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Article

Push-Out Bond Strength of Three Bioceramic Sealers to Root Canal Dentin After Different Irrigation Protocols

by
Zoran Urošević
1,
Violeta Petrović
2,
Ivana Milanović
2,
Vojislav Komlenić
2,
Tatjana Savić-Stanković
2 and
Jugoslav Ilić
2,*
1
Clinic for Dental Medicine, Military Medical Academy, 11000 Belgrade, Serbia
2
Department of Restorative Odontology and Endodontics, School of Dental Medicine University of Belgrade, 11000 Belgrade, Serbia
*
Author to whom correspondence should be addressed.
Appl. Sci. 2025, 15(17), 9359; https://doi.org/10.3390/app15179359
Submission received: 1 July 2025 / Revised: 5 August 2025 / Accepted: 23 August 2025 / Published: 26 August 2025
(This article belongs to the Special Issue New Techniques, Materials and Technologies in Dentistry: Second Edition)
Browse Figures
Versions Notes

Abstract

The adhesion of endodontic sealers to dentin may be influenced both by the chemical composition of the sealer and the final irrigation protocol. The aim of this study was to examine the push-out bond strength of three differently formulated bioceramic sealers to root canal dentin, after different irrigation protocols. Four cavities were prepared in dentine discs obtained from middle thirds of third molars with fused roots. Discs were randomly divided into three groups (n = 8). Group 1: specimens were immersed in 2.5% NaOCl; group 2: in 2.5% NaOCl followed by 17% EDTA; and group 3: in a solution of 2.5% NaOCl with 9% etidronic acid (HEDP). The cavities on each disk were filled with four tested sealers: AH Plus Bioceramic, Bio C Angelus, BioRoot RCS, and AH Plus (n = 8 per sealer). The push-out bond strength test was performed after 7 days. The data were statistically analyzed using two-way analysis of variance with the Bonferroni post hoc test (α = 0.05). Irrigation with NaOCl resulted in significantly lower bond strength values of the sealers in comparison to NaOCl/EDTA and NaOCl/HEDP groups. In the NaOCl and NaOCl/HEDP groups, BioRoot RCS showed similar push-out bond strength compared to AH Plus and significantly higher compared to Bio-C and AH Plus Bioceramic. In the NaOCl/EDTA group, bioceramic sealers achieved a significantly weaker bond strength compared to AH Plus. The bond strength of BioRoot RCS was significantly higher compared to Bio-C and AH Plus Bioceramic. The irrigation protocols and the chemical composition of the sealers significantly influenced their bond strength to dentin. Epoxy resin-based sealer achieved the strongest bond strength, while within bioceramic sealers, the highest values were obtained for BioRoot RCS and the lowest for AH Plus Bioceramic.

