Comparison of the Push-out Bond Strength of MTA and a Bio-ceramic Repair Material at the Furcal Area after Final Irrigation with 17% Ethylenediaminetetraacetic Acid (EDTA), and 20% Citric Acid
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Abstract
Background: Perforations are serious endodontic complications that require immediate repair for a successful treatment outcome. The materials used for the repair, along with the irrigants employed, play a significant role in determining the bond strength at the dentin interface. The choice of material is therefore critical for the long-term durability of the treatment.
Aim: To compare the push-out bond strength of MTA and a bioceramic repair material in furcation of mandibular molars after final irrigation with 17% Ethylenediaminetetraacetic Acid (EDTA), 20% citric acid.
Materials and methods: Forty extracted mandibular molars with standardized furcation perforations were divided into two material groups: MTA and Bio C Repair (n=20 each). Both groups were further subdivided by final irrigation: 17% EDTA and 20% citric acid (n = 10 per subgroup). After obturation and perforation repair, samples were stored for 24 hours at 100% humidity and 37°C to allow the material to set. Push-out bond strength (MPa) was measured using a universal testing machine. Data were analyzed using the Kruskal-Wallis test and Dunn’s multiple comparison test with Bonferroni correction.
Results: Bio C repair irrigated with 20% citric acid exhibited significantly higher push-out bond strength than all other subgroups. Overall, Bio C Repair showed greater push-out bond strength than MTA (P<0.05).
Conclusion: The newer putty consistency material showed better bond strength compared to conventional MTA, and its mechanical properties were significantly influenced by the type of irrigant used during bio-mechanical preparation.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
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1. Tiwari N, Borkar AC, Tandale A, Nighot N, Ghare S, Maral S. Comparative evaluation of the effect of various endodontic irrigants on the push-out bond strength of EndoSequence, biodentine™, and MTA plus™ root repair materials: An in vitro study. J Int Clin Dent Res Organ 2019;11:9-13. https://doi.org/10.4103/jicdro.jicdro_3_19
2. Sethi S, Bhushan J, Joshi RK, Singla R, Sidhu K. Effect of different irrigants on the push-out bond strength of biodentine and TheraCal LC when used for perforation repair in simulated condition. J Conserv Dent 2023;26:321-5.
3. Das Neves MJ, Prado MD, de Lima CO, Ballal V, Simão RA, Campos CN. Effect of different irrigation regimens on the bond strength of Biodentine used for furcal perforation repair. Endodontic Practice Today. 2019;13(1):49-11.
4. Hamed SA. Repair of root canal perforation by different materials. J Bagh Coll Dentistry. 2011;23(Special Issue):30–35.
5. Hong ST, Bae KS, Baek SH, Kum KY, Shon WJ, Lee W. Effects of root canal irrigants on the push-out strength and hydration behavior of accelerated mineral trioxide aggregate in its early setting phase. J Endod. 2010;36(12):1995-9. https://doi.org/10.1016/j.joen.2010.08.039
6. Toubes KS, Tonelli SQ, Girelli CFM, Azevedo CGS, Thompson ACT, Nunes E, Silveira FF. Bio-C Repair - A New Bioceramic Material for Root Perforation Management: Two Case Reports. Braz Dent J. 2021;32(1):104 110. https://doi.org/10.1590/0103-6440202103568
7. Kadali N, Alla RK, Guduri V, AV R, MC SS, Raju RV. Mineral Trioxide Aggregate: An overview of composition, properties and clinical applications. Int J Dent Mater. 2020;2(1):11-8. https://doi.org/10.37983/IJDM.2020.2103
8. Kolla VB, Kalyan Satish R, Sajjan GS, Madhu Varma K, Sigadam A, Dutta GS. Apical microleakage assessment of teeth obturated with single-cone gutta-percha using two calcium silicate sealers and a resin sealer: an in vitro study. Int J Dent Mater. 2021;3(4):100-5. https://doi.org/10.37983/IJDM.2021.3401
9. Mikheikina A, Babina K, Polyakova M, Doroshina V, Zaytsev A, Novozhilova N. Smear layer removing and pulp dissolving ability of sodium hypochlorite mixed with two etidronate-containing irrigants in continuous chelation technique. Appl Sci. 2024;14(18):8422. https://doi.org/10.3390/app14188422
10. Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: Different methods to improve efficacy and related problems. Eur J Dent. 2018;12(3):459-466. https://doi.org/10.4103/ejd.ejd_56_18
11. Gade V, Gangrade A, Jogad N, Bhede L, Thakur D, Umale K. An in vitro evaluation of effect of chelating agents on the push-out bond strength of new perforation repair materials (Biodentine, BioAggregate and Retro MTA). J Res Med Dent Sci. 2021;9(12):102–106.
