Comparative Evaluation of Push-Out Bond Strength of a Bioceramic Sealer to Radicular Dentin Pretreated with Hyaluronic Acid and 17% EDTA: An in Vitro Study

Introduction: Final irrigation modifies the dentinal surface and may influence the interaction between root canal sealers and radicular dentin. Ethylenediaminetetraacetic acid (EDTA) is widely used for smear-layer modification, whereas hyaluronic acid (HA) has attracted interest as a biocompatible alternative with potential surface-modifying properties. Objectives: The objectives were to evaluate the push-out bond strength of CeraSeal to radicular dentin following final irrigation with HA, to evaluate the corresponding bond strength following final irrigation with 17% EDTA, and to compare the bond-strength values obtained with the two final-irrigation protocols under otherwise standardized experimental conditions. Methods: Fifty freshly extracted human single-rooted mandibular premolars were selected according to predefined inclusion and exclusion criteria. Root lengths were standardized to 15 mm and canals were prepared with ProTaper nickel-titanium instruments to size 25 with a 0.06 taper. Sodium hypochlorite was used during instrumentation. Specimens were randomly allocated to two groups (n=25): Group A, HA; and Group B, 17% EDTA. Five millilitres of the assigned final irrigant was used, followed by a final saline rinse. Canals were obturated with CeraSeal bioceramic sealer and gutta-percha. Push-out bond strength was assessed using a universal testing machine and expressed in MPa. Descriptive statistics, normality testing and one-way ANOVA were used, with statistical significance set at p<0.05. Results: Mean push-out bond strength was 1.21 +/- 0.24 MPa in the HA group and 1.45 +/- 0.29 MPa in the 17% EDTA group. The mean intergroup difference was 0.24 MPa, and the reported intergroup difference was statistically significant (p=0.003). Conclusions: Under the conditions of this in-vitro study, the 17% EDTA protocol was associated with higher push-out bond strength of CeraSeal to radicular dentin than the HA protocol. The finding is specific to the tested materials and experimental conditions and should not be interpreted as evidence of universal superiority of one irrigant over the other.