1. Introduction

Three-dimensional hermetic root canal obturation is achieved using gutta-percha and root canal sealers [1]. Considering that gutta-percha lacks adhesive properties, sealers play a crucial role in creating a reliable bond between the root canal filling, dentin, and gutta-percha. This bonding helps prevent microleakage and bacterial infiltration while also stabilizing the filling during tooth function and operative procedures [2]. Due to its adhesiveness [3], dimensional stability, and insolubility in tissue fluids [4], AH Plus, an epoxy resin-based sealer, is considered the gold standard among endodontic sealers. However, shortcomings such as cytotoxicity during setting [5], and a lack of bioactivity [6], have been reported.
Recently, scientific and professional attention has been focused on bioceramic, i.e., calcium silicate-based sealers, created by modifying bioactive calcium silicate cements such as MTA and similar materials. Unlike resin-based sealers, bioceramic sealers are hydraulic in nature and set in a moist environment through the hydration of hydrophilic tricalcium and dicalcium silicate particles [7]. During hydration, calcium hydroxide is released, responsible for the alkaline pH [8], antimicrobial properties [9], and bioactivity of the sealers, i.e., the formation of hydroxyapatite crystals, at the sealer-dentin interface, through the reaction of calcium from the released calcium hydroxide and phosphates from tissue fluids [10,11]. The adhesiveness of these sealers and the bond strength to the dentin of the root canal have been investigated but with inconsistent results, which are most likely associated with different methodological approaches [12,13]. Furthermore, in line with continuous improvements of these sealers, a number of new, predominantly single-syringe (one-component) formulations are currently available. Although introduced as bioceramic sealers, these new products may differ in composition, regarding the amount of calcium silicate particles, as well as the type of vehicles and additives used [14]. In relation to the aforementioned context, Bio-C Sealer (Angelus, Londrina, PR, Brazil) is a recently developed, single-syringe, pre-mixed endodontic sealer. In addition to calcium silicates, its formulation includes tricalcium aluminate and employs propylene glycol as a vehicle [14]. Previous research suggests the biocompatibility [5,15], bioactivity [16], and mineralization potential [15] of this sealer.
AH Plus Bioceramic (Dentsply Sirona, Ballaigues, Switzerland) is one of the latest premixed, single-component bioceramic sealers, predominantly consisting of a radiopacifier and vehicle (dimethyl sulfoxide). This sealer contains only 5–15% tricalcium silicates particles, which is significantly less compared to the first premixed formulations of bioceramic sealers [14]. However, recent studies have reported on the cytocompatibility [6,17,18] and bioactivity [6,17,19] of this sealer.
The data are scarce regarding how differences in the amount of calcium silicate particles, as well as different vehicles and additives in the sealer’s composition, affect the push-out bond strength of the new commercially available products.
On the other hand, the specific hydraulic nature and chemical composition of the bioceramic sealers have raised the question about appropriate final irrigation prior to obturation. Namely, it was reported that EDTA, traditionally used to remove the smear layer, negatively affected the push-out bond strength of the BioRoot RCS [20]. Therefore, alternative chelating agents and irrigation protocols have been proposed. It has been suggested that etidronic acid (1 hydroxyethylidene-1, 1-bisphosphonate) used in a protocol of a continuous chelation (mixed with NaOCl) is effective at smear layer removal [21,22]. Also, previous studies reported the positive effect of continuous chelation on the push-out bond strength of some commercially available bioceramic sealers [23]. However, the push-out bond strength of the newly-synthesized bioceramic sealers after different irrigation protocols has not been thoroughly investigated yet.
In line with what was mentioned above, the objective of this study was to examine the push-out bond strength of three bioceramic sealers of different compositions and formulations, to root canal dentin following different irrigation protocols, and compare the obtained values with the bond strength of the control epoxy resin-based sealer.
Null hypotheses were (i) the different irrigation protocols do not affect the bond strength of sealers; and (ii) there is no difference in the bond strength to dentinal walls among the tested sealers.

2. Materials and Methods

2.1. Materials

The study was approved by the Ethics Committee of the School of Dental Medicine University of Belgrade (36/3, 2025). Four sealers were selected for examination in this study. Sealers composition, formulations, and manufacturers are listed in Table 1.

2.2. Preparation of Specimens

Intact third molars with fused roots, extracted for orthodontic reasons, were used in the study. After cleaning and disinfection, the teeth were molded in self-bonding acrylate (Duracryl plus, Spofa dental, KavoKerr corporation, Brea, CA, USA). Subsequently, teeth were cut perpendicular to the longitudinal axis of the tooth in the area of the middle third of the root, using a 0.7 mm diameter diamond saw, under water cooling (Isomet Saw; Buehler, Lake Bluff, IL, USA). In this way, two transverse discs with a thickness of 1 ± 0.1 mm were obtained from each tooth (Figure 1), making 24 discs in total. On each disc, four cavities (diameter of 1.2 mm) were prepared using a fissured cylindrical carbide bur (Densply Maillefer, Ballaigues, Switzerland) mounted in a specially designed table drill. The cavities were prepared in the paracanal dentin so that they were at least 1 mm away from the root canal, root cementum, and adjacent cavity [24].
Dentin discs were then randomly divided into three groups (n = 8) based on the irrigation protocol: Group 1: 2.5% NaOCl (i-dental, Lithuania), Group 2: sequential chelation with 2.5% NaOCl and 17% EDTA (MD-Cleanser, Meta Biomed Europe GmbH, Germany), and Group 3: continuous chelation with a mixture of 2.5% NaOCl and 9% etidronic acid (Dual Rinse HEDP; Medcem GmbH, Vienna, Austria). The irrigation protocols involved successive immersion of the discs in the respective irrigants [23], as illustrated in Figure 2.
The discs were then slightly dried with paper towels, coated with paraffin foil to prevent leaking out of the sealers, and attached to glass slides with self-adhesive tape.
Each of the four cavities prepared on every disc was filled with one of the four tested sealers, with eight samples allocated to each sealer group (n = 8). Two-component BioRoot RCS was prepared according to the manufacturer’s instructions, while one-component, premixed bioceramic sealers (Bio-C and AH Plus Bioceramic) were used directly from the syringe. Control, epoxy resin-based sealer (AH Plus) was prepared according to the manufacturer’s instructions. The sealers were delivered into the cavities with a probe, with constant vibration, after which the excess sealer was removed with a plastic instrument. Glass slides with samples were wrapped in gauze soaked in artificial tissue fluid (Hank’s balanced saline solution, Sigma Aldrich, Darmstadt, Germany) and incubated in sealed plastic containers at 37 °C and 100% humidity for 7 days [24].

