Effect of Chelating Agents on Push-Out Bond Strength of NeoMTA Plus to Root Canal Dentin

Pattath Kunjan  Anju; Tina P.  Purayil; Kishore  Ginjupalli; Nidambur V.  Ballal

Authors

Pattath Kunjan Anju
Tina P. Purayil
Kishore Ginjupalli
Nidambur V. Ballal

Keywords:

Dental Materials, Endodontics, Tensile Strength, Chelating Agents

Abstract

Objective: To evaluate and compare the effect of 17% Ethylenediaminetetraacetic Acid (EDTA), 9% Etidronic acid (HEDP), and 7% Maleic acid (MA) on the push-out bond strength of NeoMTA Plus sealer to the coronal, middle, and apical thirds of root canal dentin. Material and Methods: Forty single-rooted human maxillary central incisors were selected and decoronated to 12 mm long root fragments. Working length was established and root canals were then enlarged up to rotary Protaper F3. After each instrumentation, the root canal was irrigated with 2.5% NaOCl. For the final irrigation regimen, the specimens were divided into 4 groups (n=10) and treated with EDTA, HEDP, MA or Saline. Root canals were coated with NeoMTA Plus sealer, and obturation was done with single cone obturation technique. Subsequently, three horizontal sections were taken from the coronal, middle and apical thirds of each specimen, and POBS was measured using a universal testing machine. The type of bond failures was assessed under a stereomicroscope. Statistical analysis was done with One-way ANOVA with Tukey’s Post hoc analysis. Results: MA and EDTA showed the highest POBS. There was no significant difference in bond strength between MA and EDTA (p>0.05). HEDP and Saline showed lower POBS. Among all the four groups, the coronal third showed the highest values, followed by middle and apical thirds. Conclusion: The type of chelating agent used during the root canal treatment significantly affects the bond strength of NeoMTA Plus to the root canal dentin.

References

Faraco IM Jr, Holland R. Response of the pulp of dogs to capping with mineral trioxide aggregate or a calcium hydroxide cement. Dent Traumatol 2001; 17(4):163-6. https://doi.org/10.1034/j.1600-9657.2001.170405.x

Govindaraju L, Neelakantan P, Gutmann JL. Effect of root canal irrigating solutions on the compressive strength of tricalcium silicate cements. Clin Oral Investig 2017; 21(2):567-71. https://doi.org/10.1007/s00784-016-1922-0

Duarte MA, Demarchi AC, Yamashita JC, Kuga MC, de Fraga SC. pH and calcium ion release of 2 root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95(3):345-7. https://doi.org/10.1067/moe.2003.12

Carvalho NK, Prado MC, Senna PM, Neves AA, Souza EM, Fidel SR, et al. Do smear-layer removal agents affect the push-out bond strength of calcium silicate-based endodontic sealers? Int Endod J 2017; 50(6):612-9. https://doi.org/10.1111/iej.12662

Krastl G, Allgayer N, Lenherr P, Filippi A, Taneja P, Weiger R. Tooth discoloration induced by endodontic materials: a literature review. Dent Traumatol 2013; 29(1):2-7. https://doi.org/10.1111/j.1600-9657.2012.01141.x

Turker SA, Uzunoglu E, Bilgin B. Comparative evaluation of push-out bond strength of Neo MTA Plus with Biodentine and white ProRoot MTA. J Adhes Sci Technol 2017; 31(5):502-8. https://doi.org/10.1080/01694243.2016.1219443

Abu Zeid ST, Alamoudi NM, Khafagi MG, Abou Neel EA. Chemistry and Bioactivity of NeoMTA Plus™ versus MTA Angelus® Root Repair Materials. J Spectrosc 2017:1-9.

