OBJECTIVES: This study compared the retention of BioAggregate (BA; Innovative BioCeramix) and mineral trioxide aggregate (MTA; Angelus) as coronal plugs after applying different intracanal medications (ICMs) used in regenerative endodontics. MATERIALS AND METHODS: One-hundred human maxillary central incisors were used. The canals were enlarged to a diameter of 1.7 mm. Specimens were divided into 5 groups (n = 20) according to the ICM used: calcium hydroxide (CH), 2% chlorhexidine (CHX), triple-antibiotic paste (TAP), double-antibiotic paste (DAP), and no ICM (control; CON). After 3 weeks of application, ICMs were removed and BA or MTA were placed as the plug material (n = 10). The push-out bond strength and the mode of failure were assessed. The data were analyzed using 2-way analysis of variance, the Tukey's test, and the χ2 test; p values < 0.05 indicated statistical significance. RESULTS: The type of ICM and the type of plug material significantly affected bond strength (p < 0.01). Regardless of the type of ICM, BA showed a lower bond strength than MTA (p < 0.05). For MTA, CH showed a higher bond strength than CON, TAP and DAP; CHX showed a higher bond strength than DAP (p < 0.01). For BA, CH showed a higher bond strength than DAP (p < 0.05). The mode of failure was predominantly cohesive for BA (p < 0.05). CONCLUSIONS: MTA may show better retention than BA. The mode of bond failure with BA can be predominantly cohesive. BA retention may be less affected by ICM type than MTA retention.
Calcium Hydroxide ; Chlorhexidine ; Ciprofloxacin ; Endodontics ; Humans ; Incisor ; Metronidazole ; Miners ; Pemetrexed*

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up.Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1–14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/ antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another.Therefore, further well-designed, larger RCTs are required.

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up.Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1–14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/ antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another.Therefore, further well-designed, larger RCTs are required.