2.3. Push-Out Bond Strength Test

The measurement of the bond strength of the sealers to the dentin was carried out by push-out test on a universal testing machine (PCE-FM 200, PCE group, Germany) with the use of an indenter with a diameter of 1 mm and at a speed of 1 mm/min. The samples were placed on two glass plates with a spacing sufficient to allow for the unimpeded dislocation of the sealer. Force values at the moment of dislocation of the sealer were recorded in the belonging Lutron program. The procedure was carried out for each of the four sealers applied on one disc. The bond strength of the sealers to the root canal dentin, expressed in MPa, was calculated according to the following formula: bond strength (σ) = F/π × d × h, where F is the maximum measured force value (N), π constant (3.14), d—cavity diameter (1.2 mm), and h—disk thickness (1 mm) [23,24].

2.4. Statistical Analysis

The obtained results were statistically analyzed using two-way analysis of variance (ANOVA) with the Bonferroni post hoc t-test for multiple comparisons since data were normally distributed (Shapiro-Wilk test, p = 0.6). The significance level was set at α = 0.05. The power of the test was 1.0 for the factor “type of the sealer” and 0.813 for the factor “irrigation protocol”. Statistical analyses were performed using the SigmaPlot 14.0 software (Palo Alto, CA, USA).

3. Results

The type of endodontic sealer and the irrigation protocol utilized both had a statistically significant effect on the push-out bond strength of the evaluated sealers (p < 0.001 and p = 0.003, respectively). Their effect was mutually independent since significant interaction between these two examined factors was not identified (p = 0.359).
In the NaOCl group, although all tested bioceramic sealers demonstrated weaker bond strength compared to epoxy resin-based AH Plus sealer, these differences were significant for Bio-C and AH Plus Bioceramic. Notably, BioRoot RCS showed significantly higher push-out bond strength compared to AHBC (Figure 3). In the NaOCl/EDTA group, the bond strength of BioRoot RCS and Bio-C sealer was similar and significantly stronger compared to AH Plus Bioceramic. The bond strength of all tested bioceramic sealers was weaker compared to AH Plus (Figure 4). In the NaOCl/HEDP group, the values measured for AH Plus and BioRoot RCS sealers were mutually close and significantly higher compared to Bio-C and AH Plus Bioceramic (Figure 5).
Irrigation with solely NaOCl resulted in significantly lower bond strength values in comparison to two other investigated protocols (Figure 6). However, in all experimental irrigation protocols the strongest bond with dentine was measured for AH Plus and the weakest bond for AH Plus Bioceramic sealer. BioRoot RCS showed significantly higher bond strength with dentin in NaOCl\HEDP protocol compared to the use of NaOCl (Table 2).

