Effect of plunger diameter on the push-out bond values of different root filling materials

Bonding and Cleaning Effects of Irrigation Protocols Using Calcium Hypochlorite on the Post-space Radicular Dentin

This study evaluated the effect of 2.5% sodium hypochlorite (SH) or calcium hypochlorite (CH) submitted to passive ultrasonic irrigation (PUI) or conventional irrigation (CI) on the incidence of residues and the bond strength of the cementation system to post-space dentin. Distilled water (DW) and 2.5% SH followed by 17% EDTA (SH-ED) were used as negative and positive control groups, respectively. The cervical, middle, and apical thirds of the post space were evaluated. One hundred and twenty bovine incisors were endodontically treated and post-space preparation was performed. The specimens were randomly assigned to six groups, according to the solution and irrigation method: DW-CI, SH-ED-CI-SH, SH-CI, SH-PUI, CH-CI, and CH-PUI. The incidence of residues (n=10) over the dentin was evaluated by scores using SEM images. Other specimens were irrigated as previously described and the post cementation was immediately performed using a conventional dual resin cement and a two-step etch-and-rinse adhesive system. Push-out and failure modes were performed for bonding evaluation. Kruskal-Wallis and Dunn test for incidence of residues data and one-way ANOVA and Tukey tests for bond strength data were used at a significance level of 5%. The protocols that showed a lower incidence of residues were: SH-ED-CI-SH, SH-PUI, and CH-PUI for the cervical third and SH-ED-CI-SH for the middle third (p<0.05). In the apical third, the protocols were similar to each other (p>0.05). Bond strength values were higher after irrigation with DW-CI for all thirds (p<0.05). 2.5% sodium or calcium hypochlorite negatively impacted the adhesion interface and exhibited a greater incidence of residues over the post-space radicular dentin.

Pushout Bond Strength in Coronal Dentin: A Standardization Approach in Comparison to Shear Bond Strength

To find an alternative that is closer to clinical reality in terms of cavity geometry and configuration factor, this study investigated the pushout test on in vitro adhesive testing to coronal dentin when compared to the established shear test, both in a standardized approach. For a feasible comparison between both tests, the pushout specimen was adjusted in thickness (1.03 ± 0.05 mm) and cavity diameter (1.42 ± 0.03 mm) to receive a bonding area (4.63 ± 0.26 mm2) that matches that of the shear test (4.57 ± 0.13 mm2). Though, the configuration factor between both tests differs largely (pushout 1.5 ± 0.08; shear bond 0.20 ± 0.01). The bond strength of five different adhesives (n = 20) was investigated for both tests. The pushout test registered a high number of invalid measurements (30%) due to concomitant dentin fracture during testing. In contrast to the shear test, the pushout test failed to discriminate between different adhesives (p = 0.367). Both tests differed largely from each other when comparing adhesive groups. When solely looking at the valid specimens, Weibull modulus reached higher values in the pushout approach. Conclusively, the pushout test in this specific setup does not distinguish as precisely as the shear bond test between different adhesives and needs adaption to be routinely applied in adhesive dentistry.

Evaluation of the removal of 2-Hydroxyisocaproic acid from the root canal and its effect on the bond strength of MTA

This study aimed to evaluate the removal of 2-hydroxyisocaproic acid (HICA) from the root canal system and its effect on the bond strength of the mineral trioxide aggregate (MTA). 126 single-rooted teeth were divided into 3 experimental groups (n = 36) that were treated with double antibiotic paste (DAP), HICA and calcium hydroxide (CH) and one control group (n = 18). In the first part, 18 teeth from each experimental group (n = 54) were examined to remove HICA from the root canal. In the second part, 72 teeth (3 experimental groups (n = 54) and one control group (n = 18)) were used for the evaluation of the push-out bond strength of MTA. There was no statistically significant difference between HICA, DAP and CH residues (p > 0.05). HICA group showed significantly less push-out bond strength (p < 0.05). DAP, HICA and CH could not be removed entirely from the root canal. HICA significantly reduced the bond strength of the MTA.