12. Shivani Shreya K, Deepthi G, Khwaja Moinuddin M, Pallavi R, Asha R, Amulya R. The effect of irrigating solutions on the hydration of tricalcium silicate cements: an in vitro study. Int J Dent Mater 2023;5(2):31-6. https://doi.org/10.37983/IJDM.2023.5202
13. Kassab P, El Hachem C, Habib M, et al. The Pushout Bond Strength of Three Calcium Silicate-based Materials in Furcal Perforation Repair and the Effect of a Novel Irrigation Solution: A Comparative In Vitro Study. J Contemp Dent Pract 2022;23(3):289–294. https://doi.org/10.5005/jp-journals-10024-3309
14. Maria Do Prado M, de Lima CO, das Neves Marques J, Ballal V, Simão RA, Campos CN. Effect of different irrigation regimens on the bond strength of Biodentine used for furcal perforation repair. Int J Prosthodont. 2019;32:49 59
15. Akcay H, Arslan H, Akcay M, Mese M, Sahin NN. Evalu ation of the bond strength of root-end placed mineral tri oxide aggregate and Biodentine in the absence/presence of blood contamination. Eur J Dent 2016;10:370–375. https://doi.org/10.4103/1305-7456.184150
16. Al-Nazhan S, El Mansy I, Al-Nazhan N, Al-Rowais N, Al-Awad G. Outcomes of furcal perforation management using mineral trioxide aggregate and Biodentine: a systematic review. J Appl Oral Sci. 2022;30:e20220330. https://doi.org/10.1590/1678-7757-2022-0330
17. Lopez-Garcia S, Lozano A, Garcia-Bernal D, Forner L, Llena C, Guerrero Girones J, et al. Biological effects of new hydraulic materials on human periodontal ligament stem cells. J Clin Med 2019;8:1-13. https://doi.org/10.3390/jcm8081216
18. Leal F, De-Deus G, Brandão C, Luna A, Souza E, Fidel S. Similar sealability between bioceramic putty ready-to-use repair cement and white MTA. Braz Dent J 2013;24:362-366. https://doi.org/10.1590/0103-6440201302051
19. BIO-C® REPAIR Bioceramic reparative material, ready to use putty. Technical Scientific Profile. https://angelus.ind.br/en/materialinformativo/endodontics/repair-cements/bio-c-repair/perfil-tecnico/
20. Aushal R, Bansal R, Malhan S. A comparative evaluation of smear layer removal by using ethylenediamine tetraacetic acid, citric acid, and maleic acid as root canal irrigants: An in vitro scanning electron microscopic study. J Conserv Dent. 2020;23(1):71-78. https://doi.org/10.4103/JCD.JCD_43_20
21. Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent. 2010;13(4):256-264. https://doi.org/10.4103/0972-0707.73378
22. Fortea L, Sanz-Serrano D, Luz LB, Bardini G, Mercadé M. Update on chelating agents in endodontic treatment: a systematic review. J Clin Exp Dent. 2024;16(4):e516–e538. https://doi.org/10.4317/jced.60989
23. Dayyoub G, Al-Tayyan M, Tolibah YA, Achour H. An in vitro assessment of the irrigants and irrigation protocols effect on the ProRoot MTA marginal leakage in furcal perforations. Sci Rep. 2025;15(1):6319. https://doi.org/10.1038/s41598-025-90841-3
24. dos Reis-Prado AH, Toledo PTA, Nunes GP, Ferreira PAV, Rahimnejad M, Dal-Fabbro R, et al. Citric acid conditioning as an alternative to EDTA for growth factors release and stem cell response in regenerative endodontics: a systematic review of in vitro studies. J Endod. 2024;50(2):129–143. https://doi.org/10.1016/j.joen.2023.11.006