Sen BH, Wesselink PR, Turkun M. The smear layer: a phenomenon in root canal therapy. Int Endod J 1995; 28(3):141-8. https://doi.org/10.1111/j.1365-2591.1995.tb00289.x

White RR, Goldman M, Lin PS. The influence of the smeared layer upon dentinal tubule penetration by plastic filling materials. J Endod 1984; 10(12):558-62. https://doi.org/10.1016/S0099-2399(84)80100-4

Sayin TC, Serper A, Cehreli ZC, Kalayci S. Calcium loss from root canal dentin following EDTA, EGTA, EDTAC, and Tetracycline-HCl treatment with or without subsequent NaOCl irrigation. J Endod 2007; 33(5):581-4. https://doi.org/10.1016/j.joen.2006.12.010

Buldur B, Oznurhan F, Kaptan A. The effect of different chelating agents on the push-out bond strength of proroot mta and endosequence root repair material. Eur Oral Res 2019; 53(2):88-93. https://doi.org/10.26650/eor.20191618

Ozlek E, Rath PP, Kishen A, Neelakantan P. A chitosan-based irrigant improves the dislocation resistance of a mineral trioxide aggregate-resin hybrid root canal sealer. Clin Oral Investig 2020; 24(1):151-6. https://doi.org/10.1007/s00784-019-02916-x

Ballal NV, Kandian S, Mala K, Bhat KS, Acharya S. Comparison of the efficacy of maleic acid and ethylene-diamine-tetra-acetic acid in smear layer removal from instrumented human root canal: A scanning electron microscopic study. J Endod 2009; 35(11):1573-6. https://doi.org/10.1016/j.joen.2009.07.021

Taner CS, Serper A, Cehreli ZC, Otlu HG. The effect of EDTA, EGTA, EDTAC, & tetracycline-HCL with and without subsequent NaOCl treatment on the microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(3):418-24. https://doi.org/10.1016/j.tripleo.2007.03.021

Ballal NV, Kundabala M, Bhat S, Rao N, Rao BS. A comparative in vitro evaluation of cytotoxic effects of EDTA and maleic acid: root canal irrigants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(4):633-8. https://doi.org/10.1016/j.tripleo.2009.05.039

Vilanova WV, Carvalho-Junior JR, Alfredo E, Sousa-Neto MD, Silva-Sousa YT. Effect of intracanal irrigants on the bond strength of epoxy resin-based and methacrylate resin-based sealers to root canal walls. Int Endod J 2012; 45(1):42-8. https://doi.org/10.1111/j.1365-2591.2011.01945.x

Ravikumar J, Bhavana V, Thatimatla C, Gajjarapu S, Reddy SG, Reddy BR. The effect of four different irrigating solutions on the shear bond strength of endodontic sealer to dentin – an in-vitro study. J Int Oral Health 2014; 6(1):85-8.

Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009; 42(4):335-43. https://doi.org/10.1111/j.1365-2591.2008.01514.x

Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod 2005; 31(11):817-20. https://doi.org/10.1097/01.don.0000158233.59316.fe

Neelakantan P, Varughese AA, Sharma S, Subbarao CV, Zehnder M, De-Deus G. Continuous chelation irrigation improves the adhesion of epoxy resin-based root canal sealer to root dentine. Int Endod J 2012; 45(12):1097-102. https://doi.org/10.1111/j.1365-2591.2012.02073.x

Nagas E, Cehreli Z, Uyanik M, Vallittu P, Lassila L. Effect of several intracanal medicaments on the push-out bond strength of ProRoot MTA and Biodentine. Int Endod J 2016; 49(2):184-8. https://doi.org/10.1111/iej.12433

Topcuoglu HS, Arslan H, Akcay M, Saygili G, Cakici F, Topcuoglu G. The effect of medicaments used in endodontic regeneration technique on the dislocation resistance of mineral trioxide aggregate to root canal dentin. J Endod 2014; 40(12):2041-4. https://doi.org/10.1016/j.joen.2014.08.018

Saleh IM, Ruyter IE, Haapasalo M, Orstavik D. The effects of dentine pretreatment on the adhesion of root-canal sealers. Int Endod J 2002; 35(10):859-66. https://doi.org/10.1046/j.1365-2591.2002.00585.x

Ballal NV, Tweeny A, Khechen K, Prabhu KN, Satyanarayan, Tay FR. Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions. J Dent 2013; 41(6):556-60. https://doi.org/10.1016/j.jdent.2013.04.005

Wenzel RN. Resistance of solid surface by wetting with water. Ind Eng Chem 1936; 28(8):988-94. https://doi.org/10.1021/ie50320a024.