Effect of aging and cementation systems on the bond strength to root dentin after fiber post cementation

This study evaluated the effect of aging and cementation of fiber posts using glass ionomer and resin cements on push-out bond strength, failure mode, and resin tag formation. One hundred and twenty bovine incisors were used. After post-space preparation, the specimens were randomly allocated into 12 groups (n = 10) according to the cementation system used: GC - GC Gold Label Luting & Lining); RL - RelyX Luting 2; MC - MaxCem Elite; RU - RelyX U200 and the aging periods (24 hours, 6 months, and 12 months). Slices from the cervical, middle, and apical thirds were obtained and analyzed by push-out bond strength test and confocal laser scanning microscopy. One-way ANOVA and Tukey's post-hoc test was used at a significance level of 5%. For the push-out bond strength test, no differences among GC, RU, and MC in the cervical and middle thirds were observed, regardless of the period of storage (P > 0.05). In the apical third, GC and RU showed similar bond strength but higher than other groups (P > 0.05). After 12 months, GC showed the highest bond strength (P < 0.05). Bond strength to post-space dentin decreased over time, regardless of the cementation system used. Cohesive failure was the most frequent, regardless of the period of storage, cementation system, and post-space third. Tag formation was similar among all groups. After 12 months, GC showed the highest bond strength values.

Influence of Acidic Environmental Conditions on Push-Out Bonding Strength of Four Calcium Silicate-Based Materials to Root Dentin

Introduction. Calcium silicate-based cements (CSCs) are frequently used in various endodontic procedures such as perforation repair, vital pulp therapy, regenerative treatments, or apexification. One of their areas of use, treatment of perforations, can be challenging in clinical practice. Selection of stable, durable, and compatible material with structural and biological alterations is a must in such situations. Aim. This study aimed to compare the dislocation resistance of various calcium-silicate-containing materials used in endodontic treatment exposed to various environmental conditions in a push-out study model. Methods. Selected ninety-six human mandibular premolars with single root canals were cut from the middle portion to obtain dentin slices of 2 mm thickness (n = 192). Then, the canal lumen was enlarged by using #4Gates-Glidden drills. Specimens for each repair material (MTA, Angelus, Endosequence RRM (ERRM), Biodentine, BioMTA) were placed in shaped lumens, wrapped in pieces of gauze, and randomly divided into four groups (n = 48) according to the storage time and media: group A: 4 days in phosphate-buffered saline (PBS), group B: 4 days in acetic acid (pH = 4.4), group C: 34 days in PBS, and group D: 4 days in acetic acid (pH = 4.4) followed by exposure to PBS for 30 days. A universal testing machine measured the dislodgement resistance followed by scanning electron microscopy imaging to evaluate the material-dentin interface. Results. ERRM showed the highest dislocation resistance in all test groups ( $p<0.05$ ). The greatest bonding strength was observed (13,54 ± 5,56 MPa) after exposure to 34 days in PBS (pH = 7.2). The values for ERRM decreased in contact with acetic acid (pH = 4.4) and increased when placed in PBS ( $p>0.05$ ). Conclusion. All repair materials showed a higher dislocation resistance when stored in PBS regardless of storage time. However, the improved pH of the surrounding media was not successful in reversing the deteriorating effect caused by lower pH in relation to dislocation resistance in all tested materials except for ERRM.

Dislodgement pushout resistance of five bioceramic root-end filling materials

This study evaluated the dislodgement push-out resistance of five bioceramic materials. One hundred single-rooted teeth with one canal had the apical 3 mm and crown resected to create a 14 mm standardized length. The canals were instrumented to an apical size 80 with a 3 mm root-end preparation made with ultrasonic diamonds. The prepared roots were randomly divided into 5 root-end restorative groups (n=20). ProRoot MTA, Biodentine, EndoSequence Root Repair Material, EndoSequence Fast Set Putty, and EndoSequence BC Sealer with each material placed following manufacturer's instructions and stored at 100% humidity for 2 weeks. An apical-to-coronal static testing load with the identified dislodgement force converted into MPa with mean results analyzed with Kruskal-Wallis and Dunn's post hoc tests (α=0.05). ProRoot MTA and Biodentine displayed similar push-out stress resistance and exhibited significantly greater stress resistance than the similar Endosequence materials. However, all materials failed cohesively and were not dislodged from the root canal surface.

