The Pushout Bond Strength of Three Calcium Silicate-based Materials in Furcal Perforation Repair and the Effect of a Novel Irrigation Solution: A Comparative In Vitro Study.

AIM: To evaluate the pushout bond strength of three calcium silicate-based materials used as furcal perforation repair materials and the effect of root canal irrigants on the pushout strength of the tested repair materials. MATERIALS AND METHODS: Furcal perforations measuring 1.3 mm in diameter were made in the center of the furcation area of 90 extracted human mandibular molars. The teeth were then randomly divided into three groups (n = 30) according to the repair material: Biodentine (Septodont, St-Maur-des-Fossés, France), PD-MTA White (Produits Dentaires, Vevey, Switzerland), and K-Biocer (REKITA, Lebanon). The specimens were stored at 100% humidity at 37°C for 72 hours. They were later divided into three subgroups (n = 10) based on the irrigation protocol: 2.5% sodium hypochlorite, BioAKT (Metabolic substrate, New Tech Solutions s.r.l., Brescia, Italy), and a control group. After incubation for 48 hours, the dislodgement resistance of the samples was measured using a universal testing machine. RESULTS: The mean bond strength was significantly different between repair materials in the irrigation control group (p-value <0.001). With PD-MTA White and K-Biocer, the mean bond strength was not significantly different between irrigation groups (p-value = 0.681). The mean bond strength of Biodentine was significantly different between irrigation groups (p-value = 0.002); it was the highest with BioAKT. CONCLUSION: Biodentine showed a high performance as a perforation repair material and its resistance to dislocation increased after being exposed to BioAKT. K-Biocer had the lowest pushout bond strength. PD-MTA White showed intermediate bond strength and was not affected by the tested irrigants. CLINICAL SIGNIFICANCE: The bond strength of endodontic materials to root dentin is an important factor to consider for long-term clinical success since the teeth are constantly subjected to masticatory forces.