WH. Smear layer removal efficiency using apple vinegar: An in vitro scanning electron microscope study. Am J Dent 2019;32(1):21–27. PMID: 30834727.
  40. Nagendrababu V, Murray PE, Ordinola-Zapata R, et al. PRILE 2021 guidelines for reporting laboratory studies in endodontology: A consensus-based development. Int Endod J 2021;54(9):1482–1490. DOI: 10.1111/iej.13542.
  41. Chen WP, Chen YY, Huang SH, et al. Limitations of push-out test in bond strength measurement. J Endod 2013;39(2):283–287. DOI: 10.1016/j.joen.2012.11.002.
  42. 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.
  43. Teixeira CS, Alfredo E, Thomé LHC, et al. Adhesion of an endodontic sealer to dentin and gutta-percha: Shear and push-out bond strength measurements and SEM analysis. J Appl Oral Sci 2009;17(2):129–135. DOI: 10.1590/s1678-77572009000200011.
  44. Eldeniz AU, Erdemir A, Belli S. Shear bond strength of three resin based sealers to dentin with and without the smear layer. J Endod 2005;31(4):293–296. DOI: 10.1097/01.don.0000140577.99708.c8.
  45. Tekin B, Demirkaya K. Natural irrigation solutions in endodontics. Gulhane Med J. 2020;62:133–138. DOI: 10.4274/gulhane.galenos.2020.902.
  46. Goldman M, Kronman JH, Goldman LB, et al. New method of irrigation during endodontic treatment. J Endod 1976;2(9):257–260. DOI: 10.1016/S0099-2399(76)80085-4.
  47. Frasquetti KS, Piasecki L, Kowalczuck A, et al. Effect of different root canal drying protocols on the bond strength of two bioceramic sealers. Eur J Dent 2023;17(4):1229–1234. DOI: 10.1055/s-0042-1758807.
  48. Dias KC, Soares CJ, Steier L, et al. Influence of drying protocol with isopropyl alcohol on the bond strength of resin-based sealers to the root dentin. J Endod 2014;40(9):1454–1458. DOI: 10.1016/j.joen.2014.02.021.
  49. Kanwar SS, Taneja S, Kumar P, et al. Effect of final irrigant on depth of tubular penetration of resin-based root canal sealer and bioactive sealers using confocal laser scanning microscope. Endodontology 2020;32(4):204–208. DOI: 10.4103/endo.endo_49_20.
  50. Jain G, Rajkumar B, Boruah LC, et al. Influence of different endodontic irrigants on the push-out bond strength of an epoxy-resin based sealer and newly introduced bioceramic sealer to root dentin: An in-vitro study. J Dent Spec 2019;7(1):9–18. DOI: 10.18231/j.jds. 2019.003.
  51. Erickson RL. Surface interactions of dentin adhesive materials. Oper Dent 1992;Suppl 5:81–94. PMID: 1470557.
  52. Mello I, Kammerer BA, Yoshimoto D, et al. Influence of final rinse technique on ability of ethylenediaminetetraacetic acid of removing smear layer. J Endod 2010;36(3):512–514. DOI: 10.1016/j.joen.2009.11.004.
  53. Rödig T, Döllmann S, Konietschke F, et al. Effectiveness of different irrigant agitation techniques on debris and smear layer removal in curved root canals: A scanning electron microscopy study. J Endod 2010;36(12):1983–1987. DOI: 10.1016/j.joen.2010.08.056.
  54. Mohammadi Z, Shalavi S, Jafarzadeh H. Ethylenediaminetetraacetic acid in endodontics. Eur J Dent 2013;7(Suppl 1):S135–S142. DOI: 10.4103/1305-7456.119091.
  55. 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.
  56. Atmeh AR, Chong EZ, Richard G, et al. Dentin-cement interfacial interaction: Calcium silicates and polyalkenoates. J Dent Res 2012;91(5):454–459. DOI: 10.1177/0022034512443068.
  57. Ali L, Toma I, Saeed R. Comparative evalution of a new endodontic irrigation solution – Apple vinegar, ginger oil and sodium hypochlorite to remove the smear layer by scanning electron microscope study. J Univ Duhok 2020;22(1):30–37. DOI: 10.26682/sjuod.2020.22.1.4.
  58. Candeiro GTM, Moura-Netto C, D'Almeida-Couto RS, et al. Cytotoxicity, genotoxicity and antibacterial effectiveness of a bioceramic endodontic sealer. Int Endod J 2016;49(9):858–864. DOI: 10.1111/iej.12523.
  59. Ali A, Fawzy M, Bastawy H. Evaluation of intraradicular surface roughness following final irrigation by apple vinegar and its correlation with resin sealer bond strength. Al-Azhar Dent J Girls 2020;7(1):79–88. DOI: 10.21608/adjg.2019.7799.1102.
  60. Ragab RM, Kamel WH, Elsheikh HM. Push-out bond strength of endoseal MTA and AH plus sealers after using apple vinegar as final irrigating solution. Al-Azhar Dent J Girls 2022;9(4):613–621. DOI: 10.21608/adjg.2022.124437.1469.
  61. Neelakantan P, Sharma S, Shemesh H, et al. Influence of irrigation sequence on the adhesion of root canal sealers to dentin: A Fourier transform infrared spectroscopy and push-out bond strength analysis. J Endod 2015;41(7):1108–1111. DOI: 10.1016/j.joen.2015.02.001.
  62. Huffman BP, Mai S, Pinna L, et al. Dislocation resistance of ProRoot Endo Sealer, a calcium silicate-based root canal sealer, from radicular dentine. Int Endod J 2009;42(1):34–46. DOI: 10.1111/j.1365-2591.2008.01490.x.
  63. Shokouhinejad N, Gorjestani H, Nasseh AA, et al. Push-out bond strength of gutta-percha with a new bioceramic sealer in the presence or absence of smear layer. Aust Endod J 2013;39(3):102–106. DOI: 10.1111/j.1747-4477.2011.00310.x.
  64. Carvalho CN, Grazziotin-Soares R, Candeiro GTM, et al. Micro push-out bond strength and bioactivity analysis of a bioceramic root canal sealer. Iran Endod J 2017;12(3):343–348. DOI: 10.22037/iej.v12i3. 16091.
  65. Kadić S, Baraba A, Miletić I, et al. Push-out bond strength of three different calcium silicate-based root-end filling materials after ultrasonic retrograde cavity preparation. Clin Oral Investig 2018;22(3):1559–1565. DOI: 10.1007/s00784-017-2244-6.
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