Evaluation of Bond Strength of Four Different Root Canal Sealers

The purposes of the study were to evaluate the influence of the sealer’s chemical composition on the interfacial strength between root canal dentin and root filling material, for two different classes of endodontic sealers, and to assess their failure modes. Methods: Forty extracted single-rooted teeth were randomly divided into four groups using the following endodontic sealers: RealSeal SE and Resilon (RSSE); EndoSequence BC sealer and BC Point (EBCS); Endoseal MTA and gutta-percha (EDS); Bioroot RCS and gutta-percha (BRS). Teeth were embedded in acrylic resin, and the roots were sectioned horizontally into 1 mm slices. For each slice, the perimeter was measured. A push-out test was performed using an Instron universal testing machine. For each sample, bond strength was calculated. Specimens were examined by SEM investigation in order to analyze the dentin−sealer−core interface. Results were assessed using analysis of variance (ANOVA) and Tukey and Bonferroni test. Results: Statistical analysis revealed that EDS and gutta-percha had significantly higher resistance to dislodgement compared to the other three groups (p < 0.05). EBCS and BC Point showed significantly greater push-out bond strength values compared to RSSE and Resilon (p < 0.05). Conclusions: Bioceramic endodontic sealers showed a higher bond strength to root dentin than methacrylate resin-based endodontic sealer.

Customized Fiber Post Improves the Bond Strength and Dentinal Penetrability of Resin Cementation System to Root Dentin

OBJECTIVE

This study aimed to evaluate the effect of fiber post customization on the bond strength (24 hours and 6 months), resin cement thickness, and dentinal penetrability of Adper Scotchbond Multi-Purpose - RelyX ARC (AS-RA), RelyX U200 (R2), and Scotchbond Universal - RelyX Ultimate (SU-RU) cementation systems to root dentin from the cervical-, middle-, and apical-thirds of the post space.

METHODS

One hundred twenty bovine incisors were endodontically treated. After post space preparation, the roots were divided into six groups, according to the luting protocols (AS-RA, R2, SU- RU) and the type of fiber post [noncustomized post (NC) and customized post (C)]. Customization procedures were peformed using a resin composite (Z350 XT). 24 hours (n=60) or 6 months later (n=60), specimens from the cervical-, middle-, and apical-thirds of the post space were submitted to cementation system thickness measurement, bond strength evaluation, and dentinal penetrability analysis with Confocal Laser Scanning Microscopy (CLSM). Failure mode was classified as adhesive, cohesive, or mixed. Data were submitted to ANOVA and Tukey tests (α=0.05).

RESULTS

Cementation protocols with customized fiber posts presented the lowest cementation system thickness, regardless of the cementation system or post space-third (p<0.05), and the highest bond strength values (p<0.05), regardless of the third space (p>0.05), for both periods (24 hours or 6 months). The comparison of push-out bond strength values between 24 hours and 6 months showed a reduction in all groups for the cervical-third (p<0.05). For the middle-third, only noncustomized groups showed reduction (p<0.05). For the apical-third, no reduction was observed (p>0.05).

CONCLUSIONS

Anatomical customization favored both the bond strength of cements to dentin and the dentinal penetrability, but with lower cementation system thickness, regardless of cement composition and adhesive strategy.

Effect of the several epoxy resin-based sealer compositions on adhesion interface in radicular dentin after calcium hydroxide intracanal medication removal

Background

This study evaluated the effects of several epoxy resin-based sealer compositions (AHP, AH Plus; ADS, Adseal; SPL, Sealer Plus) on bond strength and intratubular dentin penetration of the endodontic obturation, in root canal previously treated with calcium hydroxide intracanal medication (CH) and removed by continuous ultrasonic irrigation (CUI).

Material and Methods

Forty-five maxillary canines were prepared up to F5 (ProTaper system), filled with CH, coronally sealed, and stored at 37ºC. After 1 week, CH was removed using 2.5% sodium hypochlorite energized by CUI. The specimens were randomly distributed in three groups (n=15) and root canal obturated, according to epoxy-based resin sealer composition (AHP, ADS or SPL). The roots were transversally sectioned in cervical, middle, and apical thirds. In each radicular third, push out bond strength using universal machine and intratubular dentin using confocal laser scanning microscopy (CLSM) and Image J Program were evaluated. Bond strength and intratubular dentin penetration were statistically evaluated by ANOVA one-way and Tukey tests and Kruskal Wallis test, respectively (α = 0.05).

