Push-out bond strength and SEM evaluation of new polymeric

root canal fillings

Emel Olga Onay, DDS, PhD,a Mete Ungor, DDS, PhD,b Hale Ari, DDS, PhD,c
Sema Belli, DDS, PhD,d Ersin Ogus, PhD,e Ankara and Konya, Turkey
BASKENT UNIVERSITY AND SELCUK UNIVERSITY

Objective. The objective of this study was to compare the interfacial strengths and failure modes of new polymeric
endodontic obturation systems consisting of different material combinations.
Study design. Extracted human single-rooted teeth (n ⫽ 105) were instrumented using HERO Shaper rotary
instruments and obturated with different combinations of core and sealer as follows: group 1, RealSeal/Resilon; group
2, RealSeal/Herofill; group 3, Hybrid Root Seal/Resilon; group 4, Hybrid Root Seal/Herofill; group 5, MM-Seal/Resilon;
group 6, MM-Seal/Herofill; group 7 (control). Failure modes of root slices (1.00 ⫾ 0.05-mm thick) after push-out
testing were examined with stereomicroscope and scanning electron microscopy.
Results. Hybrid Root Seal/Resilon combination had significantly greater bond strength than all the other groups (P ⬍
.001); RealSeal/Resilon combination proved to have the second highest bond strength (P ⬍ .001). Bond failure was
mainly mixed failure in both adhesive and cohesive modes at the dentin/sealer interface.
Conclusion. The push-out bond strengths of methacrylate-based sealers (Hybrid Root Seal and RealSeal) and
thermoplastic synthetic-polymer-based core material (Resilon) combinations were higher than epoxy-resin⫺based
sealer (MM-Seal) and gutta-percha (Herofill) combination. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;
107:879-885)

The bond strength of root canal sealers to dentin is
important for maintaining the integrity of the seal in
root canal filling in both static and dynamic situa-
tions.1-3 Additionally, increased adhesive properties to
dentin may lead to greater strength of the restored
tooth, which may provide greater resistance to root
fracture and clinical longevity of an endodontically
treated tooth.4-6
Improvements in adhesive technology have fostered
attempts to incorporate adhesive dentistry in endodon-
tics by introducing obturation systems with a specific
focus on obtaining a “mono-block” in which core ma-
This paper was presented at the International Association of Dental
Research (IADR) Pan European Federation (PEF) Conference in
London, UK, on September 2008.
a
Assistant Professor, Department of Endodontics, Baskent University
School of Dentistry, Ankara, Turkey.
b
Professor, Department of Endodontics, Baskent University School
of Dentistry, Ankara, Turkey.
c
Associated Professor, Department of Endodontics, Selcuk Univer-
sity, School of Dentistry, Konya, Turkey.
d
Professor, Department of Endodontics, Selcuk University, School of
Dentistry, Konya, Turkey.
e
Assistant Professor, Department of Biostatistics, Baskent University
School of Medicine, Ankara, Turkey.
Received for publication Oct 12, 2008; returned for revision Dec 21,
2008; accepted for publication Jan 12, 2009.
1079-2104/$ - see front matter
© 2009 Published by Mosby, Inc.
doi:10.1016/j.tripleo.2009.01.023
terial, sealing agent, and root canal dentin form a single
cohesive unit.7
The recent introduction of Resilon (Resilon Research
LLC, Madison, CT) as an alternative root filling mate-
rial offers the promise of adhesion to root dentin.6-8
This thermoplastic synthetic polymer is presented as a
root canal filling material having bonding ability to
methacrylate-based resin sealers through the inclusion
of dimethacrylate monomers.9 This core material can
couple to a variety of dentin adhesives and resin type
sealers, including RealSeal (SybronEndo, Glendora,
CA) and Hybrid Root Seal (Sun Medical Co., Ltd.,
Shiga, Japan). The RealSeal root canal sealant is a
dual-cured, methacrylate-based dental resin composite
sealer. The RealSeal/Resilon system is used in conjunc-
tion with a self-etching primer, which induces a chem-
ical interaction that leads to the formation of a single
resin block and adheres to the root canal walls.
