Push-out bond strength of different mineral trioxide aggregates

Fracture Resistance of Simulated Immature Teeth Filled with Three Types of Calcium Silicate Cement after Intracanal Medication with Ca(OH)2: An Ex Vivo Study

Objectives

The aim of this study was to evaluate the 1-day fracture resistance of simulated immature teeth with an apical plug with ProRoot MTA, MTA Angelus, and RetroMTA after calcium hydroxide intracanal medication.

Materials and Methods

Sixty extracted, single-rooted human mandibular premolars were randomly divided into six groups of 10 teeth each. Firstly, to standardize the 9 mm root length, the crowns were cut off at and 9 mm below the cementoenamel junction transversely. Simulations for immature apices were carried out by using No. 1-6 Peeso reamers to pass through the apex to obtain a diameter of 1.7 mm at the apical opening. One group served as a negative control without any treatment, while the other groups received 30 days of calcium hydroxide intracanal medication. Four groups were plugs with 4 mm of ProRoot MTA, MTA Angelus, RetroMTA, and gutta-percha, respectively. The last one was served as a positive control group without filling inside. After 1 day of incubation, specimens were vertically loaded in a universal testing machine at a crosshead speed of 1 mm/min until fracture occurred. The peak load to fracture (Newton) and fracture pattern were recorded. A one-way analysis of variance (ANOVA) followed by Tukey's HSD test was used for data analysis.

Results

The highest mean load to fracture was shown in the negative control group (543.33 ± 37.17 N), followed by ProRoot MTA (432.82 ± 68.06 N), MTA Angelus (396.92 ± 59.93 N), RetroMTA (389.08 ± 56.25 N), and gutta-percha (283.28 ± 43.40 N), and the lowest belonged to the positive control group (239.98 ± 27.19 N). The significant differences were found between both the control and experimental groups with an apical plug with calcium silicate cement (p  < 0.05). There were no significant differences among those three apical plugs (p  > 0.05).

Conclusion

Apical plugs with ProRoot MTA, MTA Angelus, and RetroMTA had an immediate strengthening effect on simulated immature teeth after calcium hydroxide intracanal medication had been used.

Effect of Incorporating Titanium Dioxide Nanoparticles into White Portland Cement, White Mineral Trioxide Aggregate, and Calcium Enriched Mixture Cement on the Push-out Bond Strength to Furcal Area Dentin

Statement of the Problem

Bond strength of furcation repair materials is an essential factor in clinical success. Studies on the effect of adding titanium dioxide (TiO2) nanoparticles on the push-out bond strength of commonly used endodontic cements for furcation perforation repair is limited.

Purpose

This study aimed to evaluate the effect of adding TiO2 nanoparticles to white Portland cement (PC), white mineral trioxide aggregate (MTA), and calcium enriched mixture cement (CEM) on their push-out bond strengths.

Materials and Method

In this in vitro study, 120 endodontically treated molars were assigned to six groups (n=20) based on the material used to repair the perforation. In three groups, the cements (white PC, white MTA, and CEM) were placed in pure form, and in the three remaining groups, 1 weight % of TiO2 was added. The push-out bond strength was measured using a universal testing machine at a strain rate of 0.5 mm/min. Data were analyzed using one-way ANOVA and post hoc Games-Howell test (p< 0.05).

Results

One-way ANOVA showed significant differences in the mean bond strength values between the six groups (p= 0.002). The post hoc Games-Howell test showed that the bond strengths in MTA+TiO2 and PC+TiO2 groups were significantly higher than those in MTA and PC groups, respectively. However, there was no significant difference in the bond strength between CEM and CEM+ TiO2 groups.

Conclusion

The incorporation of TiO2 into MTA and PC increased their push-out bond strength. However, it did not affect the push-out bond strength of CEM cement.

Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

This systematic review evaluated the effects of nano-sized cement particles on the properties of calcium silicate-based cements (CSCs). Using defined keywords, a literature search was conducted to identify studies that investigated properties of nano-calcium silicate-based cements (NCSCs). A total of 17 studies fulfilled the inclusion criteria. Results indicated that NCSC formulations have favourable physical (setting time, pH and solubility), mechanical (push out bond strength, compressive strength and indentation hardness) and biological (bone regeneration and foreign body reaction) properties compared with commonly used CSCs. However, the characterization and verification for the nano-particle size of NCSCs were deficient in some studies. Furthermore, the nanosizing was not limited to the cement particles and a number of additives were present. In conclusion, the evidence available for the properties of CSC particles in the nano-range is deficient-such properties could be a result of additives which may have enhanced the properties of the material.

Assessment of pH Value and Release of Calcium Ions in Calcium Silicate Cements: An In Vitro Comparative Study

The goal of this study was to evaluate the pH and the release of calcium from four calcium-silicate-based cements.

METHODS

Four materials were tested (ProClinic MTA; Angelus MTA; ProRoot MTA; Biodentine). The palatal canal root of acrylic upper molars was filled with each cement. Afterwards, they were set in phosphate-buffered saline. Measurements were taken by atomic adsorption spectroscopy (AAS) at 3, 24, 72, 168, 336, 672, and 1008 h. The pH was measured at the same timepoints. Kruskal-Wallis tests were carried out in each period, as the Kolmogorov-Smirnov and Shapiro-Wilk tests showed no parametric results.

RESULTS

Significant differences (p < 0.05) in calcium release were found at the 3-, 24-, and 72-hour evaluations. All of the analyzed groups presented a release of calcium ions up to 168 h, and the general tendency was to increase up to 672 h, with a maximum release of 25.45 mg/g in the ProRoot group. We could only observe significant differences (p < 0.05) in pH value over 168 h between the Biodentine (7.93) and Angelus MTA (7.31) groups.

CONCLUSIONS

There were significant differences (p < 0.05) in calcium release. Nevertheless, no significant differences (p > 0.05) in the pH values were found at the studied timepoints, except for the values at 168 h.

Effect of Silver Nanoparticles of Herbal Origin on the Compressive and Push-out Bond Strengths of Mineral Trioxide Aggregate

Introduction

The purpose of this in vitro study was to investigate the effect of incorporating silver nanoparticles (AgNPs) of herbal origin into mineral trioxide aggregate (MTA) on the push-out bond strength (PBS) and compressive strength (CS) in simulated furcal area perforations.

Materials and Methods

In this in vitro study, simulated furcal area perforations (1.3 mm in diameter and 2 mm in depth) were created in 40 extracted human lower molar teeth, which were divided into two groups (n=20): MTA alone and MTA combined with AgNPs (2% wt). Using a universal testing machine, PBS was evaluated by performing push-out tests, while CS was assessed using cylindrical specimens. The normal distribution of data was checked using the Kolmogorov-Smirnov test, and statistical analysis was performed using two-way ANOVA.

Results

The CS results showed no significant difference between the MTA group at 4 and 21 days (P=0.297), but a significant difference was observed in the nanosilver/MTA group (P=0.013). However, there was no significant difference in the push-out bond strength among the study groups (P>0.05).

Conclusion

The incorporation of herbal origin silver nanoparticles did not significantly affect the PBS or CS of MTA.

Push-out bond strength of two calcium silicate-based cements used for repair of artificial furcal perforation following different power outputs of Nd:YAG laser

Proper bond strength of endodontic materials is an essential factor in the final success of root canal treatments, including perforation repairs. This study was designed to evaluate the effect of two power outputs of Nd:YAG laser (1064 nm) on push-out bond strength (PBS) of ProRoot mineral trioxide aggregate (MTA) and calcium-enriched mixture cement (CEM Cement) in the repair of artificial furcal perforations. This ex vivo study enrolled 66 extracted human molars. After preparing the access cavity, perforations were created on the floor of the pulp chamber with a diameter of 1.4 mm. The teeth were randomly distributed into the following six groups according to the repair material (MTA and CEM) and power output of laser irradiation (1 W and 1.5 W); A: MTA (case), B: CEM (case), C: Nd:YAG (1 W)/MTA, D: Nd:YAG (1 W)/CEM, E: Nd:YAG (1.5 W)/MTA, and F: Nd:YAG (1.5 W)/CEM. Then, a universal testing machine was utilized to assess the PBS. Data analysis was performed using ANOVA and T tests. Significant level was considered at P < 0.05. The highest mean ± SD of PBS was noted in Group Nd:YAG (1 W)/MTA (58.92 ± 36.13), followed by Nd:YAG (1.5 W)/MTA > Nd:YAG (1.5 W)/CEM > Nd:YAG (1 W)/CEM > MTA > and CEM. A significant difference was noted between laser and non-laser applications (P < 0.05). However, the increase of power output from 1 to 1.5 W had no significant influence on PBS (P > 0.05). The PBS of MTA groups was always significantly greater than that of CEM groups (P < 0.05). Although Nd:YAG laser irradiation positively influenced on PBS values in both material studied, increasing power output was not effective.