Results

In middle and apical thirds, AHP showed higher bond strength values (p<0.05), and ADS and SPL were similar each other (p>0.05). All epoxy resin-based sealers presented similar intratubular dentin penetration, independently of the radicular thirds (p>0.05). Cohesive and mixed failures were predominant in the cervical thirds. In the middle and apical thirds, AHP showed more cohesive type failures, while ADS and SPL showed more adhesive-type failures.

Conclusions

AHP has the highest bond strength in middle and apical radicular thirds, after calcium hydroxide intracanal medication removal using continuous ultrasonic irrigation, although intratubular dentin infiltration being similar among epoxy resin-based sealer with several chemical composition. Key words:Continuous ultrasonic irrigation, endodontic sealers, epoxy resin-based sealers, root canal obturation.

Effects of radiation therapy on the dislocation resistance of root canal sealers applied to dentin and the sealer-dentin interface: a pilot study

Objectives

This study evaluated and compared the effects of radiation therapy on the dislocation resistance of AH Plus and BioRoot RCS applied to dentin and the sealer-dentin interface.

Materials and Methods

Thirty single-rooted teeth were randomly assigned to 2 groups (n = 15 each): AH Plus (Dentsply DeTrey) and BioRoot RCS (Septodont). Each group was subdivided into control and experimental groups. The experimental group was subjected to a total radiation dose of 60 Gy. The root canals of all samples were cleaned, shaped, and obturated using the single-cone technique. Dentin slices (1 mm) were sectioned from each root third for the push-out test and scanning electron microscopy (SEM) was done to examine the sealer-dentin interface. The failure mode was determined using stereomicroscopy. Bond strength data were analyzed by the independent t-test, 1-way analysis of variance, and the Tukey post hoc test (α = 0.05).

Results

Significantly lower bond strength was observed in irradiated teeth than non-irradiated teeth in the AH Plus group (p < 0.05). The BioRoot RCS group showed no significant reduction in bond strength after irradiation (p > 0.05) and showed a higher post-irradiation bond strength (209.92 ± 172.26 MPa) than the AH Plus group. SEM revealed slightly larger gap-containing regions in irradiated specimens from both groups.

Conclusions

The dislocation resistance of BioRoot RCS was not significantly changed by irradiation and was higher than that of AH Plus. BioRoot RCS may be the sealer of choice for root canal treatment in patients undergoing radiation therapy.

Data on the push-out bond strength of three different root canal treatment sealers

It is of interest to document data on the push - out bond strength of three different root canal treatment sealers such as MTA Fillapex (MTA based), AH plus (Epoxy Resin based) and Apexit plus (Calcium hydroxide based). Forty-five freshly extracted human maxillary central incisors with closed apices were selected randomly. All the teeth were sectioned at cement-enamel junction using a diamond disc before starting the root canal preparation to obtain root length of 12 mm. All teeth were instrumented using ProTaper rotary instruments. 5.25% sodium hypochlorite was used for irrigation between instrumentation followed by 17% EDTA, and final rinse by saline. Obturation procedures were done using the gutta-percha single cone technique. 45 roots were randomly assigned to 3 groups of 15 for obturation with gutta-percha cones and 1 of the 3 sealers (n=15). Group 1 = MTA Fillapex sealer + gutta-percha: Group 2 = AH plus sealer + gutta-percha:Group 3 = Apexit plus sealer + gutta-percha. The roots were sectioned horizontally to its canal into 3 sections: Coronal, Mid-root and Apical-thirds using a precision cutting machine, with a thickness of 3 mm. The specimens were subjected to push-out test using a universal testing machine that carried a plunger. The loading speed was 1mm/min until the dislodgment of the material occurred. The independent t- test was used to compare the mean scores among the study groups. The level of significance was set at 5% for all tests. After the push-out bond strength test, each sample was evaluated under stereomicroscope (40x) to determine the mode of failure and recorded as one of the following categories: adhesive, cohesive or mixed. The observations thus obtained were subjected to statistical analysis using Student - t test. AH Plus showed significantly higher values than MTA Fillapex and Apexit plus (p < 0.05). Amongst the push-out bond strength AH Plus sealer showed significant difference from MTA Fillapex and Apexit plus groups. There was no significant difference between MTA Fillapex and Apexit plus however (p>0.05). Microscopic analysis displayed that the majority of the modes were cohesive failures for AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus. . Thus, AH Plus had the highest bond strength and MTA Fillapex had the lowest bond strength to root dentin. Mean push-out bond strength values were ranked as follows; AH Plus >Apexit Plus > MTA Fillapex. Microscopic analysis displayed that the majority of the modes were cohesive failures of AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus.

