Author ORCID Identifier




Date of Graduation


Document Type


Degree Type



School of Dentistry


Dental Practice & Rural Health

Committee Chair

Samuel Dorn

Committee Co-Chair

Constance Wiener

Committee Member

Elizabeth Kao


Introduction: The purpose of this study is to compare the push-out bond strength of four bioceramic materials to root dentin that are used during regenerative endodontics. The bioceramics being tested are: 1. Biodentine®(Septodont); 2. EndoSequence BC Putty Fast Set® (Brasseler); 3. NeoPutty® (Avalon Biomed); and 4. ProRoot MTA White® (Dentsply). A high bond strength of a bioceramic material to root dentin will provide excellent seal. An improved seal may correlate with less potential for contamination of the pulp space that is undergoing regenerative activity. This in turn will lead to long-term clinical success. The null hypothesis is that there is no difference in the mean bond strength of the four Bioceramic materials to dentin. The alternative hypothesis is that there is a significant difference among the mean push-out bond strength among the four materials investigated.

Methods: One hundred 2.0 mm thick dentin slices from human teeth were created using a 0.3 mm thick diamond cut-off wheel. For standardization, the canal space of each slice was prepared to a diameter of 1.5 mm. The cavity preparations were conditioned with 1.5% NaOCl, 17% EDTA, and saline. The slices were randomly separated into four groups: Biodentine® (n = 20); EndoSequence BC Putty Fast Set® (n=20); NeoMTA Plus® (n=20); and ProRoot MTA White® (n=20). Portland cement was used as the positive control (n=10). Cavit®, with no significant bond strength to dentin was used as the negative control (n=10). The push-out bond strength values were measured using a universal testing machine. A load was delivered to the cement surface by applying downward pressure with a 1.2 mm diameter cylindrical stainless-steel plunger at a crosshead speed of 0.5 mm/min. The nature of bond failure was inspected under a surgical microscope at 6.4x magnification. Failure pattern were categorize as adhesive failure, cohesive failure, or mixed failure. R software was used for all statistical analyses. The data were analyzed using a robust linear mixed- effects model to compare the mean fracture resistance of the samples. Statistical significance was defined as a p < 0.05.

Results: The mean push-out bond strength ± standard deviation in MPa values of EndoSequence BC Putty Fast Set®; ProRoot MTA®; Biodentine®; NeoPutty®; Cavit®; and Portland Cement were 16.03 ± 4.05, 10.69 ± 3.00, 8.63 ± 3.73, 7.29 ± 2.27, 1.07 ± 0.53, and 10.71 ± 3.47 respectively. The push-out bond strength of the EndoSequence BC Putty Fast Set® was significantly greater than the other experimental and control groups (p < 0.05). Inspection of the samples revealed the bond failure of the bioceramics to be predominantly cohesive failure.

Conclusion: Bond strength of a material plays an important role in clinical practice. The proper adhesion of bioceramics with dentin is critical. It is crucial to understand how bioceramics adapt and bond to dentin as the majority of endodontic failures are related to bacteria and their toxins entering the periapical tissues due to microleakage. The findings of the present study imply that the push-out bond strength of EndoSequence BC Putty Fast Set® was statistically greater when compared to Biodentine®, NeoPutty®, ProRoot MTA®, Cavit®, and Portland Cement. The majority of bioceramic showed cohesive bond failure, while the positive and negative control groups exhibited majority adhesive bond failure.