Effect of varying durations of intracanal medicament application used in regenerative endodontic treatment on the push-out bond strength of a novel cement: NeoMTA Plus.

Abstract

Aim:The aim of the present study was to evaluate the effect of varying durations of intracanal medicament application used in regenerative endodontic treatment on the push out the bond strength of a novel cement-NeoMTA Plus.Materials and Methods:A total of 60 extracted single-rooted maxillary anterior teeth were decoronated. Roots were instrumented uniformly until Peeso Reamer size #5 to simulate open apices. A total of 60 roots were then divided into four groups according to intracanal medicaments used (n = 15): Group 1: Triple antibiotic paste (TAP); Group 2: Double antibiotic paste (DAP); Group 3: Calcium hydroxide paste (CH); and Group 4 (control): No medicament. Samples were kept in saline solution for 2, 4, and 12 weeks, after which time five roots were selected randomly from each group, representing the samples of each time point. After removal of the medicaments, NeoMTA Plus was placed into 8 mm of the coronal third of the roots and samples were incubated. Roots were sectioned to obtain 2 discs per root (n = 10). A push-out test was used to measure the sealing efficacy of NeoMTA Plus. Data were analyzed using a one-way ANOVA followed by Tukey's pairwise comparisons.Results:CH, DAP, and TAP application resulted in significantly lower values of the push-out bond strength of NeoMTA Plus after 12 weeks compared to 2 weeks (P < 0.05).Control versus calcium hydroxideP=0.0002Control versus double antibiotic pasteP=0.0312Control versus triple antibiotic pasteP=0.0002No significant differences were found between the time points in the control group (P > 0.05).Changes from 2-12 weeksMeanSDControl0.600.81SD: Standard deviationDAP showed lowest push-out bond strength.Group2 weeks4 weeks12 weeksChanges from 2 weeks to4 weeks12 weeksMeanSDMeanSDMeanSDMeanSDMeanSDDouble antibiotic paste2.820.351.890.411.460.400.930.551.360.38SD: Standard deviationConclusion:CH, DAP, and TAP cause an alteration in dentinal surface properties leading to negative effect on bond strength of NeoMTA Plus. The effect is more evident in DAP and as treatment time is prolonged. The type and duration of medicament application have to be monitored to achieve a maximum therapeutic value as well as to avoid compromise on the coronal seal.