An in vitro evaluation of endodontic sealers and an antibiotic to assess their antimicrobial effect against Enterococcus faecalis

Elizabeth Madla-Cruz; Vanascheck Dasaev Villanueva-Pérez; Myriam A. De la Garza-Ramos; Jorge Jaime Flores-Treviño; Idalia Rodríguez-Delgado; Fanny  López-Martinez

doi:10.2340/biid.v11.40646

Authors

Elizabeth Madla-Cruz Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
Vanascheck Dasaev Villanueva-Pérez Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
Myriam A. De la Garza-Ramos Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
Jorge Jaime Flores-Treviño Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
Idalia Rodríguez-Delgado Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
Fanny López-Martinez Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460

DOI:

https://doi.org/10.2340/biid.v11.40646

Keywords:

Amoxicillin, antimicrobial, endodontics, Enterococcus faecalis, direct contact test, root canal sealers

Abstract

Objective
This study aimed to compare the antimicrobial effect of three endodontic sealers (AH Plus, Mineral trioxide aggregate [MTA] Fillapex, and BioRoot RCS) with and without amoxicillin against E. faecalis.

Methodology
Amoxicillin, equivalent to 10% of the sealers’ total weight, was mixed with the sealers. Another batch was prepared without amoxicillin. The direct contact test (DCT) and the agar diffusion test were used to assess the antibacterial effect. Results were analysed using one-way analysis of variance (ANOVA), the F-test, and the Kruskal-Wallis test.

Results
AH Plus significantly suppressed E. faecalis without the addition of amoxicillin in the DCT (p = 0.011), while in the agar diffusion test, BioRoot RCS had a larger inhibition zone than the control (p < 0.001). When amoxicillin was added to the sealers, AH Plus (p = 0.003) and MTA Fillapex (p = 0.042) reduced E. faecalis growth. In contrast, all three sealers showed larger inhibition zones than the control (p = 0.001), with AH Plus displaying a larger inhibition zone than MTA Fillapex (p = 0.042) and BioRoot RCS (p = 0.032).

Conclusions
It was thus concluded that the addition of amoxicillin to endodontic sealers enhances their antimicrobial activity against E. faecalis.

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References

Wang Z, Shen Y, Haapasalo M. Antimicrobial and antibiofilm properties of bioceramic materials in endodontics. Materials (Basel). 2021;14(24):7594. https://doi.org/10.3390/ma14247594 DOI: https://doi.org/10.3390/ma14247594

Chandra S. Grossman’s endodontic practice. Wolters Kluwer India Pvt Ltd; 2014. India.

Fabricius L, Dahlén G, Sundqvist G, Happonen RP, Möller AJR. Influence of residual bacteria on periapical tissue healing after chemomechanical treatment and root filling of experimentally infected monkey teeth. Eur J Oral Sci. 2006;114(4):278–85. https://doi.org/10.1111/j.1600-0722.2006.00380.x DOI: https://doi.org/10.1111/j.1600-0722.2006.00380.x

Möller AJR, Fabricius L, Dahlén G, Sundqvist G, Happonen RP. Apical periodontitis development and bacterial response to endodontic treatment. Experimental root canal infections in monkeys with selected bacterial strains. Eur J Oral Sci. 2004;112(3):207–15. https://doi.org/10.1111/j.1600-0722.2004.00135.x DOI: https://doi.org/10.1111/j.1600-0722.2004.00135.x

Rôças IN, Siqueira JF, Santos KRN. Association of Enterococcus faecalis with different forms of periradicular diseases. J Endod. 2004;30(5):315–20. https://doi.org/10.1097/00004770-200405000-00004 DOI: https://doi.org/10.1097/00004770-200405000-00004

Siqueira JF, Rôças IN. Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):85–94. https://doi.org/10.1016/S1079-2104(03)00353-6 DOI: https://doi.org/10.1016/S1079-2104(03)00353-6

Persoon IF, Özok AR. Definitions and epidemiology of endodontic infections. Curr Oral Health Rep. 2017;4(4):278–85. https://doi.org/10.1007/s40496-017-0161-z DOI: https://doi.org/10.1007/s40496-017-0161-z

Peters OA, Boessler C, Paqué F. Root canal preparation with a novel nickel-titanium instrument evaluated with micro-computed tomography: canal surface preparation over time. J Endod. 2010;36(6):1068–72. https://doi.org/10.1016/j.joen.2010.02.023 DOI: https://doi.org/10.1016/j.joen.2010.02.023

Wang Z, Shen Y, Haapasalo M. Dental materials with antibiofilm properties. Dent Mater. 2014;30(2):e1–16. https://doi.org/10.1016/j.dental.2013.12.001 DOI: https://doi.org/10.1016/j.dental.2013.12.001

Rahimi S, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014;9(3):161–8.

