“Effect of Irrigation Activation Protocol on the Push-Out Bond Strength of Zinc Oxide Eugenol Based, Epoxy Resin Based, Calcium Hydroxide Based and Calcium Silicate Based Root Canal Sealers: An In-Vitro Study”

Aim: To evaluate the effect of needle, sonic, and passive ultrasonic irrigation activation on the push-out bond strength of AH Plus, Sealapex, Essenseal, and CeraSeal root canal sealers. Materials and Methods: Sixty extracted human mandibular single-rooted premolars were prepared and randomly divided into three groups according to the irrigation activation protocol: needle, sonic, and passive ultrasonic activation. Each group was further divided according to the root canal sealer used. After obturation and storage, 1-mm-thick root sections were obtained and subjected to a push-out bond strength test. Data were analyzed using one-way ANOVA and Tukey's post-hoc test, with p < 0.05 considered statistically significant. Results: With needle activation, AH Plus showed the highest mean bond strength (1.724 ± 0.159 MPa). With sonic activation, CeraSeal demonstrated the highest value (1.920 ± 0.123 MPa), while with passive ultrasonic activation, CeraSeal showed the highest value (1.872 ± 0.084 MPa). Significant differences among activation protocols were observed for Sealapex and Essenseal, whereas no significant differences were observed for AH Plus and CeraSeal. Conclusion: The effect of irrigation activation on push-out bond strength was sealer-dependent. Needle activation produced the highest numerical bond strength for AH Plus and Sealapex, whereas CeraSeal showed the highest numerical values with sonic and passive ultrasonic activation. No single irrigation activation protocol demonstrated a consistent effect across all tested sealers.