4. Discussion

The present study evaluated the push-out bond strength of three bioceramic sealers, which are mutually different regarding chemical composition and formulation, and the epoxy resin-based sealer used as control sealer, after three different irrigation protocols. Since different irrigation protocols significantly affected the bond strength of investigated bioceramic sealers to root canal dentin, the first hypothesis was rejected. Additionally, we found that the bond strength of sealers to root canal dentin was also significantly influenced by the type of sealers, i.e., their chemical composition. Therefore, the second hypothesis was rejected, too.
The bond strength was evaluated with a push-out test, commonly used for assessing the adhesiveness of materials [12,13], in accordance to methodology described by Scelza, et al. [24]. This methodology enables better standardization of the prepared cavities and a smaller number of samples and teeth required for research compared to methodologies where only one material per disc is evaluated. Since all the sealers were evaluated on the same dentin disc samples, the influence of age, degree of mineralization, and strength of dentin on the obtained results was equally distributed, thus reducing the incorporated selection bias. Notably, the number of included teeth was comparable between our study and the abovementioned study.
Regarding irrigations protocols, the samples of the first group were treated only with NaOCl. In the second and third groups, chelating agents were used in order to improve the cleaning of the dentine walls through the removal of inorganic debris and the smear layer, created by the use of burs during the preparation of artificial cavities. In the second group, 17% EDTA solution, the most used chelating agent during root canal irrigation, was applied, followed by NaOCl (sequential chelation protocol). The third group of samples was treated with a mixture of sodium hypochlorite solution and HEDP (continuous chelation protocol). This protocol was introduced with the aim of simplifying the irrigation protocol during root canal preparation [25]. HEDP is a mild chelating agent, effective in removing the smear layer but with slower action than EDTA [26]. Unlike EDTA, which reduces the antibacterial and organolytic capacity of NaOCl, the mixture of NaOCl and etidronic acid retains the good properties of both agents, therefore reducing the formation of a smear layer and the accumulation of inorganic debris during instrumentation [27]. Also, it dissolves the remains of pulp tissue [28] and effectively eliminates bacterial biofilms from paracanal dentin and dentinal tubules [29].
The results of this study demonstrate a significant increase in bond strength values in the groups where chelating agents were used, compared to NaOCl group where the smear layer was not removed. This confirms the statement that the application of chelating agents ensures cleaner walls of the root canal, enabling the penetration of obturation sealers into dentinal tubules and achieving a more efficient bond between the sealer and the dentin of the root canal [30]. Our results are in a line with Emekli et al., who also observed higher values of push-out bond strength of bioceramic sealers after applying chelating agents [31]. On the contrary, Donnermeyer, et al. reported lower push-out bond strength values of BioRoot after the application of EDTA and higher after NaOCl, using them as final irrigants [20]. In addition to other methodological differences, in the mentioned study, the contact time of EDTA with root canal dentin was much longer compared to our study, and EDTA was not flushed from the canals either with NaOCl or using distillated water. Prolonged exposure time and, possibly, remaining EDTA could lead to the reduction in calcium ions at the sealer-dentin interface, resulting in lower push-out bond strength. In our study, in Group 2 (sequential chelation), after the smear layer was removed with EDTA, NaOCl was used as a final irrigant. According to Fernandes Zancan et al., irrigation with NaOCl after chelating agents provides the most favorable dentin surface for bonding with bioceramic sealers [32].
The application of two different smear layer removal protocols, sequential and continuous chelation, resulted in similar bond strength values of the tested sealers. The obtained results are in accordance with recently published data [31] and suggest that continuous chelation could be an effective alternative to the traditional sequential irrigation protocol, before obturation with bioceramic sealers, but with a need for further investigations.
The different chemical composition of the sealers tested in this study resulted in differences in push-out bond strength. Superior bond strength values of epoxy resin- based AH Plus sealer compared to bioceramic sealers obtained in this study are in line with previous studies [3,20,24,33,34,35]. The adhesiveness of AH Plus sealer is attributed to the formation of covalent bonds between the epoxy rings of the sealer and the amino groups of dentin collagen, low values of polymerization contraction, and distinct cohesion of molecules within the sealer [36]. Noteworthily, in the NaOCl group, the bond strength of AH Plus was slightly weaker compared to the other two protocols where chelating agents were used. It is possible that using NaOCl only resulted in less available collagen for bonding with AH Plus [31].