Based on a similar approach, a new material (Hybrid
Root Seal) that contains 4-methacryloxyethyl trimelli-
tate anhydride (4-META) has been introduced on the
market. Hybrid Root Seal is a dual-cured and a self-
etching sealer, which does not require any additional
priming or acid etching to the root canal dentin. The
manufacturer claims that it has the advantage of form-
ing a hybrid layer that creates a bond to the dentinal
walls as well as the Resilon and gutta-percha.
Epoxy-resin sealers have been used because of their
reduced solubility,10 apical seal,11 and micro-retention

879

880 Onay et al.
to root dentin.1 MM-Seal root canal sealer (Micro-
Mega, Besançon, France) is an epoxy-resin⫺based root
canal sealer packaged in a dual syringe that is used with
gutta-percha. Thermoplasticized gutta-percha tech-
niques have been demonstrated to provide superior
adaptation to canal walls and better filling of lateral
canals when compared to lateral compaction.12,13 Hero-
fill Soft-Core obturators (Micro-Mega) consist of plas-
tic carriers coated with thermoplastic ␣-phase gutta-
percha. The central carrier has an ISO standard size and
the system provides a size verifier that ensures adequate
preparation of the canal and the selection of the corre-
sponding Herofill Soft-Core obturator.
Using the push-out test method to test the dentin
bond strength, we previously reported that Epiphany
sealer and Resilon core combination was not superior to
that of the AH Plus sealer (Dentsply De Trey GmbH,
Konstanz, Germany) and gutta-percha core combina-
tion.14 Based on the previous observed push-out test
values, the null hypothesis tested was that there are no
differences in the bond strength of the RealSeal/Resilon
combination and all the other groups tested.
The purpose of this study was to assess the interfacial
strengths and failure modes of new polymeric endodon-
tic obturation systems consisting of different material
combinations.
MATERIALS AND METHODS
A total of 105 extracted human single-rooted teeth
were used. Each tooth was placed in 5.25% sodium
hypochlorite (NaOCl) for 2 hours for surface disinfec-
tion, and then stored in distilled water until used. The
crown of each tooth was sectioned at the cemento-
enamel junction using a water-cooled diamond disk.
The working length was determined visually by sub-
tracting 1 mm from the length of a size 10 K-file
(MANI Inc., Tochigi, Japan) at the apical foramen. The
middle and coronal thirds were prepared using ISO size
1, 2, 3, 4, and 5 Gates Glidden drills (Produits Dentaires
S.A., Vevey, Switzerland). The preparations in the root
portions were standardized with a depth of 5 mm and a
diameter of 1.3 mm.
All teeth were instrumented with a crown-down tech-
nique, using HERO Shaper rotary instruments (Micro-
Mega) as follows. A #30 file with a 0.06 taper was
initially introduced in two thirds of the working length.
Shaping was completed with a #30 file with 0.04 taper
at the working length. One milliliter of 1.25% NaOCl
was used for irrigation between each instrument. A
lubricant (Glyde File Prep., Dentsply, Montigny-le-
Bretonneux, France) was used throughout the cleaning
and shaping of the root canal. The smear layer was
removed during the instrumentation with 5 mL of 17%
EDTA (pH 7.4). Finally, the root canal was flushed
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June 2009
with 5mL of 5.25% NaOCl, 5 mL of 17% EDTA, and
3 mL distilled water respectively and dried with paper
points before filling.
The roots were then divided randomly into 7 groups
(6 experimental groups of 15 roots each and 1 control
group of 15 roots) and obturated as follows:
● Group 1: After instrumentation, a self-etching
primer (RealSeal Primer; SybronEndo, Glendora,
CA) was placed into the canal with a syringe. The
primer was allowed to remain for 30 seconds and the
excess was removed with paper points. Roots were
filled with RealSeal root canal sealer and Resilon
core material (SybronEndo, Glendora, CA) using the
warm vertical compaction technique. The RealSeal
root canal sealer was introduced into the root canal
using a paper point. A Resilon point, previously
tried-in with tug back, was lightly coated with Re-
alSeal root canal sealer and placed into the canal to
working length. Down-packing was performed by
using System B (SybronEndo, Orange, CA) set at
150°C to within 4 to 5 mm of working length. Back-
filling of Resilon pellets was performed using an
Obtura II unit (Obtura Spartan, Fenton, MO) set at
140°C. After backfilling, the coronal surface of the
root filling was light-cured (Hilux Expert, Benlioglu,
Ankara, Turkey) for 40 seconds to create an imme-
diate coronal seal according to manufacturer’s rec-
ommendations.
