{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T21:44:02Z","timestamp":1774907042995,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>A proper bond between root canal filling materials and dentin surface is essential to resist dislodgement and guarantee long-term success. Blood exposure is likely to occur in various clinical situations in which calcium silicate-based materials are used; therefore, it is fundamental to render data concerning the influence of blood on bond strength. The present study aims to evaluate the effect of blood contamination on the push-out bond strength obtained with three different biomaterials to root canal dentin; Ninety extracted human mono-radicular permanent teeth were selected. The root canals were prepared with Gates Glidden burs until a diameter of 1.10 mm was achieved. Teeth were then randomly divided into six experimental groups (n = 15) according to the presence\/absence of blood contamination and biomaterial used for root canal filling (ProRoot\u00ae MTA, BiodentineTM, and TotalFill\u00ae BC Putty). After one week, each root was sectioned in three segments (coronal, middle, and apical regions). Specimens were then submitted to push-out bond strength tests. Fracture pattern evaluation was performed. The significance level was set at 5%.; Blood contamination did not affect the push-out bond strength of any of the three tested calcium silicate-based cements (p &gt; 0.05). Regardless of blood contamination, TotalFill showed statistically higher push-out bond strength when compared with Biodentine (p = 0.040) and MTA (p = 0.004). Biodentine exhibited higher bond strength than MTA (p = 0.043). Biomaterials\u2019 comparison within each radicular segment revealed statistically superior bond strength of both Biodentine and TotalFill over MTA (p &lt; 0.05) in the coronal segment. TotalFill presented higher push-out bond strength regarding the apical segment compared to Biodentine (p = 0.003). Fractures were mostly adhesive.; Overall results indicate TotalFill presents the highest push-out bond strength values, followed by Biodentine and, lastly, MTA. Blood contamination did not affect the dislodgement resistance. Biomaterials\u2019 comparison within each radicular segment revealed both TotalFill and Biodentine as the preferable alternatives for application in the coronal region. TotalFill might be the biomaterial of choice for placement in the apical region.<\/jats:p>","DOI":"10.3390\/app11156849","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T04:19:30Z","timestamp":1627273170000},"page":"6849","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Influence of Blood Contamination on Push-Out Bond Strength of Three Calcium Silicate-Based Materials to Root Dentin"],"prefix":"10.3390","volume":"11","author":[{"given":"Cristina Rodrigues","family":"Paulo","sequence":"first","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-6155","authenticated-orcid":false,"given":"Joana A.","family":"Marques","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Diana B.","family":"Sequeira","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9260-2361","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Diogo","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Rui","family":"Paiva","sequence":"additional","affiliation":[{"name":"Polytechnic of Leiria, 2411-901 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4730-8072","authenticated-orcid":false,"given":"Paulo J.","family":"Palma","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2865-9689","authenticated-orcid":false,"given":"Jo\u00e3o Miguel","family":"Santos","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"ref_1","first-page":"S128","article-title":"Bioceramics in endodontics\u2014A review","volume":"51","author":"Raghavendra","year":"2017","journal-title":"J. Istanb. Univ. Fac. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2334\/josnusd.18-0145","article-title":"Biocompatibility of a bioceramic silicone-based sealer in subcutaneous tissue","volume":"61","author":"Santos","year":"2019","journal-title":"J. Oral Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/j.1365-2591.2010.01848.x","article-title":"The impact of root dentine conditioning on sealing ability and push-out bond strength of an epoxy resin root canal sealer","volume":"44","author":"Neelakantan","year":"2011","journal-title":"Int. Endod. J."},{"key":"ref_4","first-page":"196","article-title":"Effect of Blood Exposure on Push-Out Bond Strength of Four Calcium Silicate Based Cements","volume":"12","author":"Bolhari","year":"2017","journal-title":"Iran. Endod. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.joen.2013.10.023","article-title":"Periapical inflammation subsequent to coronal inoculation of dog teeth root filled with resilon\/epiphany in 1 or 2 treatment sessions with chlorhexidine medication","volume":"40","author":"Santos","year":"2014","journal-title":"J. Endod."