Comparative Evaluation of “Continuous Soft Chelation” Using Dual-rinse HEDP on the Micro Push-out Bond Strength of Bioceramic, Epoxy Resin, and Methacrylate-based Sealers: An In Vitro Study

Aim: This study aimed to evaluate the push-out bond strength of bioceramic, epoxy resin-based, and methacrylate-based sealers to dentin treated with continuous soft chelation (CSC) using dual-rinse 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) vs the classical alternate irrigation regimen.Materials and methods: Ninety discs of 1 mm thickness were sectioned from the midroot portion of thirty single-rooted teeth and were divided into three groups (n = 30) based on irrigation regimen: group I used the alternate irrigation (NaOCl-EDTA-NaOCl), group II used CSC (NaOCl combined with dual-rinse HEDP), and group III was the control (NaOCl-distilled water).Following irrigation, each group was subgrouped (n = 10) and filled with AH Plus, MTA Plus, or MetaSEAL, respectively, and the push-out bond strength was evaluated using the universal testing machine.One-way analysis of variance ANOVA and Tukey's post hoc test were used to analyze the data, with the significance level set at p < 0.05.Results: MetaSEAL exhibited the highest push-out bond strength across all irrigation protocols.AH Plus demonstrated superior bond strength with the alternate irrigation regimen and MTA Plus with the CSC (p < 0.05).Comparable bond strengths were observed between the two irrigation groups (14.61 3.75 MPa and 14.16 3.42 MPa).The control group showed significantly lower bond strength (10.57 3.24 MPa) (p < 0.05).Conclusion: Continuous soft chelation improved the bond strength of MTA Plus, while AH Plus performed better with the alternate irrigation.Clinical significance: The results suggest that both the irrigation protocols and the sealer types should be considered for optimal results during root canal procedures.This study is an attempt to provide evidence and guide clinicians to choose sealers based on irrigation regimen and vice versa.