Effect of Drying Protocols on the Bond Strength of Bioceramic, MTA and Resin-based Sealer Obturated Teeth

Abstract

Aim The aim of this study was to evaluate the bond strength and thereafter analyze the mode of failure of the three sealers applied to smear free radicular dentine with final drying using 70% isopropyl alcohol and paper points. Materials and methods A total of sixty root canals were prepared and then segregated into two groups ( n = 30) as per the drying protocol, namely paper points or 70% isopropyl alcohol. Then, these roots were divided into three sub-groups ( n = 10) with respective sealers and obturation materials, namely AH Plus and gutta-percha (AH/GP), EndoSequence BC and gutta-percha (EBC/GP), and MTA Fillapex and gutta-percha (MFP/GP). The roots were then sectioned from each third, and the push-out test was performed. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by 2-way analysis of variance post hoc Tukey tests with a significant level of 5%. Results Overall canals dried with isopropyl alcohol showed higher bond strength values than paper point ( p < 0.05). The AH/GP group showed lower bond strength than EBC/GP ( p < 0.05) but higher than MFP/GP ( p < 0.05). The most frequent type of failure was cohesive in the AH/GP group and adhesive in the EBC/GP group whereas MFP/GP had almost similar adhesive and cohesive failures. Conclusion Seventy percent isopropyl alcohol drying improved the bond strength of the root canal sealers with the dentinal tubules better than the ideal paper point drying. How to cite this article Khurana N, Chourasia HR, et al. Effect of Drying Protocols on the Bond Strength of Bioceramic, MTA and Resin-based Sealer Obturated Teeth. Int J Clin Pediatr Dent 2019;12(1):33–36.

Comparison of push‐out bond strength of endodontic sealers after root canal drying with different techniques

“…Since no clear protocol is available for achieving an ideal state of residual moisture in the root canal (Zmener et al, 2008 ), different chemical agents such as different concentrations of alcohol have been tested for dentin moisture removal (Engel et al, 2005 ; Nagas et al, 2012 ; Stevens et al, 2006 ). Evidence shows that over‐drying may remove water from dentinal tubules and impair the efficacy of hydrophilic sealers and their adhesion to root dentin (Dias et al, 2014 ; Singh et al, 2019 ). The hydrophilicity of sealers is not enough for the ideal displacement of water in completely wet root canals, and the entrapment of water droplets at the sealer‐dentin interface compromises strong bonding.…”

“…It appears that drying the canal with ethanol or paper point along with the use of bioceramic sealers can enhance the adhesion of sealer to dentin. However, since ethanol showed a superior performance to other methods only with AH26 and did not present a significant difference with paper points, the authors would not recommend this method in general, but only for AH26, because ethanol causes over‐drying of the canal and dentinal tubules, and subsequently impairs the efficacy of hydrophilic sealers and their adhesion to root canal walls (Singh et al, 2019 ). The reason for higher efficacy of ethanol with resin‐based sealers than with bioceramic sealers is that elimination of moisture leads to a higher success rate in resin‐based sealers because resin sealers are naturally hydrophobic, and moisture degrades their structure; whereas, the effect of moisture on bioceramic sealers is much lower due to their inherently hydrophilic nature (Nagas et al, 2012 ).…”

“…| 319 adhesion to root canal walls (Singh et al, 2019). The reason for higher efficacy of ethanol with resin-based sealers than with bioceramic sealers is that elimination of moisture leads to a higher success rate in resin-based sealers because resin sealers are naturally hydrophobic, and moisture degrades their structure; whereas, the effect of moisture on bioceramic sealers is much lower due to their inherently hydrophilic nature (Nagas et al, 2012).…”

“…This finding indicates that drying of the root canal has a fundamental role in the enhancement of PBS. Singh et al (2019) compared the PBS in different drying techniques and reported that 70% isopropyl alcohol yielded the highest PBS. Kapur et al (2019) discussed that the removal of excess moisture has a fundamental role in the enhancement of PBS.…”

“…In the present study, adhesive and mixed failures were the most common in AH26 and MTA-Fillapex, and cohesive and mixed failures were the most common in Endoseal MTA and SureSeal Root sealers. In a study bySingh et al (2019) the majority of failures were cohesive and mixed in AH Plus, and adhesive and cohesive in EndoSequence BC and MTA-Fillapex.…”