Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#calcium-hydroxide #root-canal-filling-materials #dental-bonding #materials-testing #calcium-compounds

Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis

Alhajj et al., 2022 | J Esthet Restor Dent | Meta Analysis

Citation

Alhajj Mohammed Nasser, Daud Fadhilah, ... Ariffin Zaihan. Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis. J Esthet Restor Dent. 2022-Dec;34(8):1166-1178. doi:10.1111/jerd.12974

Abstract

OBJECTIVE: To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. METHODS: A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05. RESULTS: A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias. CONCLUSION: The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers. CLINICAL SIGNIFICANCE: The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.

Key Findings

A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 26
Age Range See abstract
Condition See abstract

MeSH Terms

  • Calcium Hydroxide
  • Root Canal Filling Materials
  • Dental Bonding
  • Materials Testing
  • Calcium Compounds
  • Silicates

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article, Research Support, Non-U.S. Gov't
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09