The bonding mechanism of Bioceramic sealers with dentin is different compared to that of epoxy resin-based sealers. Those sealers, due to their chemical composition, achieve a micromechanical bond with the dentin of the root canal. During setting in a wet environment, the reaction of calcium from the sealers with phosphates from tissue fluids leads to the formation of apatite crystals that are first deposited on the contact surface of the material and dentin, filling the existing micro spaces [37]. Over time, as the number of crystals increases, they are deposited in the form of finger-like extensions in the dentin tubules (Mineral infiltration zone) [32,38,39]. Since the mineralization is a time-dependent phenomenon, prolonged contact with tissue fluids can contribute to the push-out bond strength of the bioceramic sealers [10,23,40].
BioRoot, Bio-C, and AH Plus Bioceramic sealers evaluated in this study, although classified in the same group as the bioceramic sealers, have demonstrated different push-out bond strengths. Two-component BioRoot RCS exhibited superior bond strength compared to one-component, pre-mixed sealers Bio-C and AH Plus Bioceramic. Lopes, et al. also reported higher values of BioRoot RCS bond strength compared to Bio-C sealer [34]. AH Bioceramic exhibited the lowest values of push-out bond strength, significantly lower even compared to Bio-C sealer. The weak bond strength of the AH Plus Bioceramic sealer obtained in the present study is in line with the recently published data [41,42].
The superior bonding of BioRoot RCS can be attributed to the greater release of calcium ions compared to one-component sealers. According to the manufacturer, AH Plus Bioceramic sealer contains only 5–15% of tricalcium silicate particles. Recently, Chen et al. detected near three times less calcium in the AH Plus Bioceramic leachates compared to leachates of BioRoot RCS after 28 days and almost five times less after 90 days [43]. It has been proven that a lower content of calcium silicate in the material results in the weaker formation of calcium hydroxide and lower release of calcium ions, which can consequently result in a smaller number of formed apatite crystals responsible for the micromechanical bonding of sealers with dentin [10].
The obtained results could be also attributed to the different formulations of evaluated bioceramic sealers and consequential different degrees of hydration, i.e., setting after storage. The setting of the two-component BioRoot RCS starts via the mixing powder and liquid component and continues with further hydration in the root canal. In one-component bioceramic sealers such as Bio-C and AH Bioceramic, calcium silicate particles are dispersed in non-aqueous carriers and exclusively use the moisture of the dentinal tubules for setting [14]. During this research, after the application of the sealers, the samples were wrapped in gauze soaked in artificial tissue fluid and left to set for 7 days, like in methodologically similar research [24,33]. It is possible that this period of time was not enough for the adequate hydration of these one-component formulations and achieving adequate micromechanical bonding.
The distinct mechanisms through which sealer type and irrigation protocol influence push-out bond strength have been shown—via statistical analysis—to function independently, indicating that their effects are not interdependent. Nevertheless, their combined application may produce additive benefits that enhance the overall clinical performance of root canal obturation.
The main limitation of this in vitro study is the impossibility of direct interpolation of results to the clinical situation. Namely, the complex influences and relationships that affect the strength of the sealer’s bond to the dentinal wall in the root canal are very difficult to fully reproduce in experimental conditions. Nevertheless, careful interpretation of these findings in the context of clinical application suggests that utilizing chelation protocols in conjunction with a two-component bioceramic sealer may offer advantages in achieving a reliable and effective endodontic seal. Regarding sample size, the achieved strengths of the test in the analysis indicate meaningful findings. Nevertheless, a larger sample size would give additional strength to the findings, primarily regarding the mutual interaction of examined factors. Additionally, the visualization and examination of the dentin-sealer interface as well as the inclusion of more factors such as the influence of temperature changes and prolonged observation could provide valuable information on the long-term projection of bond stability and should be considered the next step in the analysis of this research problem. Our results certainly suggest that differently formulated bioceramic sealers available on the market would consequently have different properties.

