Effect of Irrigant Activation Techniques on Calcium Silicate Sealer Bond to Dentin

Yıl 2025, Cilt: 7 Sayı: 2, 151 - 162, 29.08.2025

Şeref Nur Mutlu , Ayçe Ünverdi Eldeniz

Öz

Aim: The aim of this study was to investigate the effect of irrigant activation techniques on the push-out bond strengths of calcium silicate-based sealers.
Material and Methods: 65 single-canal teeth were instrumented with ProTaper rotary instruments. The specimens were randomly divided into two groups according to sealer type. Each group was randomly subgroup into four groups according to the final irrigation activation protocol; Nd:YAG laser, Vibringe, EndoActivator, Conventional Endodontic Needle Irrigation (n=6). The root canals were obturated with single gutta-percha and BioRoot RCS or MTA Fillapex. The teeth were sectioned into 1-mm-thick disc by using Isomet. Push-out force was applied until dislocation of obturating material and the bond strength value obtained was recorded as Newton. Data were analyzed using two-way Anova and Tukey HSD test (P = 0.05).
Results: A significant interaction was found between sealers and irrigation methods (p <0.05), with the highest bond strength in the apical conventionel needle irrigation group and in the coronal Nd:YAG laser and control groups. The BioRoot RCS had higher bond strength values than the MTA Fillapex (p = 0.00). Higher bond strength values were observed from apical to coronally (p <0.05).
Conclusion: Based on the present results, within the limitations of this study, calcium silicate-based sealer (MTA Fillapex and BioRoot RCS) showed better bond strength in the presence of the smear layer.

Anahtar Kelimeler

Calcium silicate , root canal filling materials , root canal obturation

Proje Numarası

Selçuk Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü proje numarası: 13102025

Farklı ırrigasyon Aktivasyon Tekniklerinin Kalsiyum Silikat Esaslı Patların Dentine Bağlanma Dayanımı Üzerine Etkisi

Öz

Amaç: Bu çalışmanın amacı, farklı irrigasyon aktivasyon tekniklerinin kalsiyum silikat esaslı kanal dolgu patlarının push-out bağlanma dayanımı üzerindeki etkisini araştırmaktır.
Gereç ve Yöntemler: 65 adet tek kanallı diş ProTaper döner aletlerle şekillendirildi. Örnekler dolgu patlarına göre rastgele iki gruba ayrıldı. Her grup, son irrigasyon aktivasyon protokolüne göre rastgele dört gruba ayrıldı; Nd:YAG lazer, Vibringe, EndoActivator, Konvansiyonel Endodontik İğne İrrigasyonu (n=6). Kök kanalları tek kon gutta-perka ile BioRoot RCS veya MTA Fillapex kullanılarak dolduruldu. Dişler Isomet cihazı kullanılarak 1 mm kalınlığında kesilerek disklere ayrıldı. İtme kuvveti, kanal dolgu materyali yerinden oynayana kadar uygulandı ve elde edilen bağ gücü değeri Newton olarak kaydedildi. Veriler iki yönlü Anova ve Tukey HSD testi kullanılarak analiz edildi (P=0,05).
Bulgular: Sızdırmazlık maddeleri ve irrigasyon yöntemleri arasında önemli bir etkileşim bulundu (p <0,05), en yüksek bağ mukavemeti apikalde konvansiyonel iğne irrigasyon grubunda ve koronalde Nd:YAG lazer ve kontrol gruplarında bulundu. BioRoot RCS, MTA Fillapex'ten daha yüksek bağlanma dayanımı değerlerine sahipti (p = 0,00). Apikalden koronale doğru daha yüksek bağlanma dayanımı değerleri gözlendi (p <0,05).
Sonuç: Mevcut sonuçlara dayanarak, bu çalışmanın sınırlamaları dahilinde, kalsiyum silikat bazlı sızdırmazlık maddesi (MTA Fillapex ve BioRoot RCS) smear tabakasının varlığında daha iyi bağlanma değeri gösterdi.

