Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Injectable Filler | Research

Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials

Authors: Nada Omar, Rasha M. Abdelraouf, Tamer M. Hamdy

Published in: BMC Oral Health | Issue 1/2023

Login to get access

Abstract

Background

The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions.

Methods

A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test.

Results

The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05).

Conclusion

Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.
Literature
1.
Abusrewil SM, McLean W, Scott JA. The use of Bioceramics as root-end filling materials in periradicular surgery: a literature review. Saudi Dent J. 2018;30:273–82.PubMedPubMedCentralCrossRef
2.
Hemasathya B, Mony CMB, Prakash V. Recent advances in root end filling materials: a review. Biomedical and Pharmacology Journal. 2015;8SE:219–24.CrossRef
3.
Zaki DY, Zaazou MH, Khallaf ME, Hamdy TM. In vivo comparative evaluation of periapical healing in response to a calcium silicate and calcium hydroxide based endodontic sealers. Open Access Maced J Med Sci. 2018;6:1475–9.PubMedPubMedCentralCrossRef
4.
de Vasconcelos BC, Bernardes RA, Duarte MAH, Bramante CM, de Moraes IG. Apical sealing of root canal fillings performed with five different endodontic sealers: analysis by fluid filtration. J Appl Oral Sci. 2011;19:324–8.PubMedPubMedCentralCrossRef
5.
Afkhami F, Nasri S, Valizadeh S. Bacterial leakage assessment in root canals sealed with AH Plus sealer modified with silver nanoparticles.BMC Oral Health. 2021;21.
6.
Graziele Magro M, Carlos Kuga M, Regina Victorino K, Antonio Vázquez-Garcia F, Javier Aranda-Garcia A, Batista Faria-Junior N, et al. Evaluation of the interaction between sodium hypochlorite and several formulations containing chlorhexidine and its effect on the radicular dentin-SEM and push-out bond strength analysis. Microsc Res Tech. 2014;77:17–22.PubMedCrossRef
7.
Alamoudi RA. The smear layer in endodontic: to keep or remove-an updated overview. Saudi Endodontic Journal. 2019;9:71–81.
8.
Martinho JP, França S, Paulo S, Paula AB, Coelho AS, Abrantes AM, et al. Effect of different irrigation solutions on the diffusion of mta cement into the root canal dentin. Mater (Basel). 2020;13:1–10.
9.
Rossi-Fedele G, Doramac EJ, Guastalli AR, Steier L, Poli De Figueiredo JA. Antagonistic interactions between sodium hypochlorite, chlorhexidine, EDTA, and citric acid. J Endod. 2012;38:426–31.PubMedCrossRef
10.
Fibryanto E, Suprastiwi E, Meidyawati R, Gunawan HA, Herda E. The effect of sodium hypochlorite irrigation on dentin’s collagen and shear bond strength of composite resin to dentin. J Int Dent Med Res. 2019;12:111–6.
11.
Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: Effect of concentration, temperature, agitation, and surfactant. J Endod. 2010;36:1558–62.PubMedCrossRef
12.
Ahamed S, Raju VG, Krishnamurthy M, Kumar VN, Selvendran KE. Antimicrobial Efficacy of Herbal Root Canal Irrigants and 3% Sodium Hypochlorite against Enterococcus faecalis: An In-vitro Study.J Pharm Res Int. 2021;:74–8.
13.
Nakatani H, Mine A, Matsumoto M, Kabetani T, Kawaguchi-Uemura A, Higashi M, et al. Effectiveness of sodium hypochlorite and sulfinic acid sodium salt treatment on dentin-resin bonding: long-term durability of one-step self-etching adhesive. Dent Mater J. 2017;36:842–50.PubMedCrossRef
14.
Khademi A, Usefian E, Feizianfard M. Tissue dissolving ability of several endodontic irrigants on bovine pulp tissue. Iran Endod J. 2007;2:65–8.PubMedPubMedCentral
15.
Shreya S. Chlorhexidine as an irrigant in endodontics -a review. J Pharm Sci Res. 2016;8:772–4.
16.
Sato T, Fujimaki R, Suzuki J, Hamada N, Tani-Ishii N, Handa K. Bactericidal Effect of a Novel Alkaline EDTA Root Canal Cleaning Solution. Eur J Dent. 2021;15:546–50.PubMedPubMedCentralCrossRef
17.
Guo X, Miao H, Li L, Zhang S, Zhou D, Lu Y et al. Efficacy of four different irrigation techniques combined with 60°C 3% sodium hypochlorite and 17% EDTA in smear layer removal.BMC Oral Health. 2014;14.
