A STUDY TO ASSESS THE ANTIBACTERIAL PROPERTY OF FIVE ENDODONTIC SEALERSHTML Full Text
A STUDY TO ASSESS THE ANTIBACTERIAL PROPERTY OF FIVE ENDODONTIC SEALERS
M. Meenakshi * and N. P. Muralidharan
Department of Microbiology, Saveetha Dental College, Chennai- 600077, Tamil Nadu, India.
ABSTRACT: Aim: The study aims to analyze the antibacterial property of various endodontic sealers against Streptococcus mutans and Enterococcus faecilis. Objective: Pulpal tissues are frequently infected by bacteria and are considered to be the commonest etiological agents of pulpal necrosis and periapical lesions, which needs endodontic treatment for its cure. Microorganisms play an important role in endodontic failures, which is commonly due to incomplete elimination of bacteria from the canal or due to the recolonization of bacteria by leakages. Thus it becomes important for the sealers to have antibacterial property. To make long-lasting restorations, the materials should be made antibacterial. The objective of this study is to check for the antibacterial property of the restorative sealers. Methodology: The antimicrobial activity of five endodontic sealers (zinc oxide eugenol, amalgam, light cure composite, calcium hydroxide, and glass ionomer) was assessed against Enterococcus faecilis and Streptococcus mutans using the agar diffusion method. Reason: Microorganisms being the commonest reason for endodontic treatment failure, endodontic sealers should possess an antimicrobial property.
Keywords: Sealers, Endodontic failure, Recolonization, Antimicrobial property
INTRODUCTION: Secondary caries is the major factor that influences the longevity of dental restorations 1, 2, 3, 4. Microorganisms may also be present beneath a restoration as a result of microleakage or incomplete removal of caries during tooth preparation 5. Secondary caries is found to be the main reason for the restoration failure of dental restoratives, including resin composites and glass-ionomer cement 6, 7, 8, 9. To make long-lasting restorations, the materials should be antimicrobial 10. This can be achieved by instrumentation, irrigation, and intra-canal medication.
Endodontic sealers are also known to have inherent antibacterial activity, which may help to control the population of micro-organisms 11. Although bacteria superficially adhering to root canal dentin might be more easily killed than those protected in the depths of dentinal tubules, bacteria inside the dentinal tubules might also be affected by antibacterial components leaching from the irrigation solution, intracanal medication, and endodontic filling and sealing materials 12.
The ultimate goal of root canal therapy might be considered to be the complete elimination of all microorganisms from the root canal system. Unfortunately, this appears to be impossible in typical clinical situations 13. However, the use of endodontic sealers with antibacterial properties may help in reducing the number of infecting microorganisms and in eradicating infection 14. Antimicrobial properties are desirable in endodontic sealers as the sealer is likely to come in direct contact with any microorganisms remaining in the dentinal tubules and undebrided parts of the root canal system 15. The success of endodontic treatment depends on eliminating the microorganisms from the root canal and also by preventing them from re-entering the canal system.
Microorganisms play an important role in endodontic failures, which is commonly due to incomplete elimination of bacteria from the canal or due to the recolonization of bacteria by leakages. Cleansing and obturation of the root canal eliminates any pre-existing infection and provide a “hermetic seal” that is desired to prevent the bacteria from penetrating the apical tissue. The cavity is then restored using sealers to prevent leakage. The high success rate of endodontically treated teeth despite the presence of bacterial leakage along the obturated root canal emphasizes the importance of coronal seal. A study found that only 8.6% of the failures were caused by endodontic causes, 59.4% of failures were a restorative failure, and 32% of failures were periodontal. This study aims to evaluate the antimicrobial property of three major restorative sealers - the light-cured composite, glass ionomer cement, amalgam.