Anahtar Kelimeler

Bağlanma dayanımı , Kalsiyum silikat esaslı pat , Vibringe

Destekleyen Kurum

Selçuk Üniversitesi BAP Koordinatörlüğü

Proje Numarası

Selçuk Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü proje numarası: 13102025

Kaynakça

• Schilder H. Filling root canals in three dimensions. J Endod. 2006;32:281-90.
• Schwartz RS. Adhesive dentistry and endodontics. Part 2: bonding in the root canal system—the promise and the problems: a review. J Endod. 2006;32:1125-34.
• Xuereb M, Vella P, Damidot D, Sammut CV, Camilleri J. In situ assessment of the setting of tricalcium silicate–based sealers using a dentin pressure model. J Endod. 2015;41:111-24.
• Zhou H-m, Du T-f, Shen Y, Wang Z-j, et al. In vitro cytotoxicity of calcium silicate–containing endodontic sealers. J Endod. 2015;41:56-61.
• Gomes-Filho JE, Rodrigues G, Watanabe S, Bernabé PFE, et al. Evaluation of the tissue reaction to fast endodontic cement (CER) and Angelus MTA. J Endod. 2009;35:1377-80.
• Kogan P, He J, Glickman GN, Watanabe I. The effects of various additives on setting properties of MTA. J Endod. 2006;32:569-72.
• de Miranda Candeiro GT, Correia FC, Duarte MAH, Ribeiro-Siqueira DC, Gavini G. Evaluation of radiopacity, pH, release of calcium ions, and flow of a bioceramic root canal sealer. J Endod. 2012;38:842-5.
• Loushine BA, Bryan TE, Looney SW, Gillen BM, et al. Setting properties and cytotoxicity evaluation of a premixed bioceramic root canal sealer. J Endod. 2011;37:673-7.
• Atmeh A, Chong E, Richard G, Festy F, Watson T. Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res. 2012;91:454-9.
• Flores D, Rached‐Júnior F, Versiani M, Guedes D, et al. Evaluation of physicochemical properties of four root canal sealers. Int Endod J. 2011;44:126-35.
• Gandolfi M, Siboni F, Prati C. Properties of a novel polysiloxane-guttapercha calcium silicate-bioglass-containing root canal sealer. Dent Mater J. 2016;32:e113-e26.
• Vitti RP, Prati C, Sinhoreti MAC, Zanchi CH, et al. Chemical–physical properties of experimental root canal sealers based on butyl ethylene glycol disalicylate and MTA. Dent Mater J. 2013;29:1287-94.
• Viapiana R, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Camilleri J. Investigation of the effect of sealer use on the heat generated at the external root surface during root canal obturation using warm vertical compaction technique with System B heat source. J Endod. 2014;40:555-61.
• da Silva EJNL, Zaia AA, Peters OA. Cytocompatibility of calcium silicate-based sealers in a three-dimensional cell culture model. Clin Oral Investig. 2017;21:1531-6.
• Collado-González M, Tomás-Catalá CJ, Oñate-Sánchez RE, Moraleda JM, Rodríguez-Lozano FJ. Cytotoxicity of GuttaFlow Bioseal, GuttaFlow2, MTA Fillapex, and AH Plus on human periodontal ligament stem cells. J Endod. 2017;43:816-22.
• Camps J, Jeanneau C, El Ayachi I, Laurent P, About I. Bioactivity of a Calcium Silicate–based Endodontic Cement (BioRoot RCS): Interactions with Human Periodontal Ligament Cells In Vitro. J Endod. 2015;41:1469-73.
• Prüllage R-K, Urban K, Schäfer E, Dammaschke T. Material properties of a tricalcium silicate–containing, a mineral trioxide aggregate–containing, and an epoxy resin–based root canal sealer. J Endod. 2016;42:1784-8.
• Sarkar N, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31:97-100.
• Arias-Moliz MT, Ferrer-Luque CM, González-Rodríguez MP, Valderrama MJ, Baca P. Eradication of Enterococcus faecalis biofilms by cetrimide and chlorhexidine. J Endod. 2010;36:87-90.