18.
Pinheiro ET, Karygianni L, Attin T, Thurnheer T. Antibacterial effect of sodium hypochlorite and edta in combination with high-purity nisin on an endodontic-like biofilm model.Antibiotics. 2021;10.
19.
Alkhudhairy FI, Yaman P, Dennison J, McDonald N, Herrero A, Bin-Shuwaish MS. The effects of different irrigation solutions on the bond strength of cemented fiber posts. Clin Cosmet Investig Dent. 2018;10:221–30.PubMedPubMedCentralCrossRef
20.
Kumaravadivel MS, Pradeep S. Recent advancements of endodontic sealers-a review. Int J Pharm Technol. 2016;8:4060–75.
21.
Mahmoud D, Salman R. Effect of different instrument systems on the quality of bio-ceramic obturation material (an in vitro leakage and SEM study). Erbil Dent J. 2020;3:1–9.CrossRef
22.
Hamdy TM, Galal M, Ismail AG, Abdelraouf RM. Evaluation of flexibility, microstructure and elemental analysis of some contemporary nickel-titanium rotary instruments. Open Access Maced J Med Sci. 2019;7:3647–54.PubMedPubMedCentralCrossRef
23.
Khetarpal A, Chaudhry S, Talwar S, Verma M. Endodontic management of open apex using MTA and platelet - rich fibrin membrane barrier: a newer matrix concept. J Clin Exp Dent. 2013;5:291–4.CrossRef
24.
Antunes HS, Gominho LF, Andrade-Junior CV, Dessaune-Neto N, Alves FRF, Rôças IN, et al. Sealing ability of two root-end filling materials in a bacterial nutrient leakage model. Int Endod J. 2016;49:960–5.PubMedCrossRef
25.
Raura N, Garg A, Arora A, Roma M. Nanoparticle technology and its implications in endodontics: a review.Biomaterials Research. 2020;24.
26.
Alenazy MS, Mosadomi HA, Al-Nazhan S, Rayyan MR. Clinical considerations of nanobiomaterials in endodontics: a systematic review. Saudi Endodontic Journal. 2018;8:163–9.
27.
Abdelnabi A, Hamza MK, El-Borady OM, Hamdy TM. Effect of different formulations and application methods of Coral Calcium on its remineralization ability on Carious Enamel. Open Access Maced J Med Sci. 2020;8 D:94–9.CrossRef
28.
Tamer M, Hamdy, Saniour SH, Sherief MA, Zaki DY. Effect of incorporation of 20 wt% amorphous Nano-hydroxyapatite Fillers in Poly methyl methacrylate composite on the compressive strength. RJPBCS. 2015;6:975–8585.
29.
Zanjani VA, Tabari K, Sheikh-Al-Eslamian SM, Abrandabadi AN. Physiochemical Properties of Experimental Nano-hybrid MTA. J Med Life. 2018;11:51–6.PubMedPubMedCentral
30.
Jeong J, Kim JH, Shim JH, Hwang NS, Heo CY. Bioactive calcium phosphate materials and applications in bone regeneration.Biomaterials Research. 2019;23.
31.
Hamdy TM, El-Korashy SA. Novel bioactive zinc phosphate dental cement with low irritation and enhanced microhardness. E-J Surf Sci Nanotechnol. 2018;16:431–5.CrossRef
32.
Natale LC, Rodrigues MC, Alania Y, Chiari MDS, Boaro LCC, Cotrim M, et al. Mechanical characterization and ion release of bioactive dental composites containing calcium phosphate particles. J Mech Behav Biomed Mater. 2018;84:161–7.PubMedCrossRef
33.
Hamdy TM. Polymers and Ceramics Biomaterials in Orthopedics and Dentistry: a review article. Egypt J Chem. 2018;61:723–30.
34.
Huang J, Lin YW, Fu XW, Best SM, Brooks RA, Rushton N et al. Development of nano-sized hydroxyapatite reinforced composites for tissue engineering scaffolds. In:Journal of Materials Science: Materials in Medicine. 2007. p.2151–7.
35.
Hamdy TM, Mousa SMA, Sherief MA. Effect of incorporation of lanthanum and cerium-doped hydroxyapatite on acrylic bone cement produced from phosphogypsum waste. Egypt J Chem. 2020;63:1823–32.
36.
Akhtar K, Pervez C, Zubair N, Khalid H. Calcium hydroxyapatite nanoparticles as a reinforcement filler in dental resin nanocomposite.J Mater Sci Mater Med. 2021;32.
37.
Daokar S, Patel K, Pawar K, Wahane K, Kulkarni S, Mantri A. Evaluation of bonding strength of conventional glass ionomer cement modified with Micro- and Nano-Hydroxyapatite: an in vitro study. J Interdiscip Dent. 2021;11:114.CrossRef
38.