MATERIALS AND METHODS: The study analyzes the antibacterial activity of five major endodontic sealers against Streptococcus mutans and Enterococcus faecilis by agar diffusion method. The five endodontic sealers used in this study were zinc oxide eugenol, Glass ionomer cement, light cure composite, amalgam, and calcium hydroxide. Five pure cultures of Enterococcus faecilis and Streptococcus mutans were made in a Nutrient agar in which five wells each was made. The endodontic sealers were mixed according to its manufacturer's guidelines and were inoculated into the wells of both Enterococcus faecilis and Streptococcus mutans. The plates were incubated at 37 ºC for 24 h after which the zone of inhibition was measured in millimeter, and a standard mean value of each was calculated.
RESULTS: The study shows that all the endodontic sealers used in this study except light cure composite have an effective antibacterial activity against both the organisms. The mean diameters of zones of inhibition of 5 endodontic sealers are tabulated above. However, zinc oxide eugenol and amalgam showed the highest antibacterial activity against S. mutans and Enterococcus, respectively, whereas comparatively, light cure composite shows no antibacterial activity.
TABLE 1: FIG. 1: COMPARING THE EFFICACY OF ENDODONTIC SEALERS AGAINST STREPTOCOCCUS MUTANS AND ENTEROCOCCUS
|Zone of Inhibition
In E. faecilis
|Zone of Inhibition in S. Mutans
|Zinc oxide eugenol||19.8||30|
|Glass ionomer cement||20||12.5|
FIG. 1: COMPARING THE EFFICACY OF ENDODONTIC SEALERS AGAINST STREPTOCOCCUS MUTANS AND ENTEROCOCCUS (Zone size measured in mm)
DISCUSSION AND CONCLUSION: Microbes are considered to be the primary etiologic agents in endodontic diseases. Anaerobic bacteria may be especially well adapted to survive in the environment of necrotic pulp and in dentinal tubules in which the supply of blood and oxygen is limited 16. E. faecalis and S. mutans, a common isolate from infected root canals, has been used in numerous studies of antibacterial properties. Therefore, E. faecalis and S. mutans were preferred in this study, and antibacterial properties of the five endodontic sealers were evaluated by agar diffusion method 17, 18. Agar diffusion method is one of the most often used methods to assess the antibacterial activity of dental materials 19, 20. The agar diffusion assay is one method for quantifying the ability of antibiotics to inhibit bacterial growth. Interpretation of results from this assay relies on model-dependent analysis, which is based on the assumption that antibiotics diffuse freely in the solid nutrient medium 21. However, several limitations should be noted, such as lack of standardization of inoculums density, adequate culture medium, agar viscosity, plate-storage condition, size and number of specimens per plate, and time and temperature of incubation 22. Numerous root canal sealers are available, which are based on various formulas. The ideal root canal sealer should be inert, dimensionally stable, and possess good antimicrobial activity and low toxicity toward the surrounding tissue 23.
In this study, amalgam, glass ionomer cement, zinc oxide eugenol, calcium hydroxide, and light cure composite were used to assess the antibacterial property. Different results were obtained from the ADT of different root-canal sealers. More than one assaying method can be used in the process of evaluating antibacterial properties of dental materials to compare the results in further studies.
CONFLICT OF INTEREST: Nil
- Mjo ̈ r IA and Toffenetti F. Placement and replacement of amalgam restorations in Italy. Oper Dent 1992; 17: 70-73.
- Mjo ̈r IA: The reasons for replacement and the age of failed restorations in general dental practice. Acta Odontol Scand 1997; 55: 58-63.
- Mjo ̈r IA and Qvist V: Marginal failures of amalgam and composite resin restorations: 8-year findings. J Dent 1998; 26: 311-317.
- Mjo ̈r IA, Shen C, Eliasson ST and Richter S: Placement and replacement of restorations in dental practice in Iceland. Oper Dent 2002; 27: 117-123.
- De Schepper EJ, Thrasher MR and Thurmond BA: Antibacterial effects of light-cured liners. Am J Dent 1989; 2: 74-76.
