Aim To evaluate the influence of blood contamination on the bond strength and apatite forming ability of Biodentine used as root-end filling material. Methodology Eighty (n = 80) extracted single-rooted, sound human maxillary anterior teeth were prepared and obturated. Then, the roots were resected, retrograde cavities were prepared and Biodentine was inserted as the root-end filling material. Teeth were then randomly divided into 2 equal groups (n = 40) according to the setting environment of Biodentine i.e., group A where setting took place in human blood and group B where setting took place in deionized water (control group). Teeth were incubated at 37  °C for 45 min to ensure complete setting. Root discs with the filling material in their core were prepared. Push-out bond strength test was performed using a universal testing machine and failure mode was examined. Both groups were aged in HBSS for 30 days. Apatite nucleation was evaluated at one-day, 7-days, and 30-days interval using SEM for morphological analysis and EDX for elemental analysis. Calculation of the Ca/P ratios was performed in addition to XRD for crystal phase analysis. Results Blood contamination (group A) resulted in significant reduction of bond strength values. It also affected the amount of apatite deposition on the material surface and interfacial spaces with higher Ca/P ratios than that of the normal stoichiometric hydroxyapatite. Conclusions Blood contamination during setting of Biodentine had a detrimental effect on the bond strength and reduced the nucleation of apatite in comparison to non-contaminated group.

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