Chogle SMA, Duhaime CF, Mickel AK, Shaikh S, Reese R, Bogle JH, et al. Preliminary evaluation of a novel polymer nanocomposite as a root-end filling material. Int Endod J. 2011;44:1055–60.PubMedCrossRef
39.
Abdelraouf RM, Bayoumi RE, Hamdy TM. Effect of powder/water ratio variation on viscosity, tear strength and detail reproduction of dental alginate impression material (In vitro and clinical study).Polymers (Basel). 2021;13.
40.
Abdelraouf RM, Bayoumi RE, Hamdy TM. Influence of Incorporating 5% Weight Titanium Oxide Nanoparticles on Flexural Strength, Micro-Hardness, Surface Roughness and Water Sorption of Dental Self-Cured Acrylic Resin. Polym 2022, Vol 14, Page 3767. 2022;14:3767.
41.
Samantaray R, Mohapatra A, Das SS, Nanda K, Bharadwaj S. Polymers used in dentistry: an overview of literature. Indian J Forensic Med Toxicol. 2020;14:8883–7.
42.
Rokaya D, Srimaneepong V, Sapkota J, Qin J, Siraleartmukul K, Siriwongrungson V. Polymeric materials and films in dentistry: an overview. J Adv Res. 2018;14:25–34.PubMedPubMedCentralCrossRef
43.
Abdelraouf RM. Chemical analysis and microstructure examination of extended-pour alginate impression versus conventional one (characterization of dental extended-pour alginate). Int J Polym Mater Polym Biomater. 2018;67:612–8.CrossRef
44.
Karadas M, Atıcı MG. Bond strength and adaptation of pulp capping materials to dentin. Microsc Res Tech. 2020;83:514–22.PubMedCrossRef
45.
Donnermeyer D, Vahdat-Pajouh N, Schäfer E, Dammaschke T. Influence of the final irrigation solution on the push-out bond strength of calcium silicate-based, epoxy resin-based and silicone-based endodontic sealers. Odontology. 2019;107:231–6.PubMedCrossRef
46.
Shahi S, Rahimi S, Yavari HR, Samiei M, Janani M, Bahari M, et al. Effects of various mixing techniques on push-out bond strengths of white mineral trioxide aggregate. J Endod. 2012;38:501–4.PubMedCrossRef
47.
Marquezan FK, Kopper PMP, Dullius AI dos, Ardenghi S, Grazziotin-Soares DM. Effect of blood contamination on the push-out bond strength of calcium silicate cements. Braz Dent J. 2018;29:189–94.PubMedCrossRef
48.
Rodrigues MNM, Bruno KF, de Alencar AHG, Silva JDS, de Siqueira PC, de Decurcio D. A, Comparative analysis of bond strength to root dentin and compression of bioceramic cements used in regenerative endodontic procedures.Restor Dent Endod. 2021;46.
49.
El Mourad AM. Assessment of Bonding Effectiveness of Adhesive materials to tooth structure using bond strength test methods: a review of literature. Open Dent J. 2018;12:664–78.PubMedPubMedCentralCrossRef
50.
Fisher MA, Berzins DW, Bahcall JK. An in Vitro comparison of bond strength of various obturation materials to Root Canal dentin using a push-out Test Design. J Endod. 2007;33:856–8.PubMedCrossRef
51.
Ahmed I, Aggarwal S, Sanap A, Rai V, Khadtare S, Kurtarkar P. A comparative evaluation of the push-out bond strength of a resin-based sealer (AH Plus™) when two different intermediate irrigants are used, with and without a root canal brush: in vitro study. Endodontology. 2019;31:57.CrossRef
52.
Akbulut MO, Ozbay Y, Erdemir A. Comparison of various irrigation activation procedures after post space preparation on push-out bond strength of fiber posts: an in vitro study. G Ital Endod. 2021;35:10–8.
53.
Kadić S, Baraba A, Miletić I, Ionescu A, Brambilla E, Ivanišević Malčić A, 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;22:1559–65.PubMedCrossRef
54.
Rebolloso de Barrio E, Pérez-Higueras JJ, García-Barbero E, Gancedo-Caravia L. Effect of exposure to etidronic acid on the bond strength of calcium silicate-based cements after 1 and 21 days: an in vitro study.BMC Oral Health. 2021;21.
55.
Shaheen NA, El-Helbawy NGED. In vitro comparative evaluation of the fracture resistance of simulated immature teeth reinforced with different apical barriers and obturation combination. World J Dent. 2016;7:113–8.CrossRef
56.
57.
Nagas E, Cehreli ZC, Durmaz V, Vallittu PK, Lassila LVJ. Regional push-out bond strength and coronal microleakage of Resilon after different light-curing methods. J Endod. 2007;33:1464–8.PubMedCrossRef
