Effect of Blood Contamination on The Push-Out Bond Strength of Calcium Silicate Cements

Abstract

This study investigated the effect of blood-contamination on the push-out bond strength of BiodentineTM (BD) and MTA Angelus® (MTA-A) to root dentin over time. Twenty-five teeth were sectioned horizontally to obtain 120 root slices. The lumens were filled with MTA-A or BD: 60 for each cement (30 uncontaminated and 30 blood contaminated). Push out bond strength to dentin was assessed at 24 h (n=10), 7 days (n=10) and 28 days (n=10). Failure modes were classified as: cohesive, adhesive or mixed failure. Two-way ANOVA was used to investigate the interaction between blood contamination vs. hydration period. Mann Whitney test compared different materials in each period, and it also compared the contaminated versus uncontaminated material for each period. Friedman, followed by Dunn`s test, compared periods of hydration for each material, regardless of blood contamination. Failure modes were reported descriptively. The interaction hydration period vs. blood contamination was highly significant for MTA-A (P=0.001) and it was not significant for BD (P=0.474). There were no differences between bond strength of uncontaminated and contaminated BD in any of the periods. Bond strength of uncontaminated MTA-A increased at each time of hydration; but it remained stable over time for blood-contaminated samples. BD had higher bond strength than MTA-A in all periods of hydration. Cohesive failure predominated. Only for MTA-A, the over time bond strength to dentin was affected by blood contamination.

Push‐out bond strength of the calcium silicate‐based endodontic cements in the presence of blood: A systematic review and meta‐analysis of in vitro studies

“…Nine studies evaluated the bond strength of Biodentine to the dentinal wall after blood exposure. In three studies, bond strength was notably increased after blood contamination (Shalabi et al, 2019 ; Singla et al, 2018 ; Yazdi et al, 2017 ); while four studies did not report any significant differences before and after blood exposure (Aggarwal et al, 2013 ; Bhagya et al, 2018 ; Marquezan et al, 2018 ; Üstün et al, 2015 ). In spite of these manuscripts, two studies reported the adverse effects of blood contamination on the bond strength of Biodentine (Adl et al, 2019 ; Akcay et al, 2016 ).…”

“…Seven studies used the standard diameter of 1.3 mm for the perforated area (Adl et al, 2016 , 2019 ; Marquezan et al, 2018 ; Rahimi et al, 2013 ; Ratih & Putri, 2017 ; Üstün et al, 2015 ; Yazdi et al, 2017 ).…”

“…The major reviewed articles evaluated the bond strength at different periods. Most of these studies reported significant increases in bond strength of CSCs by time passing (Adl et al, 2016 ; Aggarwal et al, 2013 ; Marquezan et al, 2018 ; Rahimi et al, 2013 ; VanderWeele et al, 2006 ).…”

“…Among three studies that evaluated bond strength of AMTA, one study indicated notable decreases in bond strength (Singla et al, 2018 ); while Adl et al (Adl et al, 2016 ) and Marquezan et al (Marquezan et al, 2018 ) studies reported not significant and increased bond strength of AMTA after blood contamination, respectively.…”

Dentin Microhardness and Sealer Bond Strength to Root Dentin are Affected by Using Bioactive Glasses as Intracanal Medication

“…The presence of remaining particles of Ca(OH) 2 attached to the canal walls might affect the sealer setting [6]. This would increase the likelihood of filling material dislodgment, microbial (re)contamination and percolation of fluids from the coronal and apical paths [7].…”