Dislodgement pushout resistance of five bioceramic root-end filling materials

This study evaluated the dislodgement push-out resistance of five bioceramic materials. One hundred single-rooted teeth with one canal had the apical 3 mm and crown resected to create a 14 mm standardized length. The canals were instrumented to an apical size 80 with a 3 mm root-end preparation made with ultrasonic diamonds. The prepared roots were randomly divided into 5 root-end restorative groups (n=20). ProRoot MTA, Biodentine, EndoSequence Root Repair Material, EndoSequence Fast Set Putty, and EndoSequence BC Sealer with each material placed following manufacturer's instructions and stored at 100% humidity for 2 weeks. An apical-to-coronal static testing load with the identified dislodgement force converted into MPa with mean results analyzed with Kruskal-Wallis and Dunn's post hoc tests (α=0.05). ProRoot MTA and Biodentine displayed similar push-out stress resistance and exhibited significantly greater stress resistance than the similar Endosequence materials. However, all materials failed cohesively and were not dislodged from the root canal surface.

The effect of different intracanal medicaments on the dislodgement resistance of mineral trioxide aggregate

BACKGROUND

This study aimed to assess the effect of different commercially used calcium hydroxide [Ca(OH)₂], the mixture of Ca(OH)₂ + silver nanoparticles (AgNPs), and other intracanal medicaments on dislodgement resistance of mineral trioxide aggregate (MTA) to root canal dentin in short- and long-term application.

METHODS

Forty-six human single-rooted maxillary teeth were sectioned horizontally at mid-root into 1 mm thick slices. The lumen of the slices was standardized using #2-#5 Gates Glidden drills to a standard diameter of 1.3 mm in all samples. After smear layer removal, the samples were randomly divided into eight groups (n = 20) and treated with the following medicaments; Ca(OH)₂ paste, Calcipex, Metapex, chlorhexidine (CHX), Ca(OH)₂/CHX paste, Ca(OH)₂/AgNPs, triple antibiotic paste and control group (normal saline). The samples were then incubated at 37 °C with 100% humidity for 1 week. Next, half of the teeth in each group (n = 10) were removed from the incubator and washed in an ultrasonic bath. ProRoot MTA was placed in the canal lumen and the samples were incubated at 37 °C and 100% humidity for 48 h to allow complete setting of MTA. The remaining half in each group (n = 10) was subjected to the same process after 1 month of application of medicaments. The dislodgement resistance of MTA to root dentin was measured. The data were analysed using two-way ANOVA and Tukey's post hoc test.

RESULTS

No significant difference was noted in dislodgement resistance of samples after 1 week and 1 month in any group (P > 0.05). The only significant difference was noted between the control and CHX groups and the higher dislodgement resistance was recorded in the CHX group (P = 0.006). No other significant differences were noted between the groups (P > 0.05).

CONCLUSION

Duration of application and the type of intracanal medicament do not affect the dislodgement resistance of MTA to root dentin. Although there was no statistically significant difference in the dislodgment resistance of MTA between the medicaments, CHX had a promising effect.

Push-Out Bond Strength of EndoSeal Mineral Trioxide Aggregate and AH Plus Sealers after Using Three Different Irrigation Protocols

OBJECTIVE

 The current study was designed to assess the bonding strength of EndoSeal MTA and AH Plus sealers after using three irrigation protocols as follows: (1) 17% Ethylenediamine tetraacetic acid, (2) 7% maleic acid, and (3) 37% phosphoric acid.