58.
Prada I, Micó-Muñoz P, Giner-Lluesma T, Micó-Martínez P, Muwaquet-Rodríguez S, Albero-Monteagudo A. Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. J Clin Experimental Dentistry. 2019;11:e185–93.CrossRef
59.
Topçuoʇlu HS, Arslan H, Akçay M, Saygili G, Çakici F, Topçuoʇlu G. The effect of medicaments used in endodontic regeneration technique on the dislocation resistance of mineral trioxide aggregate to root canal dentin. J Endod. 2014;40:2041–4.CrossRef
60.
Majeed A, Alshwaimi E. Push-out bond strength and surface microhardness of Calcium Silicate-Based biomaterials: an in vitro study. Med Princ Pract. 2017;26:139–45.PubMedCrossRef
61.
62.
Souza MA, Menon CZ, Nery LF, Bertol CD, Rossato-Grando LG, Cecchin D. Effect of root canal preparation techniques on chlorhexidine substantivity on human dentin: a chemical analysis. Clin Oral Investig. 2018;22:859–65.PubMedCrossRef
63.
Adam S, Abdelsalam N, fayyad dalia, Darrag A. Comparative evaluation of the cytotoxic effect of different intracanal medicaments. Dent Sci Updat. 2021;2:123–33.CrossRef
64.
De Lima CO, Dutra HG, Duque TM, Campos CN, Ballal V, Simão RA, et al. Effect of previous irrigation with chlorhexidine on the push-out bond strength of a calcium silicate–based material. Gen Dent. 2019;67:58–61.PubMed
65.
Saghiri MA, Asgar K, Lotfi M, Garcia-Godoy F. Nanomodification of mineral trioxide aggregate for enhanced physiochemical properties. Int Endod J. 2012;45:979–88.PubMedCrossRef
66.
67.
68.
Saghiri MA, Asatourian A, Orangi J, Lotfi M, Soukup JW, Garcia-Godoy F, et al. Effect of particle size on calcium release and elevation of pH of endodontic cements. Dent Traumatol. 2015;31:196–201.PubMedCrossRef
69.
Abuhaimed TS, Neel EAA. Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin. BioMed Research International. 2017;2017.
70.
Samarth NB, Mahanwar PA. Degradation of Polymer & Elastomer Exposed to Chlorinated Water—A Review. Open J Org Polym Mater. 2021;11:1?50.
71.
Marending M, Luder HU, Brunner TJ, Knecht S, Stark WJ, Zehnder M. Effect of sodium hypochlorite on human root dentine - mechanical, chemical and structural evaluation. Int Endod J. 2007;40:786–93.PubMedCrossRef
72.
73.
Turk T, Ozisik B, Aydin B. Time-dependent effectiveness of the intracanal medicaments used for pulp revascularization on the dislocation resistance of MTA.BMC Oral Health. 2015;15.
74.
Alsubait SA. Effect of sodium hypochlorite on push-out bond strength of four calcium silicate-based endodontic materials when used for repairing perforations on human dentin: an in vitro evaluation. J Contemp Dent Pract. 2017;18:289–94.PubMedCrossRef
75.
76.
77.
78.
Turkun M, Cal E, Toman M, Toksavul S. Effects of dentin disinfectants on the shear bond strength of all-ceramics to dentin.Oper Dent. 2005.
79.
80.
81.
82.
83.
Saber S-EDM, El-Askary FS. The outcome of Immediate or delayed application of a single-step self-etch adhesive to coronal dentin following the application of different endodontic irrigants. Eur J Dent. 2009;03:83–9.CrossRef
84.
Metadata
Title
Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials
Authors
Nada Omar
Rasha M. Abdelraouf
Tamer M. Hamdy
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-02858-7

Other articles of this Issue 1/2023

BMC Oral Health 1/2023 Go to the issue

Research

Knowledge, perceptions, and behavior regarding children’s oral health among Syrian pediatricians: a cross-sectional study

Research

Nickel ion release and surface analyses on instrument fragments fractured beyond the apex: a laboratory investigation

Research

A population-based study to assess two convolutional neural networks for dental age estimation

Research

Virtual reality and behaviour management in paediatric dentistry: a systematic review

Research

Effect of lactoferrin on enamel characteristics of primary and permanent teeth: an in-vitro study

Research

Effect of lactobacillus reuteri-derived probiotic nano-formulation on recurrent aphthous stomatitis: a double-blinded randomized clinical trial