Tummala M, Chandrasekhar V, Rashmi AS, Kundabala M, Ballal V. Assessment of the wetting behavior of three different root canal sealers on root canal dentin. J Conserv Dent 2012; 15(2):109-12. https://doi.org/10.4103%2F0972-0707.94573

Goracci C, Tavares AU, Fabianelli A, Monticelli F, Raffaelli O, Cardoso PC, et al. The adhesion between fiber posts and root canal walls: comparison between microtensile and push-out bond strength measurements. Eur J Oral Sci 2004; 112(4):353-61. https://doi.org/10.1111/j.1600-0722.2004.00146.x

Ballal NV, Mala K, Bhat KS. Evaluation of decalcifying effect of maleic acid and EDTA on root canal dentin using energy dispersive spectrometer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112(2):e78-84. https://doi.org/10.1016/j.tripleo.2011.01.034

Rotstein I, Dankner E, Goldman A, Heling I, Stabholz A, Zalkind M, et al. Histochemical analysis of dental hard tissues following bleaching. J Endod 1996; 22(1):23 5. https://doi.org/10.1016/S0099-2399(96)80231-7

Nikiforuk G, Sreebny L. Demineralization of hard tissues by organic chelating agents at neutral pH. J Dent Res 1953; 32(6):859-67. https://doi.org/10.1177%2F00220345530320061401

Gandhi P, Ballal NV, George JE, George SD, Narkedamalli RK. Effect of chelating agents on the wettability of BioRoot RCS and AH Plus sealers. Saudi Endod J 2020; 10(2):100-5. https://doi.org/10.4103/sej.sej_82_19

Tartari T, Bachmann L, Zancan RF, Vivan RR, Duarte MAH, Bramante CM. Analysis of the effects of several decalcifying agents alone and in combination with sodium hypochlorite on the chemical composition of dentine. Int Endod J 2018; 51(Suppl 1):e42-54. https://doi.org/10.1111/iej.12764

Neelakantan P, Subbarao C, Subbarao CV, De-Deus G, Zehnder M. The impact of root dentine conditioning on sealing ability and push-out bond strength of an epoxy resin root canal sealer. Int Endod J 2011; 44(6):491-8. https://doi.org/10.1111/j.1365-2591.2010.01848.x

Alamoudi RA, Abu Zeid ST. Effect of irrigants on the push-out bond strength of two bioceramic root repair materials. Materials 2019; 12(12):1921. https://doi.org/10.3390/ma12121921

Sonmez IS, Oba AA, Sonmez D, Almaz ME. In vitro evaluation of apical microleakage of a new MTA-based sealer. Eur Arch Paediatr Dent 2012; 13(5): 252-5.

Guneser MB, Akbulut MB, Eldeniz AU. Effect of various endodontic irrigants on the push-out bond strength of biodentine and conventional root perforation repair materials. J Endod 2013; 39(3):380-4. https://doi.org/10.1016/j.joen.2012.11.033

Erickson RL. Surface interactions of dentin adhesive materials. Oper Dent 1992; 5:81-94.

Paque F, Luder HU, Sener B, Zehnder M. Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals. Int Endod J 2006; 39(1):18-25. https://doi.org/10.1111/j.1365-2591.2005.01042.x

Huffman BP, Mai S, Pinna L, Weller RN, Primus CM, Gutmann JL, et al. Dislocation resistance of ProRoot Endo Sealer, a calcium silicate-based root canal sealer, from radicular dentine. Int Endod J 2009; 42(1):34-46. https://doi.org/10.1111/j.1365-2591.2008.01490.x

Eldeniz AU, Erdemir A, Belli S. Shear bond strength of three resin based sealers to dentin with and without the smear layer. J Endod 2005; 31(4):293-6. https://doi.org/10.1097/01.don.0000140577.99708.c8