● Group 2: The roots were treated with the primer and
then filled with RealSeal root canal sealer. A size 30
Herofill obturator was heated for 35 seconds in the
Herofill oven, and then it was seated to the working
length. The handle of the obturator and excess ma-
terial were removed after cooling with a small round
bur. The canal orifice was light-cured for 40 seconds.
● Group 3: The roots were filled with Hybrid Root
Seal and Resilon core material using the warm ver-
tical compaction technique. As specified by the man-
ufacturer’s instructions, 3 drops of liquid and 1 scoop
of powder were dispensed onto a mixing pad with a
spatula. The homogeneous texture was introduced
into the root canal using a paper point. The root canal
filling was completed in the same manner as in group
1. The coronal surface of the root filling was light-
cured for 20 seconds to create an immediate coronal
seal according to manufacturer’s recommendations.
● Group 4: The roots were filled with Hybrid Root
Seal and Herofill core material in the same manner as
in group 2. The canal orifice was light-cured for 20
seconds.
● Group 5: The roots were filled with MM-Seal root
canal sealer and Resilon core material using the
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Volume 107, Number 6 Onay et al. 881

Table I. Mean push-out bond strengths (MPa) (⫾ SD) and failure modes for the experimental groups
Failure mode, n (%)
Material (n ⫽ 15) Mpa (Mean) ⫾ SD Adhesive Cohesive Mixed
Group 1 RealSeal/Resilon 3.18 ⫾ 2.16b 2 (13.3) 7 (46.7) 6 (40)
Group 2 RealSeal/Herofill 1.42 ⫾ 1.25a 2 (13.3) 5 (33.3) 8 (53.4)
Group 3 Hybrid Root Seal/Resilon 3.43 ⫾ 2.07c 1 (6.6) 8 (53.4) 6 (40)
Group 4 Hybrid Root Seal/Herofill 1.33 ⫾ 1.47a 0 (0) 5 (33.3) 10 (66.7)
Group 5 MM Seal/Resilon 1.95 ⫾ 0.84d 2 (13.3) 4 (26.7) 9 (60)
Group 6 MM Seal/Herofill 2.66 ⫾ 1.51e 2 (13.3) 2 (13.3) 11 (73.4)
a
Groups identified by the same superscript letter were not significantly different (P ⬎ .05).
b,c,d,eDifferent superscript letters identify significantly different groups (P ⬍ .001).

warm vertical compaction technique. As specified by
the manufacturer’s instructions, the base and catalyst
(2:1 wt. ratio) were dispensed onto a mixing plate,
and then placed into the canal with paper points. The
root canal filling was completed in the same manner
as in group 1.
● Group 6: The roots were filled with MM-Seal root
canal sealer and Herofill core material in the same
manner as in group 2.
● Group 7 (control group): The roots were filled
Herofill core material without any sealer.
All 105 roots were stored in gauze dampened with
sterile saline and enclosed in sealed tubes for 7 days to
allow the sealer to set.
Preparation of roots for push-out bond strength
testing
Each slice was marked on its coronal side with an
indelible marker. The coronal portion just below the
cemento-enamel junction of each root was sectioned
perpendicular to its long axis to create 1.00 ⫾ 0.05-
mm-thick slices using a water-cooled diamond blade on
an Isomet machine (Buehler, Lake Bluff, IL). If the
sample contained filling material of a noncircular cross-
sectional shape, it was discarded, as this would result in
nonuniform stress distribution15 during testing and in-
accurate measurements.16,17
After measuring the thickness of each slice with
digital calipers, the filling material was loaded with a
1-mm-diameter cylindrical plunger that provided the
most extended coverage over the filling material with-
out touching the canal wall. Loading was performed on
a universal testing machine (Instron, Canton, MA) at a
speed of 1 mm/min until bond failure occurred. The
load was applied to the apical aspect of the root slice
and in an apical-coronal direction, so as to push the
filling material toward the larger part of the root slice,
thus avoiding any limitation to the filling material
movement. The bond strength was determined by using
a real-time computer software program, which plotted a
load/time curve during compression testing. Bond fail-
ure load was noted when a sharp decline was observed
on the graph and/or complete dislodgement of the root
filling material.