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dawood, A.E., Parashos, P., Wong, R.H.K., Reynolds, E.C., and Manton, D.J. (2017). Calcium silicate-based cements: Composition, properties, and clinical applications. J. Investig. Clin. Dent., 8.","DOI":"10.1111\/jicd.12195"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5395\/rde.2015.40.1.1","article-title":"Current perspectives of bio-ceramic technology in endodontics: Calcium enriched mixture cement-review of its composition, properties and applications","volume":"40","author":"Utneja","year":"2015","journal-title":"Restor. Dent. Endod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.joen.2009.09.006","article-title":"Mineral trioxide aggregate: A comprehensive literature review\u2014Part I: Chemical, physical, and antibacterial properties","volume":"36","author":"Parirokh","year":"2010","journal-title":"J. Endod."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Santos, J.M., Pereira, J.F., Marques, A., Sequeira, D.B., and Friedman, S. (2021). Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes. Medicina, 57.","DOI":"10.3390\/medicina57060573"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Palma, P.J., Martins, J., Diogo, P., Sequeira, D., Ramos, J.C., Diogenes, A., and Santos, J.M. (2019). Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures?. Appl. Sci., 9.","DOI":"10.3390\/app9193942"},{"key":"ref_11","first-page":"247","article-title":"Mineral trioxide aggregate (MTA): Its history, composition, and clinical applications","volume":"36","author":"Tawil","year":"2015","journal-title":"Compend. Contin. Educ. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.joen.2009.09.009","article-title":"Mineral trioxide aggregate: A comprehensive literature review\u2014Part III: Clinical applications, drawbacks, and mechanism of action","volume":"36","author":"Parirokh","year":"2010","journal-title":"J. Endod."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pinto, D., Marques, A., Pereira, J.F., Palma, P.J., and Santos, J.M. (2020). Long-Term Prognosis of Endodontic Microsurgery-A Systematic Review and Meta-Analysis. Medicina, 56.","DOI":"10.3390\/medicina56090447"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Palma, P.J., Marques, J.A., Santos, J., Falacho, R.I., Sequeira, D., Diogo, P., Caramelo, F., Ramos, J.C., and Santos, J.M. (2020). Tooth Discoloration after Regenerative Endodontic Procedures with Calcium Silicate-Based Cements-An Ex Vivo Study. Appl. Sci., 10.","DOI":"10.3390\/app10175793"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/iej.12841","article-title":"Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview\u2014Part I: Vital pulp therapy","volume":"51","author":"Parirokh","year":"2018","journal-title":"Int. Endod. J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Li, Q., Hurt, A.P., and Coleman, N.J. (2019). The Application of Si-29 NMR Spectroscopy to the Analysis of Calcium Silicate-Based Cement using Biodentine (TM) as an Example. J. Funct. Biomater., 10.","DOI":"10.3390\/jfb10020025"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"160951","DOI":"10.1155\/2014\/160951","article-title":"A Review on Biodentine, a Contemporary Dentine Replacement and Repair Material","volume":"2014","author":"Malkondu","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s00784-018-2453-7","article-title":"Properties of calcium silicate-monobasic calcium phosphate materials for endodontics containing tantalum pentoxide and zirconium oxide","volume":"23","author":"Zamparini","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1016\/j.joen.2011.06.022","article-title":"Antibacterial activity of endosequence root repair material and proroot MTA against clinical isolates of Enterococcus faecalis","volume":"37","author":"Lovato","year":"2011","journal-title":"J. Endod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.joen.2010.11.027","article-title":"Cytotoxicity comparison of mineral trioxide aggregates and EndoSequence bioceramic root repair materials","volume":"37","author":"Damas","year":"2011","journal-title":"J. Endod."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Santos, J.M., Marques, J.A., Diogo, P., Messias, A., Sousa, V., Sequeira, D., and Palma, P.J. (2021). Influence of pre-operative pulp inflammation in the outcome of full pulpotomy using a dog model. J. Endod.","DOI":"10.1016\/j.joen.2021.06.018"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.5395\/rde.2019.44.e5","article-title":"The push-out bond strength of BIOfactor mineral trioxide aggregate, a novel root repair material","volume":"44","author":"Akbulut","year":"2019","journal-title":"Restor. Dent. Endod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.joen.2009.10.009","article-title":"The biomineralization ability of mineral trioxide aggregate and Portland cement on dentin enhances the push-out strength","volume":"36","author":"Felippe","year":"2010","journal-title":"J. Endod."