Evaluation of the Dislodgement Resistance of a New Pozzolan-Based Cement (EndoSeal MTA) Compared to ProRoot MTA and Biodentine in the Presence and Absence of Blood

Introduction. This in vitro study investigated the dislodgement resistance of EndoSeal MTA, a new pozzolan-containing calcium silicate-based material, in comparison with ProRoot MTA and Biodentine in the presence and absence of contamination with blood. Methods. Standard furcal perforations were created in 180 human mandibular first molars. The teeth were randomly allocated to 12 groups of 15 each. ProRoot MTA, Biodentine, and EndoSeal MTA were used to repair the perforations. In half of the samples, the walls of the perforated areas were contaminated with blood, whereas saline was injected into the other half. A push-out test was performed using a universal testing machine after 24 hours or 7 days. To evaluate failure patterns, the samples were split into half and were examined under a stereomicroscope at a 20x magnification. Data were analyzed using three-way analysis of variance, Tukey test, and Student's t-test. Results. At both time intervals and in the presence and absence of contamination with blood, ProRoot MTA and Biodentine had significantly higher retention values than EndoSeal MTA (p<0.001). Contamination with blood had no effect on EndoSeal MTA; however, it negatively affected the dislodgement resistance of Biodentine at 24 hours and ProRoot MTA at both time intervals (p<0.05). Time significantly affected only the bond strength of the uncontaminated groups (p>0.001). The most common type of failure was mixed for ProRoot MTA and Biodentine, whereas it was cohesive for EndoSeal MTA. Conclusions. ProRoot MTA and Biodentine showed higher values of bond strength than EndoSeal MTA and may thus be better options for the repair of root perforations.