To express the bond strength in MPa, the load at
failure recorded in Newtons was divided by the area of
the bonded interface as calculated by the following
formula18: A ⫽ 2␲r ⫻ h, where ␲ is the constant 3.14,
r is the root canal radius, and h is the thickness of the
slice in millimeters.
Analysis of failure modes
After adhesion testing, the sections were split longi-
tudinally in buccolingual direction using a diamond
disk and dentin surfaces were examined under a ste-
reomicroscope (Leica MZ12, Leica Microsystems,
Wetzlar, Germany) at ⫻40 magnification to determine
the nature of bond failure: 1, adhesive failure at the
filling material/dentin interface; 2, cohesive failure
within the filling material; 3, mixed failure in both the
filling material and dentin.
Scanning Electron Microscope evaluation
Four randomly selected samples from each group
were prepared for scanning electron microscope (SEM)
examination. Each specimen was sectioned longitudi-
nally, and then mounted on stubs, sputter coated with
gold, and examined under SEM (JSM-6400; JEOL,
Tokyo, Japan).
Statistical analysis
Nonparametric statistical analysis (Kruskal-Wallis)
followed by a multiple comparison test (Dunn’s test)
indicated significant differences among the groups. The
statistical significance was set at a P less than .05.
RESULTS
The respective mean push-out test values for groups
1 to 7 were: 3.18 ⫾ 2.16 MPa, 1.42 ⫾ 1.25 MPa, 3.43
⫾ 2.07 MPa, 1.33 ⫾ 1.47 MPa, 1.95 ⫾ 0.84 MPa, 2.66
 OOOOE
882 Onay et al. June 2009

Fig. 1. Remnants of RealSeal could be observed on the Fig. 2. Residual sealer material covering the surface in the
debonded dentin surfaces of the RealSeal/Resilon group. Hybrid Root Seal/Resilon group. Some finer filler particles
clogged or partially occluded dentinal tubules.

⫾ 1.51 MPa, and 0.1 ⫾ 0.07 MPa (Table I). Significant

difference (P ⬍ .001) occurred among the groups.
Multiple comparisons (Dunn’s test) revealed that group
3 (Hybrid Root Seal/Resilon) had significantly (P ⬍
.001) greater bond strength than all the other groups;
group 2 (RealSeal/Herofill) and group 4 (Hybrid Root
Seal/Herofill) were not significantly different from each
other (P ⬎ .05), but both had significantly (P ⬍ .001)
lower bond strength than all the other experimental
groups. RealSeal/Resilon (group 1) combination
proved to have second highest bond strength (P ⬍
.001).

Failure modes
Stereomicroscopic examination of 90 samples re-
vealed that the bond failure to be mainly mixed failure
(55.6%) in both adhesive and cohesive modes at the
filling material/dentin interface (Table I). Cohesive fail-
ures within the filling material were mostly observed in
Hybrid Root Seal/Resilon combination (group 3)
(53.4%). Mixed failures in both adhesive and cohesive
modes at the filling material/dentin interface were
mostly observed in MM-Seal/Herofill combination
(group 6) (73.4%). Most of the groups failed 13.3% in
adhesion between filling material and dentin interface,
whereas no instances were found of adhesive failure for
the samples of Hybrid Root Seal/Herofill combination
(group 4) (Table I).
When samples were examined under SEM, resin
particles often obscured tubule orifices (Figs. 1 and 2),
and clear dentin surfaces were also found where some
tags had sheared off but remained in the dentinal tu-
bules (Fig. 3).