MATERIALS AND METHODS

 Push-out bond strength was evaluated for 60 middle root slices of 1-mm thickness each. They were horizontally cut from freshly extracted single-rooted human teeth. A hole in the root canal was made using a carbide round bur of 1.1 mm in diameter in a middle third root slice. Specimens were dipped in 2.5% NaOCl, and then they were grouped into three groups; G1: 17% EDTA, G2: 7% maleic acid, and G3: 37% phosphoric acid as a final irrigant for 3 minutes. Each group was subdivided into two subgroups, according to the type of sealer, either EndoSeal MTA or AH Plus.

STATISTICAL ANALYSIS

 After the full set of the sealer, the bond strength was evaluated with the push-out test by applying a force to each slice using a plunger with a 1-mm diameter. The one-way Tukey's post hoc test, analysis of variance (ANOVA) test, and Student's t-test were utilized to gather data and statistically evaluate it.

RESULTS

 The irrigation protocol used exhibited significant influence on the bond strength of EndoSeal MTA and AH Plus sealers. AH Plus sealer subgroups showed the highest bond strength with 7% maleic acid, followed by 37% phosphoric acid, and 17% EDTA. While in the EndoSeal MTA sealer subgroups, the highest bond strength was shown with the 17% EDTA followed by 7% maleic acid and 37% phosphoric acid, respectively.

CONCLUSION

 The present study revealed that the type of the final irrigant significantly impacts the bond strength of the sealer used. The AH Plus sealer bond strength was improved by using the 7% maleic acid as a final irrigant. In contrast, the EndoSeal MTA sealer showed the best results with the 17% EDTA as a final irrigant.

Push-out bond strength and marginal adaptation of apical plugs with bioactive endodontic cements in simulated immature teeth

Objectives

This study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison.

Materials and Methods

A total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics.

Results

The comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05).

Conclusions

The bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.

Comparative evaluation of push-out bond strength of root-end filling materials in root-end cavities prepared by laser or ultrasonic technique: An in vitro study

Context:

The use of mineral trioxide aggregate (MTA) and Biodentine as a root-end filling materials used in the root-end cavities prepared by laser or ultrasonic technique is a current topic in the branch of dentistry and push-out bond strength is used to measure the adhesiveness provided by the root-end filling materials.

Aim:

The aim of this study is to evaluate the push-out bond strength of MTA and Biodentine in root-end cavities prepared by erbium:yttrium-aluminium-garne (Er:YAG) laser and ultrasonic retrotip.

Materials and Methods:

A total of 40 extracted maxillary central incisors and canines were selected. Chemomechanical preparation and obturation were done. Root-end resections were performed followed by the root-end cavity preparation and root-end filling. Specimens were divided into four groups. Root-end cavities prepared by Er:YAG laser and filled with MTA, root-end cavities prepared by Er:YAG laser and filled with Biodentine, root-end cavities prepared by ultrasonic retrotip and filled with MTA and root-end cavities prepared by ultrasonic retrotip and filled with Biodentine, respectively. The apical end was again sectioned perpendicular to the long axis. The push-out bond strength was evaluated using a universal testing machine.

Statistical Analysis Used:

The data were analyzed using the analysis of variance and post hoc Tukey test.

Results:

Difference between push-out bond strength of root-end filling materials to root-end cavity walls prepared by laser and ultrasonic retrotips was statistically nonsignificant. Push-out bond strength of MTA and Biodentine did not differ significantly.

Conclusion:

Difference between push-out bond strength of MTA and Biodentine to root-end cavity walls prepared by Er:YAG Laser or ultrasonic retrotip were statistically nonsignificant.