5. Conclusions

Under the conditions of this in vitro study, the irrigation protocols and the chemical composition of the sealers significantly influenced their bond strength to dentin. Irrigation protocols that included chelating agents positively influenced the bond strength of the tested sealers. In all the irrigation protocols, epoxy resin-based sealer achieved the strongest bond to dentin, while within bioceramic sealers the highest values were obtained for BioRoot® RCS and the lowest for the AH Plus® Bioceramic.

Author Contributions

Conceptualization, J.I. and V.P.; methodology, J.I., V.P. and I.M.; software, J.I. and T.S.-S. validation, V.P. and Z.U.; formal analysis, V.P. and J.I.; investigation, I.M.; resources, T.S.-S.; data curation, V.K.; writing—original draft preparation, Z.U. and V.P.; writing—review and editing, V.P. and J.I. visualization, T.S.-S.; and supervision, V.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of University of Belgrade, School of Dental Medicine (36/3 2025).

Informed Consent Statement

Not applicable.

Data Availability Statement

The original contributions presented in the study are included in the article; further inquiries can be directed to the corresponding author.

Acknowledgments

This study was supported by funds of University of Belgrade, School of Dental Medicine.

Conflicts of Interest

The authors declare no conflicts of interest.

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Applsci 15 09359 g001
Figure 1. Preparation of the specimens. The intact third molars with fused roots were molded in self-bonding acrylate. Teeth were cut perpendicular to the longitudinal axis of the tooth in the area of the middle third of the root obtaining two transverse discs per tooth (thickness = 1 ± 0.1mm). Four cavities (d = 1.2 mm) were prepared in the paracanal dentin so that they were at least 1 mm away from the root canal, root cementum, and adjacent cavity. Each cavity was filled with one of the tested fillers.
Figure 1. Preparation of the specimens. The intact third molars with fused roots were molded in self-bonding acrylate. Teeth were cut perpendicular to the longitudinal axis of the tooth in the area of the middle third of the root obtaining two transverse discs per tooth (thickness = 1 ± 0.1mm). Four cavities (d = 1.2 mm) were prepared in the paracanal dentin so that they were at least 1 mm away from the root canal, root cementum, and adjacent cavity. Each cavity was filled with one of the tested fillers.
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Figure 2. Irrigation protocols in experimental groups. Group 1: 5 mL of 2.5% NaOCl for 15 min followed by 5 mL of fresh 2.5% NaOCl for 1 min; Group 2: 5 mL 2.5% NaOCl for 15 min followed by 5 mL of 17% EDTA for 1 min followed by 5 mL of 2.5% NaOCl for 1 min; and Group 3: 5 mL of a mixture of 2.5% NaOCl and 9% etidronic acid for 15 min followed by 5 mL of a fresh mixture for 1 min. In all groups, between the irrigants, discs were immersed in 5 mL of deionized water for 1 min. After each irrigation protocol, discs were additionally immersed in 5 mL of deionized water for 1 min.
Figure 2. Irrigation protocols in experimental groups. Group 1: 5 mL of 2.5% NaOCl for 15 min followed by 5 mL of fresh 2.5% NaOCl for 1 min; Group 2: 5 mL 2.5% NaOCl for 15 min followed by 5 mL of 17% EDTA for 1 min followed by 5 mL of 2.5% NaOCl for 1 min; and Group 3: 5 mL of a mixture of 2.5% NaOCl and 9% etidronic acid for 15 min followed by 5 mL of a fresh mixture for 1 min. In all groups, between the irrigants, discs were immersed in 5 mL of deionized water for 1 min. After each irrigation protocol, discs were additionally immersed in 5 mL of deionized water for 1 min.
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Figure 3. Push-out bond strength in experimental group with NaOCl irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
Figure 3. Push-out bond strength in experimental group with NaOCl irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
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Figure 4. Push-out bond strength in experimental group with NaOCl/EDTA irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
Figure 4. Push-out bond strength in experimental group with NaOCl/EDTA irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
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Figure 5. Push-out bond strength in experimental group with NaOCl/HEDP irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
Figure 5. Push-out bond strength in experimental group with NaOCl/HEDP irrigation protocol. The group consisted of dentin discs (n = 8) with four prepared cavities on each disc, filled with each of tested sealers. Values are presented as mean (vertical bars) and standard deviations (lines) of bond strength of tested sealers to root canal dentin. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
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Figure 6. Mean values (vertical bars) and standard deviations (lines) of push-out bond strength values obtained with tested irrigation protocols. Irrigation protocol with NaOCl resulted in significantly lower bond strength values in comparison to two other investigated protocols. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
Figure 6. Mean values (vertical bars) and standard deviations (lines) of push-out bond strength values obtained with tested irrigation protocols. Irrigation protocol with NaOCl resulted in significantly lower bond strength values in comparison to two other investigated protocols. Columns sharing the same uppercase letter are not significantly different (p > 0.05).
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Table 1. Manufacturers, formulation, and composition of the sealers used in the study.
Table 1. Manufacturers, formulation, and composition of the sealers used in the study.
Sealer Brand Name and ManufacturerFormulationComposition
AH Plus Bioceramic
Dentsply Sirona, Ballaigues, Switzerland		Premixed
One-component		Tricalcium silicate (5–15%), zirconium dioxide (50–70%), dimethyl sulfoxide (10–30%), lithium carbonate (<0.5%), and
thickening agents (<6%)
Bio C
Angelus, Londrina, PR Brazil		Premixed
One-component		Calcium silicates, tricalcium aluminate, calcium oxide, zirconium oxide, iron oxide, silicon dioxide, and dispersing agents (propylene glycol)
BioRoot RCS
Septodont, Saint-Maur-des-Fossés, France		Powder/liquid
Two-component		Powder: tricalcium silicate, zirconium oxide (20–50%), calcium carbonate 25–50%, and povidone
Liquid: aqueous solution of calcium chloride with polycarboxylate
AH Plus
Dentsply De Trey GmbH,
Konstanz, Germany		Paste–paste
Two-component		Paste A: bisphenol-A epoxy resin, bisphenol-F epoxy resin, calcium tungstate, zirconium oxide, silica, and iron oxide pigments
Paste B: dibenzyl-diamine, aminoadamantane, tricyclodecane-diamine, calcium tungstate, zirconium oxide, silica, and silicone oil
Table 2. Values (mean ± SD) of push-out bond strength for tested sealers after application of different irrigation protocols. In all experimental irrigation protocols, the strongest bond with dentine was measured for AH Plus and the weakest bond for AH Plus Bioceramic sealer. Letter A in superscript indicates significantly higher bond strength value for BioRoot RCS in NaOCl\HEDP group compared to NaOCl group (p = 0.02).
Table 2. Values (mean ± SD) of push-out bond strength for tested sealers after application of different irrigation protocols. In all experimental irrigation protocols, the strongest bond with dentine was measured for AH Plus and the weakest bond for AH Plus Bioceramic sealer. Letter A in superscript indicates significantly higher bond strength value for BioRoot RCS in NaOCl\HEDP group compared to NaOCl group (p = 0.02).
Irrigating Protocol
SealerNaOClNaOCl\EDTANaOCl\HEDP
AHBC0.657 ± 0.3521.601 ± 0.8881.450 ± 1.023
Bio-C3.057 ± 0.9495.350 ± 3.0174.854 ± 2.167
BioRoot5.908 ± 2.4377.117 ± 2.6609.091 ± 2.115 A
AH Plus7.943 ± 3.49610.639 ± 1.6289.196 ± 2.150
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MDPI and ACS Style