Fig. 3. The dentin surface of the pulpal wall of a canal
obturated with MM-Seal/Herofill showed a clean dentin wall
with resin tags partially or completely pulled out.
DISCUSSION
All 7 of the groups tested showed measurable adhe-
sive properties. The Hybrid Root Seal/Resilon combi-
nation (group 3) had the highest bond strength. Re-
alSeal/Resilon (group 1) combination proved to have
second highest bond strength. According to the results
of this study we have to reject the null hypothesis that
there are no differences in bond strength of the Re-
alSeal/Resilon combination (group 1) and all the other
groups tested.
Bond-strength testing has become a popular method
for determining the effectiveness of adhesion between
endodontic materials and tooth structure. There are
many methods for measuring the adhesion of endodon-
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Volume 107, Number 6
tic root canal sealers, but none has yet been widely
accepted.19 The tensile strength test is sensitive, with
the result that small alterations in the specimen or in
stress distribution during load application have a sub-
stantial influence on the results.20 On the other hand, a
major problem with shear testing is that it is difficult to
closely align the shear-loading device with the bond
interface. The load is offset at some distance from the
bonded interface, resulting in unpredictable torque
loading on the specimen.21
In this study, the push-out test method was used to
test the dentin bond strengths of different root canal
sealers. The model has been shown to be effective and
reproducible.22 Another advantage of this method is
that it allows root canal sealers to be evaluated even
when bond strengths are low.
Development of molecules that will adhere to tooth
structure is a high-priority area of dental research.
Although dentin presents formidable obstacles to adhe-
sive mechanisms, there is substantial progress in the
formulation of agents that are already altering certain
procedures.
The materials and techniques currently used for ad-
hesive bonding to dentin in restorative dentistry have
been developed over many years. The latest generation
dentin-bonding systems achieve high bond strength and
reduced microleakage by micromechanical bonding or
by forming a hybrid layer between the dentin and the
resin.23 Studies have examined the potential of adhe-
sive resins as root canal filling materials.24,25
4-META adhesive resins have been reported in the
dental literature for more than 20 years. 4-META oc-
curs in nature as a white crystalline structure with a
melting point of 95°C to 96°C. It can be prepared by the
condensation of 2-hydroxyethyl methacrylate and trim-
ellitic anhydride chloride in the presence of pyridine to
remove hydrogen chloride. It consists of hydrophobic
and hydrophilic groups and promotes the infiltration of
monomers into the hard tissue.26 In 1982, Nakabayashi
et al.27 demonstrated that the addition of 4-META to
the monomer of a luting agent increased adhesion of an
acrylic rod to etched enamel and dentin.
Nakabayashi et al.28 first described a “hybrid” layer
when working with 5% 4-META in methyl methacry-
late, initiated by partially oxidized tri-n-butyl borane in
the presence of poly-methyl methacrylate powder on
vital human dentin. This transitional or hybrid layer
was assumed to be durable, “of resin-reinforced dentin
created by the impregnation, co-mingling, and envel-
opment of collagen bundles, and encapsulation of hy-
droxylapatite crystals.”28, p135
In the present study, both 4-META containing Hy-
brid Root Seal and RealSeal showed superior bonding
ability to root dentin with Resilon core material. The
Onay et al. 883
mostly cohesive failures at the filling material/dentin
interface and occluded dentinal tubule formation (Figs.
1 and 2) in these groups corresponded to the good
bonding of Hybrid Root Seal and RealSeal to dentin. It
is also interesting to note in the current study that in
addition to a greater bonding ability, both the groups
had a much greater standard deviation than the other
experimental groups. Although the manufacturer’s di-
rections for placement of these materials were followed
precisely, two potential reasons may have led to incon-
sistent results. Obturation techniques that use heat ap-
plication could have affected the adaptation and the
penetration of the methacrylate-based sealers. A study
by Lawson et al.29 using the push-out test design and
SEM analysis has shown the patent dentinal tubules and
the absence of resin-rich zones in samples obturated
with MetaSEAL (Hybrid Root Seal; Parkell Inc., Farm-
ingdale, NY) and gutta-percha combination by warm
vertical compaction technique. The authors also con-
cluded that the evaporation of the liquid resin compo-
nent of the sealer by heat generated during down-
packing with the System B heat source could have
resulted in a highly viscous sealer that had a limited
flow capacity into the patent dentinal tubules.
