Effect of root canal irrigants on push-out bond strength of endodontic sealers: a systematic review

This study aimed to assess root canal irrigants' effect on the bond strength between endodontic sealers and root canal dentin, through a systematic review. The study protocol is available online (https://osf.io/x9tw4/). We selected studies considering the effects of root canal irrigants on sealer bond strength and comparing the influence of such agents used during the endodontic treatment and/or at final irrigation. The search was performed in the PubMed and Scopus databases. The screening was performed by two independent researchers. Data were extracted by one researcher and verified by another. A descriptive analysis was performed. A total of 39 studies were included. The majority demonstrated that using some irrigant substances such as ethylenediaminetetraacetic acid, maleic acid, phosphoric acid, and peracetic acid could improve, or at least not damage, the push-out bond strength. In opposition, a decrease in this outcome was observed when using only sodium hypochlorite or saline solution. The use of irrigant substances capable of demineralizing the surface of root canal dentin and/or removing the remnant smear layer seems to enhance, or, at least, does not compromise the push-out bond strength of the sealer to root dentin.