• Gu LS, Kim JR, Ling J, Choi KK, et al. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35:791-804.
• Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J. 2010;43:663-72.
• de Gregorio C, Estevez R, Cisneros R, Heilborn C, Cohenca N. Effect of EDTA, sonic, and ultrasonic activation on the penetration of sodium hypochlorite into simulated lateral canals: an in vitro study. J Endod. 2009;35:891-5.
• Rodig T, Bozkurt M, Konietschke F, Hulsmann M. Comparison of the Vibringe system with syringe and passive ultrasonic irrigation in removing debris from simulated root canal irregularities. J Endod. 2010;36:1410-3.
• Ahmad M, Roy R, Kamarudin A. Observations of acoustic streaming fields around an oscillating ultrasonic file. Dent Traumatol. 1992;8:189-94.
• Bolles JA, He J, Svoboda KK, Schneiderman E, Glickman GN. Comparison of Vibringe, EndoActivator, and needle irrigation on sealer penetration in extracted human teeth. J Endod. 2013;39:708-11.
• DiVito E, Peters OA, Olivi G. Effectiveness of the erbium: YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation. Lasers Med Sci. 2012;27:273-80.
• Peeters HH, Suardita K. Efficacy of smear layer removal at the root tip by using ethylenediaminetetraacetic acid and erbium, chromium: yttrium, scandium, gallium garnet laser. J Endod. 2011;37:1585-9.
• Deleu E, Meire MA, De Moor RJ. Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci. 2015;30:831-5.
• Moon Y-M, Kim H-C, Bae K-S, Baek S-H, Shon W-J, Lee W. Effect of laser-activated irrigation of 1320-nanometer Nd: YAG laser on sealer penetration in curved root canals. J Endod. 2012;38:531-5.
• McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod. 1975;1:238-42.
• Ørstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Dent Traumatol. 1990;6:142-9.
• 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;31:293-6.
• Saleh IM, Ruyter IE, Haapasalo MP, Ørstavik D. Adhesion of endodontic sealers: scanning electron microscopy and energy dispersive spectroscopy. J Endod. 2003;29:595-601.
• Basrani B, Haapasalo M. Update on endodontic irrigating solutions. Endodontic Topics. 2012;27:74-102.
• Donnermeyer D, Dornseifer P, Schäfer E, Dammaschke T. The push-out bond strength of calcium silicate-based endodontic sealers. Head Face Med. 2018;14:13.
• Silva EJNL, Carvalho NK, Prado MC, Zanon M, et al. Push-out bond strength of injectable pozzolan-based root canal sealer. J Endod. 2016;42:1656-9.
• Goracci C, Tavares AU, Fabianelli A, Monticelli F, et al. The adhesion between fiber posts and root canal walls: comparison between microtensile and push‐out bond strength measurements. Eur J Oral Sci. 2004;112:353-61.
• Ungor M, Onay E, Orucoglu H. Push‐out bond strengths: the Epiphany–Resilon endodontic obturation system compared with different pairings of Epiphany, Resilon, AH Plus and gutta‐percha. Int Endod J. 2006;39:643-7.
• Pane ES, Palamara JE, Messer HH. Critical evaluation of the push-out test for root canal filling materials. J Endod. 2013;39:669-73.
• Collares F, Portella F, Rodrigues S, Celeste R, et al. The influence of methodological variables on the push‐out resistance to dislodgement of root filling materials: a meta‐regression analysis. Int Endod J. 2016;49:836-49.
• Saleh I, Ruyter I, Haapasalo M, Ørstavik D. The effects of dentine pretreatment on the adhesion of root-canal sealers. Int Endod J. 2002;35:859-66.
