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Background <p>Repairing strip perforations is challenging due to limited access and visibility. Mineral trioxide aggregate (MTA) is the standard material for perforation repair but is difficult to handle, whereas calcium silicate–based sealers (CSBSs) offer good adaptation, biocompatibility, and easier application during obturation. However, their ability to repair perforations during canal obturation, has not been validated in blood-contaminated conditions. This in vitro study compared the push-out bond strength and failure modes of iRoot SP (IR), BioRoot RCS (BR), and ProRoot MTA in strip-perforated canals under blood and saline contamination.</p> Methods <p>Thirty mandibular molars with two separate mesial root canals were selected. Mesial root canals were prepared using reciprocating files, and strip perforation was created on the distal surface of the mesial roots. The roots were randomly assigned to blood or saline contamination. Each group was then randomly obturated with (1) Gutta-percha + IR, (2) Gutta-percha + BR, or (3) ProRoot MTA (10 canals/subgroup). Each root was sectioned into a slice at the perforation site for push-out testing. Bond-strength data were analyzed with one-way ANOVA and independent T-test (<i>p</i> &lt; 0.05). Failure modes were assessed under a stereomicroscope.</p> Results <p>MTA exhibited significantly higher bond strength than both sealers under all conditions (<i>p</i> &lt; 0.05). Blood contamination significantly increased the bond strength of IR <i>(p</i> = 0.016<i>)</i> but had no effect on BR <i>(p</i> = 0.878<i>)</i> or MTA <i>(p</i> = 0.33<i>).</i> MTA showed adhesive failures, while IR and BR exhibited mixed and adhesive failures under blood contamination.</p> Conclusions <p>ProRoot MTA showed the highest bond strength and distinct failure modes. Blood contamination increased IR’s bond strength but did not affect BR or ProRoot MTA. Under in vitro conditions, CSBSs may offer a feasible option for repairing strip perforations during obturation, but further studies are needed to confirm clinical applicability.</p>

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Evaluating the feasibility of calcium silicate-based sealers for strip perforation repair compared to mineral trioxide aggregate: an in-vitro study on bond strength

  • 期刊论文

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  • 发表日期：

    2026年2月18日

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  • Nanticha Preutthipan,
  • Uraiwan Chokechanachaisakul,
  • Thanomsuk Jearanaiphaisarn

摘要

Background

Repairing strip perforations is challenging due to limited access and visibility. Mineral trioxide aggregate (MTA) is the standard material for perforation repair but is difficult to handle, whereas calcium silicate–based sealers (CSBSs) offer good adaptation, biocompatibility, and easier application during obturation. However, their ability to repair perforations during canal obturation, has not been validated in blood-contaminated conditions. This in vitro study compared the push-out bond strength and failure modes of iRoot SP (IR), BioRoot RCS (BR), and ProRoot MTA in strip-perforated canals under blood and saline contamination.

Methods

Thirty mandibular molars with two separate mesial root canals were selected. Mesial root canals were prepared using reciprocating files, and strip perforation was created on the distal surface of the mesial roots. The roots were randomly assigned to blood or saline contamination. Each group was then randomly obturated with (1) Gutta-percha + IR, (2) Gutta-percha + BR, or (3) ProRoot MTA (10 canals/subgroup). Each root was sectioned into a slice at the perforation site for push-out testing. Bond-strength data were analyzed with one-way ANOVA and independent T-test (p < 0.05). Failure modes were assessed under a stereomicroscope.

Results

MTA exhibited significantly higher bond strength than both sealers under all conditions (p < 0.05). Blood contamination significantly increased the bond strength of IR (p = 0.016) but had no effect on BR (p = 0.878) or MTA (p = 0.33). MTA showed adhesive failures, while IR and BR exhibited mixed and adhesive failures under blood contamination.

Conclusions

ProRoot MTA showed the highest bond strength and distinct failure modes. Blood contamination increased IR’s bond strength but did not affect BR or ProRoot MTA. Under in vitro conditions, CSBSs may offer a feasible option for repairing strip perforations during obturation, but further studies are needed to confirm clinical applicability.