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

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.