Effect of Blood Contamination on The Push-Out Bond Strength of Calcium Silicate Cements

Abstract This study investigated the effect of blood-contamination on the push-out bond strength of BiodentineTM (BD) and MTA Angelus® (MTA-A) to root dentin over time. Twenty-five teeth were sectioned horizontally to obtain 120 root slices. The lumens were filled with MTA-A or BD: 60 for each cement (30 uncontaminated and 30 blood contaminated). Push out bond strength to dentin was assessed at 24 h (n=10), 7 days (n=10) and 28 days (n=10). Failure modes were classified as: cohesive, adhesive or mixed failure. Two-way ANOVA was used to investigate the interaction between blood contamination vs. hydration period. Mann Whitney test compared different materials in each period, and it also compared the contaminated versus uncontaminated material for each period. Friedman, followed by Dunn`s test, compared periods of hydration for each material, regardless of blood contamination. Failure modes were reported descriptively. The interaction hydration period vs. blood contamination was highly significant for MTA-A (P=0.001) and it was not significant for BD (P=0.474). There were no differences between bond strength of uncontaminated and contaminated BD in any of the periods. Bond strength of uncontaminated MTA-A increased at each time of hydration; but it remained stable over time for blood-contaminated samples. BD had higher bond strength than MTA-A in all periods of hydration. Cohesive failure predominated. Only for MTA-A, the over time bond strength to dentin was affected by blood contamination.

摘要 本研究旨在探讨血液污染对碧定（Biodentine™，BD）与天使MTA（MTA Angelus®，MTA-A）与牙根牙本质之间的推出粘结强度随时间变化的影响。本研究截取25颗离体恒牙，通过水平切片制备120个牙根薄片。将根管内腔分别填充MTA-A或BD：每种牙科水门汀各60例，其中30例未受血液污染，30例经血液污染。分别于24 h（n=10）、7 d（n=10）及28 d（n=10）三个时间点检测其与牙本质的推出粘结强度。破坏模式分为内聚破坏、黏着破坏及混合破坏三类。采用双因素方差分析探究血液污染与养护期的交互效应；采用曼-惠特尼U检验分别比较同一时期不同材料的粘结强度差异，以及同一材料受污染与未受污染样本的差异；采用弗里德曼检验结合邓恩多重比较，分析两种材料在不考虑血液污染的情况下，粘结强度随养护期的变化规律。破坏模式采用描述性统计方法进行报告。结果显示：血液污染与养护期的交互作用对MTA-A的粘结强度具有极显著影响（P=0.001），而对BD的粘结强度无显著影响（P=0.474）。在所有养护时期中，受污染与未受污染BD的粘结强度均无统计学差异。未受血液污染的MTA-A粘结强度随养护时间延长逐步升高，但经血液污染的MTA-A样本粘结强度随时间无明显变化。在所有养护时期中，BD的粘结强度均显著高于MTA-A。内聚破坏为主要的破坏模式。仅针对MTA-A而言，其与牙本质的推出粘结强度随时间的变化受到血液污染的影响。