Effect of blood contamination and various hemostatic procedures on the push-out bond strength of Biodentine when used for furcation perforation repair

Background: Perforations in the furcation area are common procedural accidents that can impact the outcome of treatment. There are many bioactive materials available to repair these defects. Aim: The purpose of this study was to determine and compare the effect of 25% aluminum chloride solution, 20% ferric sulfate solution, and a 980-nm diode laser, when used for hemostasis, on the dislocation resistance of Biodentine placed to repair furcation perforation. Materials and Methods: This in vitro study was conducted on fifty extracted human permanent mandibular molars, with ten teeth in each group. The stimulated perforations were contaminated with blood, except for one group. The contaminated groups were either treated with aluminum chloride, ferric sulfate, diode laser, or none at all. All the perforations were restored with Biodentine and tested for push-out bond strength. Statistical Analysis Used: One-way analysis of variance and Tukey's HSD post hoc test were applied with a level of significance set at 0.05. Results: The dislocation resistance of Biodentine was found to be highest when aluminum chloride or diode laser was used for arresting bleeding. In contrast, the ferric sulfate group gave the lowest value for push-out bond strength (P < 0.05). Conclusions: According to the present study, the use of ferric sulfate as a hemostatic agent showed a negative effect on the bond strength of the calcium silicate cement to dentin. Furthermore, Biodentine performed better when diode laser and aluminum chloride were used for hemostasis.