Effect of irrigation systems on the bond strength of calcium-silicate-based cement used as pulp barrier in regenerative endodontic treatment

Abstract

This study aimed to evaluate the effects of irrigation systems on the bond strength of Biodentine, used as a pulp barrier in regenerative endodontic treatment (RET), to the root canal dentin. Following standardized preparation to obtain an immature tooth model, a modified triple antibiotic paste (mTAP) consisting of metronidazole, ciprofloxacin, and clindamycin was applied to the root canals. Teeth were randomly divided into five groups according to the irrigation system (n¼10): Group 1, Conventional Syringe Irrigation (CSI); Group 2, Passive Ultrasonic Irrigation (PUI); Group 3, EndoActivator (EA); Group 4, EndoVac (EV); and Group 5, Nd:YAG laser (LSR). After removing the mTAP from the root canals, parallel sections of 1mm thickness were obtained, with three sections per tooth. Biodentine was applied to the obtained sections, and a push-out test was performed. The data were recorded in MPa, and images of the fracture types were examined. There was no significant difference between the PUI and EV groups (p>0.05), and their respective values, (4.43 ± 0.63) and (4.37 ± 0.47), were greater than those of the other groups (p<0.05). Although the push-out bond strength of the LSR group was higher than those of the EA and CSI groups, there was no difference between EA and CSI groups (p>0.05). The irrigation system type had a significant effect on the push-out bond strength of Biodentine to the root canal dentin in the RET. PUI and EV groups had significantly higher bond strength values than the other groups.