Effect of several intracanal medicaments on the push-out bond strength of ProRoot MTA and Biodentine

Aim: To evaluate the effect of prior application of several intracanal medicaments on the push-out bond strength of ProRoot MTA and Biodentine. Methodology: Sixty freshly extracted maxillary anterior teeth were sectioned below the cementoenamel junction, and the root canals instrumented using rotary files. Thereafter, a parallel post drill was used to obtain a standardized root canal dimension. The roots were randomly assigned into one of the following groups with respect to the intracanal medicament applied: group 1: calcium hydroxide (CH) powder (Merck, Darmstadt, Germany) mixed with distilled water; group 2: a mixture of metronidazole, ciprofloxacin and minocycline (triple antibiotic paste); group 3: a combination of amoxicillin and clavulanic acid (Augmentin; Champs Pharmacy, San Antonio, TX, USA); group 4: an antibiotic-corticoid compound paste (Ledermix; Riemser, Greifswald, Germany); and group 5: no medicament (control). Following removal of medicaments with instrumentation and irrigation, the roots were cut into 1-mm-thick parallel transverse sections in a coronal-to-apical direction (5 slices/tooth). Thereafter, the specimens were divided into two subgroups according to the calcium silicate cement applied (n = 30/group): (i) ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA) and (ii) Biodentine (Septodont, Saint-Maur-des-Fosses, France). A push-out test was performed, and the data were analysed statistically using two-way anova and Tukey's post hoc test. Results: Regardless of the type of intracanal medicament used, Biodentine had significantly higher bond strength than MTA (P < 0.05). The highest push-out bond strength results were obtained in CH-treated dentine. Compared with other medicaments, this value was only significantly higher than that of Ledermix (P < 0.05). In both the MTA and Biodentine groups, pairwise comparisons between other medicaments showed similar debonding values (P > 0.05). Conclusions: Biodentine had a higher bond strength to root canal dentine than ProRoot MTA. Prior CH in distilled water intracanal placement increased the dislodgment resistance of both calcium silicate cements.