Effect of irrigation protocols for post space preparation on the bond of the resin luting agent and post to a hydraulic calcium silicate filled root: An in vitro study.

Abstract

Statement of problem: The hydraulic calcium silicate-based sealers (HCSSs) used in endodontic treatments have been reported to interfere with the bond of the post to root canal dentin. Post space irrigation plays a significant role in optimizing the bond, but which protocol is effective for cleaning HCSS-smeared intraradicular dentin is unclear.

Purpose: The purpose of this in vitro study was to evaluate the effect of passive ultrasonic irrigation (PUI) as an adjunct to different irrigation protocols, including with ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX), and sodium hypochlorite (NaOCl), and root regions on the push-out bond strength of a self-etch primer-assisted resin luting agent adhered a post to root canal obturated with hydraulic calcium silicate sealer.

Material and methods: The palatal root of 60 human maxillary premolars were shaped and obturated with gutta-percha and HCSS (iRoot SP). The post space was prepared using a peeso reamer and double taper drill, and the specimens were divided into 6 groups (n=10) according to the following irrigation protocols: distilled water with conventional syringe, distilled water with PUI, 17% EDTA with PUI, 2% CHX with PUI, 17% EDTA + 2.5% NaOCl with PUI, and 17% EDTA + 2% CHX with PUI. Fiber-reinforced posts (DT Light-Post) were cemented with dual-polymerizing resin luting agent with self-etching primer (Panavia V5). Specimens underwent 6000 thermocycles, were sectioned into 3 slices, and were tested for push-out bond strength and failure mode. The 2-way mixed ANOVA, Kruskal-Wallis H, Dunn post hoc, and chi-squared tests were used for statistical analysis (α=.05).

Results: The PUI/EDTA/NaOCl group exhibited significantly higher push-out bond strength than irrigation with distilled water, whether incorporated with PUI or not (P=.001 and P=.007, respectively). The root region showed no statistical effects on bond strength (P>.05). The irrigation protocol was significantly associated with failure mode (P=.049).

Conclusions: PUI with EDTA/NaOCl followed by distilled water improved the bond strength of self-etch primer-assisted resin luting agent and fiber-reinforced post to an HCSS-obturated tooth. Alternative irrigation protocols did not significantly enhance bond strength.