University of Oulu

R.M. Lindblad, L.V.J. Lassila, P.K. Vallittu, L. Tjäderhane, The effect of chlorhexidine and dimethyl sulfoxide on long-term sealing ability of two calcium silicate cements in root canal, Dental Materials, Volume 37, Issue 2, 2021, Pages 328-335, ISSN 0109-5641,

The effect of chlorhexidine and dimethyl sulfoxide on long-term sealing ability of two calcium silicate cements in root canal

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Author: Lindblad, R. M.1; Lassila, L. V. J.2; Vallittu, P. K.2,3;
Organizations: 1City of Helsinki Health Centre, University Dental Clinic, Helsinki, Finland
2Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
3City of Turku, Welfare Division, Turku, Finland
4Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland, Research Unit of Oral Health Sciences, and Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2022-02-28


Objectives: To evaluate the long-term effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) on the sealing ability and biomineralization of two different calcium silicate cements (CSC) in root canal.

Methods: Sixty human third molar root canals were obturated with ProRoot MTA or Biodentine. Before obturation the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage was tested after three days and after six months. After additional six months (12 months after root filling) the roots were cut into 2 mm thick dentine discs. The discs were stored in artificial saliva for one year. The bond strength was measured with the push-out method, and the failure mode was evaluated with a stereomicroscope. The most apical disc of each tooth was used for Vickers hardness test.

Results: No significant differences between the groups was found in initial microleakage. The leakage increased significantly during the 6-month storage in all groups except in Biodentine-CHX group and Biodentine-DMSO group. CHX and DMSO irrigation significantly increased the leakage with ProRoot MTA with time, but there was no statistically significant difference compared to the ProRoot MTA-control group at six months’ time point. CHX significantly reduced the push-out bond strength of ProRoot MTA. With Biodentine irrigation with CHX or DMSO resulted with significantly higher push-out strength compared to the Biodentine control group. Fracture analysis showed statistically significant difference in the distribution of the fractures between the groups, but neither CHX nor DMSO change the fracture pattern statistically significantly. With Vickers hardness test ProRoot MTA with and without DMSO as the final irrigant showed significantly higher dentin hardness than any Biodentine-group.

Significance: Considering that aging increased the leakage in all groups except with Biodentine-DMSO and the differences in the push-out strength and surface microhardness data, it appears that the time-related biomineralizing effect of MTA and Biodentine does not improve sealing to dentin. CHX significantly reduced ProRoot MTA bond strength and increased pure adhesive failures with both cements.

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Series: Dental materials
ISSN: 0109-5641
ISSN-E: 1879-0097
ISSN-L: 0109-5641
Volume: 37
Issue: 2
Pages: 328 - 335
DOI: 10.1016/
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: This work was supported by VTR funding of Helsinki University Hospital and Oulu University Hospital to LT.
Copyright information: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license by