Urošević, Z.; Petrović, V.; Milanović, I.; Komlenić, V.; Savić-Stanković, T.; Ilić, J. Push-Out Bond Strength of Three Bioceramic Sealers to Root Canal Dentin After Different Irrigation Protocols. Appl. Sci. 2025, 15, 9359. https://doi.org/10.3390/app15179359

AMA Style

Urošević Z, Petrović V, Milanović I, Komlenić V, Savić-Stanković T, Ilić J. Push-Out Bond Strength of Three Bioceramic Sealers to Root Canal Dentin After Different Irrigation Protocols. Applied Sciences. 2025; 15(17):9359. https://doi.org/10.3390/app15179359

Chicago/Turabian Style

Urošević, Zoran, Violeta Petrović, Ivana Milanović, Vojislav Komlenić, Tatjana Savić-Stanković, and Jugoslav Ilić. 2025. "Push-Out Bond Strength of Three Bioceramic Sealers to Root Canal Dentin After Different Irrigation Protocols" Applied Sciences 15, no. 17: 9359. https://doi.org/10.3390/app15179359

APA Style

Urošević, Z., Petrović, V., Milanović, I., Komlenić, V., Savić-Stanković, T., & Ilić, J. (2025). Push-Out Bond Strength of Three Bioceramic Sealers to Root Canal Dentin After Different Irrigation Protocols. Applied Sciences, 15(17), 9359. https://doi.org/10.3390/app15179359

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