- Barkhordar RA, Kempler D, Pelzner RRB and Stark MM: Antimicrobial action of glass-ionomer lining cement on sanguis and S. mutans. Dent Mater 1989; 5: 281-82.
- Forss and E. Widstrom: Reasons for Restorative therapy and longevity of restorations in adults. Acta Odontologica Scandinavica 2004; 62(2): 82-86.
- Manhart J, Garcia-Godoy F and Hickel R: Direct Posterior Restorations: Clinical results and new developments. Dental Clinics of North America 2002; 46(2): 303-339. doi:10.1016/S0011-8532(01)00010-6
- Deligeorgi V, Mjor IA and Wilson NH: An overview of reasons for the placement and replacement of restorations. Primary Dental Care 2001; 8(1): 5-11. doi:10.1308/13557 6101771799335
- Craig RG and Power JM: Restorative dental materials. Mosby-Year Book Inc., St Louis, Edition 11th, 2002.
- Zhang H, Shen Y, Dorin Ruse N and Haapasalo M: Antibacterial activity of endodontic sealers by modified direct contact test against Enterococcus faecalis. Journal of Endodontics 2009; 35: 1051-5.
- Kayaoglu G, Erten H, Alaçam T and Ørstavik D: Short-term antibacterial activity of root canal sealers towards Enterococcus faecalis. Int Endod J 2005; 38: 483- 488
- Sundqvist G, Figdor D, Persson S and Sjogren U: Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 1998; 85: 86-93.
- Grossman L: Antimicrobial effect of root canal cement. Journal of Endodontics 1980; 6: 594-7.
- Nair PN, Henry S, Cano V and Vera J: Microbial status of the apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 2005; 99: 231-52.
- Lai CC, Huang FM and Yang HW: Antimicrobial activity of four root canal sealers against endodontic pathogens. Clin Oral Investig 2001; 5: 236-9.
- Chong BS, Owadally ID, Pitt Ford TR and Wilson RF: Antibacterial activity of potential retrograde root filling materials. Endod Dent Traumatol 1994; 10: 66-70.
- Fuss Z, Weiss EI and Shalhav M: Antibacterial activity of calcium hydroxide containing endodontic sealers on faecalis in-vitro. Int Endod J 1997; 30: 397-402.
- Al-Khatib ZZ, Baum RH, Morse DR, Yesilsoy C, Bhambhani S and Furst ML: The antimicrobial effect of various endodontic sealers. Oral Surg Oral Med Oral Pathol 1990; 70: 784-90.
- Weiss E, Shalhav M and Fuss Z: Assessment of antibacterial activity of endodontic sealers by a direct contact test. Endod Dent Traumatol 1996; 12: 179-84.
- Bonev B, Hooper J and Parisot J: Principles of assessing bacterial susceptibility to antibiotics using the agar diffusion method. Journal of Antimicrobial Chemotherapy 2008; 61(6): 1295-1301.
- Pumarola J, Berastegui E, Brau E, Canalda C and Jimenez de Anta MT: Antimicrobial activity of seven root canal sealers. Results of agar diffusion and agar dilution tests Oral Surg Oral Med Oral Pathol 1992; 74: 216-20.
- slutzky-goldberg I, Slutzky H, Solomonov M, Moshonov J, Weiss E and Matalon S: Antibacterial properties of four endodontic sealers. Journal of Endodontics 2008; 34(6): 735-738. Doi: 10.1016/j.joen.2008.03.012.
How to cite this article:
Meenakshi M and Muralidharan NP: A study to assess the antibacterial property of five endodontic sealers. Int J Life Sci & Rev 2015; 1(12): 326-28. doi: 10.13040/IJPSR.0975-8232.IJLSR.1(12).326-28.
All © 2015 are reserved by International Journal of Life Sciences and Review. This Journal licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
M. Meenakshi* and N. P. Muralidharan
Department of Microbiology, Saveetha Dental College, Chennai, Tamil Nadu, India.
10 November 2015
20 December 2015
26 December 2015
31 December 215