Effect of Distinctive Moisture Conditions on Push-out Bond Strength of Three Root Canal Sealers-An In-Vitro Study

Objective:

Endodontic sealer should adhere to both dentin and the core filling material but the moisture conditions of the canals affect the adhesive properties of the sealer. An ideal sealer with perfect moisture conditions will lead to greater strength of the restored tooth, which may provide greater resistance to tooth fracture and clinical longevity of an endodontically treated tooth. The aim of this study was to evaluate the effect of moisture conditions on the push-out bond strength of three root canal sealers: AH Plus^® (Dentsply-Tulsa Dental, Tulsa, OK), Epiphany (Pentron Clinical Technologies, Wallingford, CT), and GuttaFlow (Coltene/Whaledent, Altstatten, Switzerland).

Materials and Methods:

A total of 120 single-rooted, non-carious teeth were collected for the study and were stored in normal saline. The root canals were prepared using step-back technique. Teeth were divided into four groups based on type of drying procedure used and further subdivided into three subgroups based on the type of sealer used. The samples were cut horizontally to produce slices and then tested for push-out bond strength using Universal Testing Machine (Servo Series 50 kN; P S I Sales Private Limited, New Delhi, India). The specimens were examined for mode of fracture under magnification and the results were analyzed statistically.

Results:

Distinctive moisture conditions for all sealers were observed and the highest strength of AH Plus^® was evaluated under moist condition, Epiphany under dry condition, and GuttaFlow under normal condition, respectively.

Conclusion:

Distinctive moisture conditions affect the push-out bond strength of the sealers.

Duration of Immersion and Type of Immersion Solution Distort the Outcome of Push-Out Bond Strength Testing Protocols

This study aimed to investigate the influence of immersion duration and the type of immersion solution on the outcome of push-out bond strength (POBS) tests. Root canals of 120 straight single-rooted teeth were instrumented to a diameter of 1.5 mm and irrigated with 5 mL of 3% NaOCl. Four horizontal slices with a thickness of 1 mm were cut, representing the mid-portion of the root. The specimens (n = 480) were irrigated with 17% ethylenediaminetetraacetic acid(EDTA) for 60 seconds, then twice with distilled water (DW) for 30 s each. The canals were filled with either AH Plus (Dentsply Sirona, Konstanz, Germany) or BioRoot RCS (Septodont, St. Maur-des-Fossés, France) (n = 240). Separated into four groups per type of sealer (n = 60), the specimens were incubated at 37 °C covered with gauze moistened in DW or phosphate-buffered saline (PBS) for either one or eight weeks. Dislodgement resistance was measured and POBS was calculated. Statistical analysis was performed using the analysis of variance (ANOVA) test and the Student-Newman-Keuls test (p = 0.05). AH Plus showed higher POBS when stored in PBS compared to DW, irrespective of the incubation period (p < 0.05). BioRoot RCS displayed higher POBS when stored in DW compared to PBS after eight weeks of incubation (p < 0.05). No difference was found after one week of incubation (p > 0.05). Irrespective of the sealer or the immersion solution, POBS decreased from one week to eight weeks (p < 0.05). Mixed failure modes were found in all groups irrespective of sealer, immersion medium, or immersion period. POBS decreased after a longer incubation time in both immersion solutions. Duration of immersion and the type of immersion solution had a significant impact on the outcome of the POBS testing protocol.

The push-out bond strength of BIOfactor mineral trioxide aggregate, a novel root repair material

Objectives

The aim of this in vitro study was to evaluate the push-out bond strength of a novel calcium silicate-based root repair material-BIOfactor MTA to root canal dentin in comparison with white MTA-Angelus (Angelus) and Biodentine (Septodont).

