Manisha Sharma, Tony Mathew
Under the conditions of this in vitro study, Biodentine demonstrated significantly greater push-out bond strength, whereas modified bioactive bone cement exhibited significantly greater antimicrobial activity against Enterococcus faecalis. These findings demonstrate distinct mechanical and antimicrobial properties of the two materials but should not be interpreted as evidence of clinical superiority. Further studies evaluating biocompatibility, sealing ability, long-term material behavior, and in vivo performance are required before the clinical applicability of modified bioactive bone cement can be established.
INTRODUCTION: The long-term success of endodontic microsurgery depends on the use of root-end filling materials that provide effective apical sealing while preventing microbial leakage. An ideal retrograde filling material should possess excellent bond strength, biocompatibility, and antimicrobial properties. Biodentine has demonstrated favorable biological and mechanical properties. However, modified bioactive bone cement incorporating mineral trioxide aggregate (MTA) and gentamicin may offer enhanced antibacterial performance. This study compared the push-out bond strength and antimicrobial efficacy of Biodentine and modified bioactive bone cement as root-end filling materials.
MATERIALS AND METHODS: This in vitro experimental study included 60 extracted human mandibular premolars, which were randomly allocated into two groups (n=30): Biodentine and modified bioactive bone cement. Standardized root-end cavity preparation was performed following canal instrumentation and obturation. Push-out bond strength was evaluated using a universal testing machine, while antimicrobial efficacy against Enterococcus faecalis was assessed using the agar diffusion method by measuring the zone of inhibition. Data normality was assessed using the Shapiro-Wilk test, and intergroup comparisons were performed using independent-samples t-tests with Welch's correction where appropriate. Statistical significance was established at p<0.05.
RESULTS: Biodentine demonstrated significantly greater push-out bond strength than modified bioactive bone cement (p<0.001). Conversely, modified bioactive bone cement exhibited significantly greater antimicrobial efficacy against Enterococcus faecalis than Biodentine (p<0.001). Both comparisons demonstrated large effect sizes, indicating clinically relevant differences between the two materials. These findings suggest that each material possesses distinct advantages in terms of mechanical retention and antibacterial performance.
CONCLUSION: Under the conditions of this in vitro study, Biodentine demonstrated significantly greater push-out bond strength, whereas modified bioactive bone cement exhibited significantly greater antimicrobial activity against Enterococcus faecalis. These findings demonstrate distinct mechanical and antimicrobial properties of the two materials but should not be interpreted as evidence of clinical superiority. Further studies evaluating biocompatibility, sealing ability, long-term material behavior, and in vivo performance are required before the clinical applicability of modified bioactive bone cement can be established.