Push-out bond strength of calcium-silicate cements following Er:YAG and diode laser irradiation of root dentin

This study aimed to compare the effects of diode and Er:YAG laser irradiation of root dentin on push-out bond strength of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cements. An in vitro experimental study was conducted on 90 dentin discs, cut out of freshly extracted human teeth. The discs were instrumented to obtain 1.3-mm lumen diameter. Then, they were randomly divided into six groups (n = 15). Groups 1 and 4 subjected to diode laser (Wiser, Doctor Smile, Italy) (980 nm, 1 W, continuous mode) for 10 s and filled with MTA and CEM cements. Groups 2 and 5 subjected to Er:YAG laser (Deka, Italy) (2940 nm, 1 W, 10 Hz, 230 μs) for 10 s and filled with MTA and CEM cements. Groups 3 and 6 (control groups) were filled with MTA and CEM cements without laser irradiation. After 7 days, push-out bond strength test was performed using a universal testing machine in order to evaluate the adhesion of the biomaterials to dentin. The samples were evaluated under a light microscope at × 40 magnification to determine the mode of fracture. Data were analyzed using two-way ANOVA. The highest push-out bond strength (8.76 ± 3.62 MPa) was noted in group 1 (diode/MTA), which was significantly higher than the other groups (P < 0.001). The lowest bond strength (2.61 ± 0.81) was noted in group 6 (control/CEM). Diode laser significantly increased the bond strength of both cements (P < 0.05), but Er:YAG laser irradiation only increased the bond strength of CEM and had no significant effect on MTA (P = 0.603). The bond strength of MTA control group was higher than that of CEM control group (P = 0.001). Push-out bond strength of endodontic cements can be affected by dentin conditioning with diode 980 nm and Er:YAG laser. Nine hundred eighty-nanometer diode laser irradiation is recommended to increase the bond strength of endodontic cements particularly the CEM cement to dentin.

Effect of Propylene Glycol on the Bond Strength of Two Endodontic Cements

Introduction

This study evaluated the effect of propylene glycol (PG) on the push-out bond strength of calcium-enriched mixture (CEM) cement compared to mineral trioxide aggregate (MTA).

Methods and Materials

The lumens of two hundred 2±0.2 mm-thick root sections from human extracted teeth were prepared to achieve a diameter of 1.3 mm. The samples were then allocated into eight groups of 25 on the basis of the materials used (MTA or CEM cement) and different proportions of PG (0%, 20%, 505, and 100%). In each group, 0.4 mL of the liquid was mixed with 1 g MTA or CEM cement. After incubation, the push-out strength of the samples was measured using a universal testing machine. Data were analyzed using the two-way ANOVA followed by one-way ANOVA and student's t-test.

Results

The MTA group showed significantly higher bond strength in comparison with CEM group (P≤0.001). Also 100% and 20% PG increased the bond strength of MTA (P≤0.001). For CEM cement, 100% and 50% PG decreased the bond strength (P≤0.001).

Conclusion

This in vitro study demonstrated that while PG increased the push-out bond strength of MTA, it is not recommended for mixing with CEM cement.

Design Variability of the Push-out Bond Test in Endodontic Research: A Systematic Review

INTRODUCTION

There is limited literature on the impact of testing variables on the push-out bond test (POBT). This review identified designs of the POBT used in the endodontic literature and aimed to determine which experimental variables may influence the push-out bond strength (POBS).

METHODS

A systematic review based on PRISMA guidelines was performed by searching the PubMed, SCOPUS, and Cochrane library databases using terms including push-out and dislocation resistance and descriptions of endodontic materials. Test variables assessed included method of root preparation, timing of sectioning compared with filling, thickness, diameter and taper of sections, and plunger size and velocity. The POBS of 3 common materials (gutta-percha and AH Plus, mineral trioxide aggregate, and Biodentine) were collected from investigations, and a comparison was attempted.

RESULTS

One hundred thirty-three studies assessed the POBS of root-filling materials, 68 assessed root repair cements/root-end filling materials, and 16 assessed orifice barrier materials other than mineral trioxide aggregate. There was significant variation in all of the assessed variables, resulting in a large range of reported values for the POBS of the various materials. Because of this heterogeneity in study design, no further statistical analysis of the impact of the test variables on POBS was possible.

CONCLUSIONS

There was considerable variation in the POBT design used in endodontic research. Greater standardization is required for future research as well as accurate reporting for all test variables to assess the impact of specific design variables on POBS.