Materials and Methods

The coronal parts of 12 central incisors were removed and the roots were embedded in acrylic resin blocks. Midroot dentin of each sample was horizontally sectioned into 1.1 mm slices and 3 slices were obtained from each root. Three canal-like standardized holes having 1 mm in diameter were created parallel to the root canal on each dentin slice with a diamond bur. The holes were filled with MTA-Angelus, Biodentine, or BIOfactor MTA. Wet gauze was placed over the specimens and samples were stored in an incubator at 37°C for 7 days to allow complete setting. Then samples were subjected to the push-out test method using a universal test machine with the loading speed of 1 mm/min. Data was statistically analyzed using Friedman test and post hoc Wilcoxon signed rank test with Bonferroni correction.

Results

There were no significant differences among the push-out bond strength values of MTA-Angelus, Biodentine, and BIOfactor MTA (p > 0.017). Most of the specimens exhibited cohesive failure in all groups, with the highest rate found in Biodentine group.

Conclusions

Based on the results of this study, MTA-Angelus, Biodentine, and BIOfactor MTA showed similar resistances to the push-out testing.

Push-Out Bond Strength of Experimental Apatite Calcium Phosphate Based Coated Gutta-Percha

Objectives

To evaluate the push-out bond strength of experimental apatite calcium phosphate coated gutta-percha (HAGP) compared to different commercially available coated gutta-percha root obturation points.

Methods

Extracted teeth were selected and instrumented using ProTaper rotary files. The canals were assigned into five equal groups and obturated using matching single cone technique as follows: EndoREZ cones and EndoREZ sealer, Bioceramic Endosequence gutta-percha (BCGP) with Endosequence BC sealer, Active GP with Endosequence BC sealer (ActiV GP), conventional GP with Endosequence BC sealer, and HAGP with Endosequence BC sealer. Each root was sectioned transversally at the thickness of 1±0.1 mm to obtain 5 sections (n=25 per group). The specimens were subjected to push-out test using a Universal Test Machine at a loading speed of 0.5 mm/ min. Failure modes after push-out test was examined under stereomicroscope and the push-out data were analyzed using ANOVA and the post hoc Dunnett T3 test (p = 0.05).

Results

The highest mean bond strength was yielded by HAGP followed by BCGP, ActiV GP, conventional GP, and EndoREZ. There were significant differences between EndoREZ and all other groups (p<0.001). The prominent failure mode of HAGP was mixed mode, whereas EndoREZ exhibited adhesive failure mode. Conventional GP, ActiV GP, and BCGP showed cohesive failure mode.

Conclusion

HAGP showed promising results to be used as root canal filling material in combination with bioceramic sealer.

Design Variability of the Push-out Bond Test in Endodontic Research: A Systematic Review

INTRODUCTION

There is limited literature on the impact of testing variables on the push-out bond test (POBT). This review identified designs of the POBT used in the endodontic literature and aimed to determine which experimental variables may influence the push-out bond strength (POBS).

METHODS

A systematic review based on PRISMA guidelines was performed by searching the PubMed, SCOPUS, and Cochrane library databases using terms including push-out and dislocation resistance and descriptions of endodontic materials. Test variables assessed included method of root preparation, timing of sectioning compared with filling, thickness, diameter and taper of sections, and plunger size and velocity. The POBS of 3 common materials (gutta-percha and AH Plus, mineral trioxide aggregate, and Biodentine) were collected from investigations, and a comparison was attempted.

RESULTS

One hundred thirty-three studies assessed the POBS of root-filling materials, 68 assessed root repair cements/root-end filling materials, and 16 assessed orifice barrier materials other than mineral trioxide aggregate. There was significant variation in all of the assessed variables, resulting in a large range of reported values for the POBS of the various materials. Because of this heterogeneity in study design, no further statistical analysis of the impact of the test variables on POBS was possible.

CONCLUSIONS

There was considerable variation in the POBT design used in endodontic research. Greater standardization is required for future research as well as accurate reporting for all test variables to assess the impact of specific design variables on POBS.

