Analysis of Bond Strength of Bioceramic Sealer Following Irrigation with Chlorhexidine

氯己定冲洗后生物陶瓷封闭剂粘接强度的分析

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Abstract

INTRODUCTION: This study aimed to evaluate the bond strength of a bioceramic endodontic sealer and AH-Plus sealer irrigated with 2% chlorhexidine (CHX), compared to irrigation with 2.5% sodium hypochlorite (NaOCl) as a control group. MATERIALS AND METHODS: Thirty freshly extracted single-rooted human teeth were prepared using reciprocating R25 and R40 files. Irrigation consisted of 2.5% NaOCl in the control group and 2% CHX gel in the experimental group, with additional irrigation using saline solution after each instrument change. Samples were divided into four groups: two with CHX, one with bioceramic sealer, and the other with AH-Plus sealer, and two with hypochlorite, one with bioceramic sealer and the other with AH-Plus sealer. The teeth were sectioned, and the resulting slices were subjected to the push-out test using a mechanical testing machine for measuring the microtensile force. After testing, samples were examined to determine the failure pattern. Data normality was assessed (Shapiro-Wilk, P<0.05), and non-parametric analyses (Kruskal-Wallis with Dunn's post hoc, Wilcoxon rank-sum with Benjamini-Hochberg correction) were applied. Effect sizes (Cohen's d, Cliff's Delta), bootstrap 95% confidence intervals (CIs) (2000 replicates), and the post hoc power were calculated. Significance was set at P<0.05. RESULTS: AH-Plus exhibited higher bond strength than Sealer Plus BC across all root thirds, independent of irrigant. For Sealer Plus BC, bond strength was influenced by irrigant, with NaOCl producing higher values than CHX (P<0.05). CONCLUSION: AH-Plus exhibited superior bond strength irrespective of the irrigant used. In contrast, the bond strength of the Sealer Plus bioceramic sealer was influenced by the irrigant, with NaOCl yielding higher values than CHX.

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