Evaluation of the effectiveness of ozone application on the bond strength of epoxy resin and bioceramic-based root canal sealers using push-out test

ABSTRACT Aim: The aim of this study is to evaluate the effect of ozone gas application on the bond strength of two different contents of root canal sealer using the push-out test. Materials and Methods: In this study, 60 extracted single-rooted and single-canal human lower premolar teeth were used. The crowns of the teeth were cut away from the cemento-enamel border with a diamond fissure bur under water cooling, and all roots were equalized to 17 mm in length in order to standardize the root lengths. After opening the entry cavity for the teeth, a glide path was created with a number 15 K type file. Shaping of the root canals was completed with a Reciproc #40 rotary file. During the irrigation phase, 5% NaOCl and 17% EDTA were applied to all samples in a standard manner. Final irrigation was performed with 5 ml of distilled water (DW). The teeth were randomly divided into four groups (Group 1: AH Plus, Group 2: AH Plus and ozone gas, Group 3: AH Plus Bioceramic, Group 4: AH Plus Bioceramic and ozone gas). Root canal filling was performed for the tooth groups (Group 1 and Group 3) that would not be treated with ozone gas. For the groups to be applied with ozone gas (Group 2 and Group 4), root canal filling was completed after ozone application. Root canal filling in all groups was performed using the simple single-cone filling method. AH Plus and AH Plus Bioceramic root canal sealer were used in the study. Three sections were taken from the teeth with a precision cutting device at apical distances of 2, 5, and 8 mm. The obtained sections were tested on a push-out test device to measure the push bond strength. Data were analyzed with the R program. To compare bond strength values that were not normally distributed according to canal sealer, final irrigation, and section, the three-way Robust test was used using the WRS2 package in the R program, and multiple comparisons were examined with Bonferroni correction. Results: There is a statistically significant difference between the trimmed mean values of bond strength according to final irrigation (p<0.001). While the trimmed average of the bond strength in the distilled water group was 0.17, it was obtained as 0.25 in the ozone gas group. There is a statistically significant difference between the trimmed mean values of bond strength according to the root canal sealer (p=0.015). While the trimmed average of bond strength in AH Plus root canal sealer was 0.23, it was 0.19 in AH Plus Bioceramic root canal sealer. There is a statistically significant difference between the trimmed average values of bond strength according to cross-section. It differed in the apical section from the coronal and midsections. A decrease was observed in the apical section compared to the others. There is no statistically significant difference between the trimmed mean values of bond strength according to root canal sealer, final irrigation, and section (p = 0.340). Conclusion: The application of ozone gas to the root canal increases the bond strength of the root canal sealer compared to final irrigation with distilled water. Keywords: AH Plus, AH Plus Bioceramic, bond strength, ozone, push-out test.