Effect of intracanal medicaments used in endodontic regeneration on the push-out bond strength of a calcium-phosphate-silicate-based cement to dentin.

Elif Aybala Oktay,Seyda Ersahan,Selcuk Gokyay

doi:10.12669/pjms.342.14630

Elif Aybala Oktay, Seyda Ersahan + Show 1 more

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https://doi.org/10.12669/pjms.342.14630

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Abstract

Objective:To evaluate the effects of various endodontic regeneration agents on the push-out bond strength of Endosequence Root Repair Material (ERRM) to root-canal dentin.Methods:Fifty single-rooted human teeth were selected and instrumented to obtain a standard internal diameter of 1.5 mm. Specimens were randomly divided into four experimental groups and treated with an intracanal medicament [calcium hydroxide (CH), double antibiotic paste (DAP), triple antibiotic paste (TAP), TAP with amoxicillin (mTAP)] and a non-treated control group. Medicaments were removed after three weeks, and ERRM was applied to all specimens. The coronal portion of each root was then sliced into 2-mm-thick parallel transverse sections (2 slices per tooth, n=20 slices per group), and a push-out test was used to measure the bond strength of ERRM to dentin. Data were analyzed using Bonferroni-corrected Mann-Whitney tests, with the level of significance set at p<0.05.Results:The push-out bond strength of the CH group was significantly higher than that of the TAP, DAP and mTAP groups (p< 0.005). Furthermore, the bond strength of the control group was higher than the bond strength of both the DAP and mTAP groups.Conclusion:The use of CH in clinical practice may help improve the adhesion of ERRM to dentin.

Highlights

Regenerative endodontic protocols generally involve disinfection of the root canal followed by the introduction of a blood clot and/or stem/ progenitor cells into the root-canal space, which is restored with a microorganism-impregnable material, allowing tissue repair and further root maturation.[1]Triple antibiotic paste (TAP), which is a mixture of metronidazole, ciprofloxacin and minocycline, is the medicament most widely used in endodontic regeneration.[2]
Experimental groups were treated with either calcium hydroxide (CH), Double antibiotic paste (DAP), TAP, or modified triple antibiotic paste (mTAP) as an intracanal medicament, whereas no dressing was used for the control group.[13]
No significant differences were found between the CH and control (p = 0.495), TAP and control (p = 0.012), TAP and DAP (p=0.007), or DAP and mTAP (p=0.841) groups

Summary

Introduction

Regenerative endodontic protocols generally involve disinfection of the root canal followed by the introduction of a blood clot and/or stem/ progenitor cells into the root-canal space, which is restored with a microorganism-impregnable material, allowing tissue repair and further root maturation.[1]Triple antibiotic paste (TAP), which is a mixture of metronidazole, ciprofloxacin and minocycline, is the medicament most widely used in endodontic regeneration.[2]. Pak J Med Sci March - April 2018 Vol 34 No 2 www.pjms.com.pk 310 the discoloration caused by minocycline.[2] Recently, a modified triple antibiotic paste (mTAP) comprised of metronidazole, ciprofloxacin and amoxicillin has been suggested as another alternative.[3] Calcium hydroxide [Ca(OH)[2], CH] has been used to disinfect the canal during endodontic regeneration.[4] both antibiotic pastes and CH have regenerative effects, they can alter the chemical structure of dentin and the mineral content of dentin surfaces.[5] If the dressing is not thoroughly removed from the root canal, it can interfere with the bond between root dentin and the root-canal sealant applied prior to the final restoration.[6]

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