An even more challenging concern is that of the
geometric variables in the use of adhesive sealers. The
configuration factor (C-factor) defined as the ratio of
bonded to unbonded surface areas of cavities, in a root
canal is highly unfavorable and contributes to maximiz-
ing the polymerization stress of resin-based materials
along the root canal walls.30 Previous studies have
described that the extremely high C-factors encoun-
tered in long, narrow root canals tended to cause a
resistance in the relieving of shrinkage stresses during
polymerization.18,30 Focusing on this issue becomes
more critical as the resin sealer is light-cured to create
an immediate coronal seal, because this prevents stress
relief by resin flow and the resin sealer may detach
from dentin walls, thus creating interfacial gaps and
decreasing the interfacial strength.18
The design of this in vitro study might also have
some limitations, making it difficult to compare the
results with the clinical situation. Beside the adverse
effects of the filling techniques that use heat application
and C-factor, the unpredictable variation in tooth mor-
phology such as continued dentin deposition in older
teeth31 may also explain the relatively high standard
deviations where the push-out bond strength varied
considerably within groups for all sealer types.32
Resilon is the central component of the Epiphany
Soft Resin Endodontic Obturation System (Pentron
Clinical Technologies, LLC), and RealSeal
(SybronEndo). The mean push-out bond strength val-
ues for Resilon and RealSeal (or Epiphany) combina-

884 Onay et al.
tion reported in the literature vary within wide range:
from 0.32 MPa to 5 MPa.14,16,17,33-38 These different
results can be related to the variety of samples and
protocols to test the bond strength in these various
studies.
Using the cold lateral condensation technique and
push-out test method to compare the bond strength of
different material combinations, we reported the Epiph-
any sealer and Resilon core combination was not supe-
rior to that of the epoxy-resin⫺based AH Plus sealer
and gutta-percha core combination.14 In the present
study, the RealSeal/Resilon combination performed
better and had higher bond strength when compared
with the previous study. This might be attributable to
the advantage of the continuous wave of condensation
technique that creates a homogeneous mass of Resilon
that corresponds to an increase in Resilon density when
compared with cold lateral condensation technique.
This result is consistent with findings of Ureyen Kaya
et al.36 who compared the interfacial strength of differ-
ent root canal filling materials consisting of different
obturation techniques and material combinations. The
authors showed that the Epiphany/Resilon used with
combined warm vertical compaction had significantly
higher bond strength value than when used in combi-
nation with cold lateral condensation technique.
Numerous investigations have shown that the epoxy-
resin⫺based sealers had higher bond strength than most
other sealers.39,40 Although the specimen evaluation by
SEM revealed clear dentin surface where some resin
tags had sheared off but remained in the dentinal tu-
bules (Fig. 3), the MM-Seal/Herofill combination may
be viewed as having intermediate bond strength in the
present study when compared with other root canal
sealer and core material combinations. To our knowl-
edge, no study investigating the MM-Seal/Herofill
combination appeared in the literature and so the results
found in the present study could not be compared.
The current study showed that the newly developed
Hybrid Root Seal and Resilon core material combina-
tion had the greatest push-out bond strength of all of the
materials tested. Nevertheless, adhesive strength is only
one aspect of the quality of root canal sealer. Further
investigation of other features of root canal sealers is
required.
REFERENCES
1. Tagger M, Tagger E, Tjan AHL, Bakland LK. Measurement of
adhesion of endodontic sealers to dentin. J Endod 2002;28:351-4.
2. Ørstavik D, Eriksen HM, Beyer-Olsen EM. Adhesive properties
and leakage of root canal sealers in vitro. Int Endod J
1983;16:59-63.
3. Stewart GG. A comparative study of three root canal sealing
agents (Part 1). Oral Surg 1958;11:1029-41.
