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 (n = 10): 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 1 mm 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.