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.joen.2012.01.001","article-title":"Effects of various mixing techniques on push-out bond strengths of white mineral trioxide aggregate","volume":"38","author":"Shahi","year":"2012","journal-title":"J. Endod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"370","DOI":"10.4103\/1305-7456.184150","article-title":"Evaluation of the bond strength of root-end placed mineral trioxide aggregate and Biodentine in the absence\/presence of blood contamination","volume":"10","author":"Akcay","year":"2016","journal-title":"Eur. J. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.joen.2005.09.007","article-title":"Effect of blood contamination on retention characteristics of MTA when mixed with different liquids","volume":"32","author":"Vanderweele","year":"2006","journal-title":"J. Endod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1111\/j.1365-2591.2010.01745.x","article-title":"The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate","volume":"43","author":"Nekoofar","year":"2010","journal-title":"Int. Endod. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.joen.2013.01.002","article-title":"Effect of blood contamination on the retention characteristics of two endodontic biomaterials in simulated furcation perforations","volume":"39","author":"Rahimi","year":"2013","journal-title":"J. Endod."},{"key":"ref_29","first-page":"37","article-title":"The effect of blood contamination on the compressive strength of calcium-enriched mixture","volume":"16","author":"Adl","year":"2015","journal-title":"J. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.joen.2012.11.002","article-title":"Limitations of push-out test in bond strength measurement","volume":"39","author":"Chen","year":"2013","journal-title":"J. Endod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1590\/0103-6440201801766","article-title":"Effect of Blood Contamination on The Push-Out Bond Strength of Calcium Silicate Cements","volume":"29","author":"Marquezan","year":"2018","journal-title":"Braz. Dent. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/j.1600-0722.2004.00146.x","article-title":"The adhesion between fiber posts and root canal walls: Comparison between microtensile and push-out bond strength measurements","volume":"112","author":"Goracci","year":"2004","journal-title":"Eur. J. Oral Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/01.DON.0000133155.04468.41","article-title":"Physicochemical basis of the biologic properties of mineral trioxide aggregate","volume":"31","author":"Sarkar","year":"2005","journal-title":"J. Endod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1111\/j.1365-2591.2011.01924.x","article-title":"Uptake of calcium and silicon released from calcium silicate-based endodontic materials into root canal dentine","volume":"44","author":"Han","year":"2011","journal-title":"Int. Endod. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1016\/j.chemosphere.2013.09.052","article-title":"Bioactivity, toxicity and dissipation of hexaconazole enantiomers","volume":"93","author":"Han","year":"2013","journal-title":"Chemosphere"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1007\/s00784-017-2244-6","article-title":"Push-out bond strength of three different calcium silicate-based root-end filling materials after ultrasonic retrograde cavity preparation","volume":"22","author":"Kadic","year":"2018","journal-title":"Clin. Oral Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.dental.2007.02.006","article-title":"Characterization of Ca3SiO5\/CaCl2 composite cement for dental application","volume":"24","author":"Wang","year":"2008","journal-title":"Dent. Mater."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jmbbm.2018.02.029","article-title":"An analysis of crack growth in dentin at the microstructural scale","volume":"81","author":"An","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/0014-5793(83)80160-4","article-title":"Red blood cell targeting to collagen-coated surfaces","volume":"154","author":"Samokhin","year":"1983","journal-title":"FEBS Lett."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.joen.2006.03.004","article-title":"Influence of humidity and setting time on the push-out strength of mineral trioxide aggregate obturations","volume":"32","year":"2006","journal-title":"J. Endod."}],"container-title":["Applied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3417\/11\/15\/6849\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:34:53Z","timestamp":1760164493000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3417\/11\/15\/6849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,26]]},"references-count":40,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["app11156849"],"URL":"https:\/\/doi.org\/10.3390\/app11156849","relation":{},"ISSN":["2076-3417"],"issn-type":[{"value":"2076-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,26]]}}}