4. Schäfer E, Zandbiglari T, Schäfer J. Influence of resin-based
adhesive root canal fillings on the resistance to fracture of end-
OOOOE
June 2009
odontically treated roots: an in vitro preliminary study. Oral Surg
Oral Med Oral Pathol Oral Radiol Endod 2007;103:274-9.
5. Hammad M, Qualtrough A, Silikas N. Effect of new obturating
materials on vertical root fracture resistance of endodontically
treated teeth. J Endod 2007;33:732-6.
6. Teixeira FB, Teixeira EC, Thompson JY, Trope M. Fracture
resistance of roots endodontically treated with a new resin filling
material. J Am Dent Assoc 2004;135:646-52.
7. Shipper G, Ørstavik D, Teixeira FB, Trope M. An evaluation of
microbial leakage in roots filled with thermoplastic synthetic
polymer-based root canal filling material (Resilon). J Endod
2004;30:342-7.
8. Shipper G, Teixeira FB, Arnold RR, Trope M. Periapical inflam-
mation after coronal microbial inoculation of dog roots filled
with gutta-percha or Resilon. J Endod 2005;31:91-6.
9. Jia W, Alpert B, inventors. Root canal filling material. Assignee:
Pentron Clinical Technologies, LLC (Wallingford, CT, US). US
patent application 20030113686, June 19, 2003.
10. Carvalho-Junior JR, Guimaraes LF, Correr-Sobrinho L, Pecora
JD, Sousa-Neto MD. Evaluation of solubility, disintegration, and
dimensional alterations of a glass ionomer root canal sealer. Braz
Dent J 2003;14:114-8.
11. Sousa-Neto MD, Passarinho-Neto JG, Carvalho-Junior JR, Cruz-
Filho AM, Pecora JD, Saquy PJ. Evaluation of the effect of
EDTA, EGTA and CDTA on dentin adhesiveness and microleak-
age with different root canal sealers. Braz Dent J 2002;13:123-8.
12. Weller RN, Kimborough WF, Anderson RW. A comparison of
thermoplastic obturation techniques: adaptation to the canal
walls. J Endod 1997;23:703-6.
13. Bowman CJ, Baumgartner JC. Gutta-percha obturation of lateral
grooves and depressions. J Endod 2002;28:220-3.
14. Ungor M, Onay EO, Orucoglu H. Push-out bond strengths: the
Epiphany-Resilon endodontic obturation system compared with
different pairings of Epiphany, Resilon, AH Plus and gutta-
percha. Int Endod J 2006;39:643-7.
15. Prokopenko VM, Mileiko ST. Evaluation of the fibre/matrix
interface strength by the pushing out of fibres of non-symmetri-
cal cross-section. Comp Sci Technol 2001;61:1649-52.
16. Skidmore LJ, Berzins DW, Bahcall JK. An in vitro comparison
of the intraradicular dentin bond strength of Resilon and gutta-
percha. J Endod 2006;32:963-6.
17. Lee BS, Lai EH, Liao KH, Lee CY, Hsieh KH, Lin CP. A novel
polyurethane-based root canal-obturation material and urethane-
acrylate-based root canal sealer-part 2: evaluation of push-out
bond strengths. J Endod 2008;34:594-8.
18. Goracci C, Tavares AU, Fabianelli A, Monticelli F, Raffaelli O,
Cardoso PC, et al. The adhesion between fiber posts and root
canal walls: comparison between microtensile and push-out bond
strength measurements. Eur J Oral Sci 2004;112: 353-61.
19. Gogos C, Economides N, Stavrianos C, Kolokouris I, Kokorikos
I. Adhesion of a new methacrylate resin-based sealer to human
dentin. J Endod 2004;30:238-40.
20. Van Noort R, Cardew GE, Howard IC, Noroozi S. The effect of
local interfacial geometry on the measurement of the tensile bond
strength to dentine. J Dent Res 1991;70:889-93.
21. Watanabe LG, Marshall GW Jr, Marshall SJ. Variables influence
on shear bond strength testing to dentin. In: Tagami J, Toledano
M, Prati C, editors. Advanced adhesive dentistry, Granada Inter-
national Symposium 3-4 December 1999. 1st ed. Como, Italy:
Kuraray Co.; 2000. p. 75-90.