Push-out bond strength of different types of mineral trioxide aggregate in root dentin

OBJECTIVE

The objective of this study was to measure the push-out bond strength of three types of mineral trioxide aggregate (MTA) materials in root dentin.

METHODS

The study was carried out at the College of Dentistry, Imam Abdulrahman Bin Faisal University from March 2014 to January 2015. Thirty extracted maxillary central incisors were selected, instrumented, irrigated, and randomly assigned into three groups (n = 10): Group 1 - Ortho MTA; Group 2 - MTA Angelus; and Group 3 - ProRoot MTA. Materials were mixed following the manufacturers' recommendations and canals were filled. Teeth were stored in distilled water for 6 months. The push-out bond strength was evaluated using 2-mm thick coronal root sections. The data were analyzed with one-way ANOVA and Tukey-Kramer multiple comparison tests statistically significant at P < 0.05.

RESULTS

The mean bond strength values were 68.69 ± 29.63 MPa for Ortho MTA, 42.54 ± 32.78 MPa for MTA Angelus, and 72.75 ± 26.27 MPa for ProRoot MTA groups. There were no significant differences between the bond strengths of tested materials (P > 0.05).

CONCLUSION

Ortho MTA, MTA Angelus, and ProRoot MTA materials showed similar push-out bond strength values in root dentin.

Evaluation of the bond strength of root-end placed mineral trioxide aggregate and Biodentine in the absence/presence of blood contamination

Objective:

Mineral trioxide aggregate (MTA) has been accepted as an appropriate root-end filling material in endodontic microsurgery because of setting ability in the wet environment. The aim of this study was to assess the bond strength of root-end placed MTA and Biodentine (Septodont, Saint Maur des Fossés, France) in the absence/presence of blood contamination.

Materials and Methods:

Forty-eight single-rooted maxillary incisors were used. subsequent to root-end resection and apical preparation using ultrasonic retro-tips, the specimens were randomly separated into two groups according to the root-end filling materials: MTA (Cerkamed Medical Company, Stalowa, Poland) or Biodentine. The specimens were then separated into two subgroups according to storage condition (absence/presence of blood) (n = 12). After obtaining 2.0 ± 0.1 mm slices, push-out tests were performed. Each slice was examined under a stereomicroscope to evaluate the failure mode. The data were analyzed using two-way analysis of variance and Tukey's post hoc test for multiple comparisons. The failure modes were analyzed using the Chi-square test (P = 0.05).

Results:

The bond strength was significantly affected by the presence of blood contamination and root-end filling material type (P < 0.001). Biodentine had better bond strength than MTA (P < 0.001). The most common failure type was adhesive failure. According to the Chi-square test, there were no statistically significant differences among the groups (P = 0.394).

Conclusions:

Biodentine had better bond strength values compared to MTA, and the bond strength of both MTA and Biodentine as root-end filling materials was negatively affected by the presence of blood.

Effect of irrigation technique for removal of triple antibiotic paste on bond strength of MTA to root dentin

This study evaluated the bond strength of mineral trioxide aggregate (MTA) to root canal dentin after the performance of various irrigation procedures to remove triple antibiotic paste (TAP). A total of 56 single-rooted human mandibular premolars were instrumented using a rotary system to size 40 and divided randomly into a control group (no intracanal dressing) and three experimental groups (TAP application for 28 days). TAP was then removed by rinsing with 10 mL 2.5% NaOCl using three irrigation systems (Vibringe sonic irrigation, CanalBrush, and syringe irrigation). The coronal and middle parts of root canals were then obturated with MTA. After storage for 1 week, each specimen was embedded in an acrylic block and sectioned horizontally (2-mm-thick slices) at two levels (coronal and middle). Bond strength of MTA to root canal dentin was assessed in 28 samples per group via push-out test using a universal testing machine. Data from the four groups were compared using one-way analysis of variance. Tukey's test was used for multiple comparisons. Push-out bond strength values were significantly higher in the control and Vibringe groups than in the CanalBrush and syringe irrigation groups (p < 0.001). TAP removal from root canals with the Vibringe irrigation system may increase the push-out bond strength of MTA compared with the use of the CanalBrush or syringe irrigation.