• Trope M, Debelian G. Microbial control: the first stage of root canal treatment. Gen Dent. 2008;57:580-8.
• Angerame D, De Biasi M, Pecci R, Bedini R, et al. Analysis of single point and continuous wave of condensation root filling techniques by micro-computed tomography. Ann Ist Super Sanita. 2012;48:35-41.
• Martins C, Leoni G, Oliveira H, Arid J, et al. Influence of therapeutic cancer radiation on the bond strength of an epoxy‐or an MTA‐based sealer to root dentine. Int Endod J. 2016;49:1065-72.
• Simon S, Flouriot AC. BioRootTM RCS a new biomaterial for root canal filling. J Clin Case Stud. 2016;13:4-11.
• Amin SAW, Seyam RS, El-Samman MA. The effect of prior calcium hydroxide intracanal placement on the bond strength of two calcium silicate–based and an epoxy resin–based endodontic sealer. J Endod. 2012;38:696-9.
• Assmann E, Scarparo RK, Böttcher DE, Grecca FS. Dentin bond strength of two mineral trioxide aggregate–based and one epoxy resin–based sealers. J Endod. 2012;38:219-21.
• Sagsen B, Ustun Y, Demirbuga S, Pala K. Push-out bond strength of two new calcium silicate-based endodontic sealers to root canal dentine. Int Endod J. 2011;44:1088-91.
• Sönmez I, Sönmez D, Almaz M. Evaluation of push-out bond strength of a new MTA-based sealer. Eur Arch Paediatr Dent. 2013;14:161-6.
• Tanalp J, Dikbas I, Malkondu Ö, Ersev H, et al. Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts. Dent Traumatol. 2012;28:457-64.
• Borges R, Sousa‐Neto M, Versiani M, Rached‐Júnior F, et al. Changes in the surface of four calcium silicate‐containing endodontic materials and an epoxy resin‐based sealer after a solubility test. Int Endod J. 2012;45:419-28.
• Camilleri J. Evaluation of selected properties of mineral trioxide aggregate sealer cement. J Endod. 2009;35:1412-7.
• Camilleri J. Modification of mineral trioxide aggregate. Physical and mechanical properties. Int Endod J. 2008;41:843-9.
• Hong S-T, Bae K-S, Baek S-H, Kum K-Y, et al. Effects of root canal irrigants on the push-out strength and hydration behavior of accelerated mineral trioxide aggregate in its early setting phase. J Endod. 2010;36:1995-9.
• Ingle JI, Bakland LK. Endodontics. 4th ed. Baltimore: Williams & Wilkins; 1994. p. 37-8.
• Carneiro S, Sousa‐Neto M, Rached‐Júnior F, Miranda C, et al. Push‐out strength of root fillings with or without thermomechanical compaction. Int Endod J. 2012;45:821-8.
• Neelakantan P, Subbarao C, Subbarao CV, De‐Deus G, Zehnder M. The impact of root dentine conditioning on sealing ability and push‐out bond strength of an epoxy resin root canal sealer. Int Endod J. 2011;44:491-8.
• Mjör I, Smith M, Ferrari M, Mannocci F. The structure of dentine in the apical region of human teeth. Int Endod J. 2001;34:346-53.
• Paqué F, Luder H, Sener B, Zehnder M. Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals. Int Endod J. 2006;39:18-25.
• EL-Ma’aita AM, Qualtrough AJ, Watts DC. The effect of smear layer on the push-out bond strength of root canal calcium silicate cements. Dent Mater J. 2013;29:797-803.
• Dederich DN, Zakariasen KL, Tulip J. Scanning electron microscopic analysis of canal wall dentin following neodymium-yttrium-aluminum-garnet laser irradiation. J Endod. 1984;10:428-31.
• Harashima T, Takeda FH, Kimura Y, Matsumoto K. Effect of Nd: YAG laser irradiation for removal of intracanal debris and smear layer in extracted human teeth. J Clin Laser Med Surg. 1997;15:131-5.