22. Haller B, Hofmann N, Klaiber B, Pfannkuch A. Beständigkeit
des Komposit-Dentinverbundes bei künstlicher Alterung. Deut-
sche Zahnärztliche Zeitschrift 1993;48:100-4.
23. Nakabayashi N. Bonding of restorative materials to dentin: the
present status in Japan. Int Dent J 1985;35:145-54.
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Volume 107, Number 6
24. Leonard JE, Gutmann JL, Guo IY. Apical and coronal seal of
roots obturated with a dentine bonding agent and resin. Int Endod
J 1996;29:76-83.
25. Ahlberg KMF, Tay WM. A methacrylate-based cement used as
a root canal sealer. Int Endod J 1998;31:15-21.
26. Chang JC, Hurst TL, Hart DA, Estey AW. 4-META use in
dentistry: a literature review. J Prosthet Dent 2002;87:216-24.
27. Nakabayashi N, Kojima K, Masuhara E. The promotion of ad-
hesion by the infiltration of monomers into tooth substrates.
J Biomed Mater Res 1982;16:265-73.
28. Nakabayashi N, Ashizawa M, Nakamura M. Identification of
resin-dentin hybrid layer in vital human dentin created in
vivo: durable bonding to vital dentin. Quintessence Int
1992;23:135-41.
29. Lawson MS, Loushine B, Mai S, Weller N, Pashley DH, Tay FR,
et al. Resistance of a 4-META-containing, methacrylate-based
sealer to dislocation in root canals. J Endod 2008;34:833-7.
30. Tay FR, Loushine RJ, Lambrechts P, Weller RN, Pashley DH.
Geometric factors affecting dentin bonding in root canals: a
theoretical modeling approach. J Endod 2005;31:584-9.
31. Torneck CD. Dentin-pulp complex. In: Ten Cate AR, editor. Oral
histology: development, structure, and function. St Louis, MO:
Mosby; 1998. p. 150-96.
32. Jainaen A, Palamara JEA, Messer HH. Push-out bond strengths
of the dentine-sealer interface with and without a main cone. Int
Endod J 2007;40:882-90.
33. Sly MM, Moore BK, Platt JA, Brown CE. Push-out bond
strength of a new endodontic obturation system (Resilon/Epiph-
any). J Endod 2007;33:160-2.
34. Fisher MA, Berzins DW, Bahcall JK. An in vitro comparison of
Onay et al. 885
bond strength of various obturation materials to root canal dentin
using a push-out test design. J Endod 2007;33:856-8.
35. Gesi A, Raffaelli O, Goracci C, Pashley DH, Tay FR, Ferrari M.
Interfacial strength of Resilon and gutta-percha to intraradicular
dentin. J Endod 2005;31:809-13.
36. Ureyen Kaya B, Keçeci AD, Orhan H, Belli S. Micropush-out
bond strengths of gutta-percha versus thermoplastic synthetic
polymer-based systems–an ex vivo study. Int Endod J 2008;41:
211-8.
37. Nagas E, Cehreli ZC, Durmaz V, Vallittu PK, Lassila LV.
Regional push-out bond strength and coronal microleakage of
Resilon after different light-curing methods. J Endod 2007;33:
1464-8.
38. Bouillaguet S, Bertossa B, Krejci I, Wataha JC, Tay FR, Pashley
DH. Alternative adhesive strategies to optimize bonding to ra-
dicular dentin. J Endod 2007;33:1227-30.
39. Gettleman BH, Messer HH, ElDeeb ME. Adhesion of sealer
cements to dentine with and without the smear layer. J Endod
1991;17:15-20.
40. Pecora JD, Cussioli AL, Guerisoli DM, Marchesan MA, Sousa-
Neto MD, Brugnera Junior A. Evaluation of Er:YAG laser and
EDTAC on dentine adhesion of six endodontic sealers. Braz
Dent J 2001;12:27-30.
Reprint requests:
Emel Olga Onay, DDS, PhD
Department of Endodontics
Baskent University School of Dentistry
11. sok. No: 26 06490
Bahcelievler, Ankara, Turkey
eonay@baskent.edu.tr