Effect of calcium hydroxide on the bond strength of two bioactive cements and SEM evaluation of failure patterns

The aim of this study was to assess the effect of calcium hydroxide on bond strength of two bioactive cements. One-mm thick longitudinal slabs of root dentin were obtained from freshly extracted human monorradicular teeth (n = 60). Simulated root perforations (1 mm in diameter) were prepared in radicular dentin. Thereafter, the specimens were randomly divided into two groups (n = 30), according to the repair material: MTA (n = 30) and Biodentine (BD) (n = 30). Next, the specimens in each group were further randomly divided into 4 equal subgroups (n = 15) according to the prior use of Ca(OH)2: MTA/Ca(OH)2 and BD/Ca(OH)2 groups: perforations were filled with calcium hydroxide [Ca(OH)2] and after 7 days, it was removed, and MTA and BD groups: calcium hydroxide dressing were not used. Push-out test was performed at a crosshead speed of 1 mm/min. Bond strength values were compared statistically using Kruskal-Wallis test and Dunn's post-test at a significance level of 5%. The failure analysis was performed using a stereoscopic and classified as adhesive, cohesive and mixed. The push-out bond strength of MTA and BD was not affected by the prior use of Ca(OH)2 (p > 0.05). BD yielded higher push-out bond strength values compared with those of MTA, regardless of the use of Ca(OH)2 (p < 0.05). Mixed failures were predominant in all groups. Ca(OH)2 placement for perforations sealing does not alter the bond strength of MTA and BD to the root dentin. BD presented higher bond strength values than MTA. SCANNING 38:240-244, 2016. © 2015 Wiley Periodicals, Inc.

Resilon: a comprehensive literature review

Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilon's physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.

Push-out bond strength of MTA with antiwashout gel or resins

AIM

Assessment of the push-out bond strength of four MTA-based formulations for use as root-end filling materials.

METHODOLOGY

MTA Plus mixed with (i) water ('MTA-W'); (ii) a proprietary water-based antiwashout gel ('MTA-AW'); (iii) Superbond C&B chemically curing resin ('MTA-Chem'); and (iv) Heliobond light-curing resin ('MTA-Light') was tested. Root slices 3 mm thick human had a 1.5 mm diameter hole drilled centrally and were treated with 17% EDTA for 60s. Forty specimens divided into groups 1-4 were prepared and filled with MTA-W, MTA-AW, MTA-Chem and MTA-Light, respectively. Groups 3 and 4 were etched with 37% phosphoric acid for 60s, and bonding agent was applied to the dentine surface. Specimens were stored for 28 days in Hanks' Balanced Salt Solution at 37 °C. Push-out strength was tested with a punch and die (punch diameter 1.3 mm, die diameter 2.0 mm, punch speed 1 mm min(-1)). Stereomicroscopy was used to classify failure mode (adhesive, cohesive or mixed type).

RESULTS

The resulting push-out strengths were 5.1 MPa (MTA-W), 4.3 MPa (MTA-AW), 4.7 MPa (MTA-Chem) and 11.0 MPa (MTA-Light). MTA-W had higher push-out strength than MTA-AW (P = 0.022). The same was noted for MTA-Light relative to the other materials (P < 0.05). All materials exhibited adequate push-out strengths compared with MTA-W. Failure was predominantly mixed, except for MTA-Chem (predominantly adhesive).

CONCLUSIONS

All materials exhibited adequate push-out strength. Previous studies have shown the new formulations have additional advantages including increased washout resistance and faster setting time, making them promising for future dental applications.

Critical evaluation of the push-out test for root canal filling materials

INTRODUCTION

The push-out test has been widely used in experimental endodontics but has been criticized on technical grounds particularly because the soft-core material undergoes plastic deformation under load. This study systematically evaluated the technique by comparing push-out strength and load profiles in relation to core material stiffness, canal diameter, punch diameter, sample orientation, and mode of failure.

METHODS

Straight palatal roots of 90 maxillary molars were obturated with an epoxy resin-based sealer alone (10 roots) or gutta-percha (70) or epoxy resin (10) cores with a thin layer of sealer cement. Roots were embedded in mounting resin vertically or at an angle of 5° or 10° to the long axis of the root. One-millimeter sections were tested using a universal testing machine with a punch diameter corresponding to 50%, 75%, or 90% of the canal diameter. Bond strengths (MPa) were calculated, and data were analyzed using analysis of variance with post hoc Tukey multiple comparisons (P < .05). After push out, core materials and canal walls were examined using scanning electron microscopy.

RESULTS

Push-out strength was affected by core material stiffness. Angulation up to 10° from vertical had little effect on push-out strength, but load profiles were strongly influenced by orientation. No effect of the punch diameter was observed when the diameter was 90% of the canal diameter, but push-out strength was lower when the punch diameter was 50%-60% of the canal size.

CONCLUSIONS

Despite limitations, the push-out test may still be suitable for ranking the bonding of root filling materials.