Abusrewil SM, McLean W, Scott JA. The use of Bioceramics as root-end filling materials in periradicular surgery: a literature review. Saudi Dent J. 2018;30(4):273–82. https://doi.org/10.1016/j.sdentj.2018.07.004 DOI: https://doi.org/10.1016/j.sdentj.2018.07.004

Wang Z. Bioceramic materials in endodontics. Endodontic Topics. 2015;32(1):3–30. https://doi.org/10.1111/etp.12075 DOI: https://doi.org/10.1111/etp.12075

Torabinejad M, Parirokh M. Mineral trioxide aggregate: a comprehensive literature review – part II: leakage and biocompatibility investigations. J Endod. 2010;36(2):190–202. https://doi.org/10.1016/j.joen.2009.09.010 DOI: https://doi.org/10.1016/j.joen.2009.09.010

Gopikrishna V, Kandaswamy D, Jeyavel RK. Comparative evaluation of the antimicrobial efficacy of five endodontic root canal sealers against Enterococcus faecalis and Candida albicans. J Conserv Dent. 2006;9(1):2. https://doi.org/10.4103/0972-0707.41303 DOI: https://doi.org/10.4103/0972-0707.41303

Marín-Bauza GA, et al. Physicochemical properties of endodontic sealers of different bases. J Appl Oral Sci. 2012;20(4):455–61. https://doi.org/10.1590/S1678-77572012000400011 DOI: https://doi.org/10.1590/S1678-77572012000400011

Nunes VH, Silva RG, Alfredo E, Sousa-Neto MD, Silva-Sousa YTC. Adhesion of Epiphany and AH Plus sealers to human root dentin treated with different solutions. Braz Dent J. 2008;19(1):

–50. https://doi.org/10.1590/S0103-64402008000100008 DOI: https://doi.org/10.1590/S0103-64402008000100008

Kuga MC, de Campos EA, Hernandez-Viscardi P, Zapparoli-Carrilho P, Castilho-Xaviér F, Pereira-Silvestre N. Hydrogen ion and calcium releasing of MTA Fillapex® and MTA-based formulations. RSBO Revista Sul-Brasileira de Odontologia. 2011;8(3):271–6. https://doi.org/10.21726/rsbo.v8i3.1070 DOI: https://doi.org/10.21726/rsbo.v8i3.1070

Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review – Part I: chemical, physical, and antibacterial properties. J Endod. 2010;36(1):16–27. https://doi.org/10.1016/j.joen.2009.09.006 DOI: https://doi.org/10.1016/j.joen.2009.09.006

Reszka P, Nowicka A, Lipski M, Dura W, Droździk A, Woźniak K. A comparative chemical study of calcium silicate-containing and Epoxy Resin-based root canal sealers. Biomed Res Int. 2016;2016:9808432. https://doi.org/10.1155/2016/9808432 DOI: https://doi.org/10.1155/2016/9808432

Baer J, Maki JS. In vitro evaluation of the antimicrobial effect of three endodontic sealers mixed with amoxicillin. J Endod. 2010;36(7):1170–3. https://doi.org/10.1016/j.joen.2010.03.033 DOI: https://doi.org/10.1016/j.joen.2010.03.033

Hoelscher AA, Bahcall JK, Maki JS. In vitro evaluation of the antimicrobial effects of a root canal sealer-antibiotic combination against Enterococcus faecalis. J Endod. 2006;32(2):145–7. https://doi.org/10.1016/j.joen.2005.10.031 DOI: https://doi.org/10.1016/j.joen.2005.10.031

Segura-Egea JJ, et al. Antibiotics in Endodontics: a review. Int Endod J. 2017;50(12):1169–1184. https://doi.org/10.1111/iej.12741 DOI: https://doi.org/10.1111/iej.12741

Pinheiro ET, Gomes BPFA, Drucker DB, Zaia AA, Ferraz CCR, Souza-Filho FJ. Antimicrobial susceptibility of Enterococcus faecalis isolated from canals of root filled teeth with periapical lesions. Int Endod J. 2004;37(11):756–63. https://doi.org/10.1111/j.1365-2591.2004.00865.x DOI: https://doi.org/10.1111/j.1365-2591.2004.00865.x

Bansal R, Jain A. Overview on the current antibiotic containing agents used in endodontics. N Am J Med Sci. 2014;6(8):351–8. https://doi.org/10.4103/1947-2714.139277 DOI: https://doi.org/10.4103/1947-2714.139277

Weiss EI, Shalhav M, Fuss Z. Assessment of antibacterial activity of endodontic sealers by a direct contact test. Endod Dent Traumatol. 1996;12(4):179–84. https://doi.org/10.1111/j.1600-9657.1996.tb00511.x DOI: https://doi.org/10.1111/j.1600-9657.1996.tb00511.x

Arora S, Mir S, Gautam A, Batra R, Soni S, Lata K. Evaluation of antimicrobial efficacy of root canal sealers against Enterococcus faecalis: a comparative study. J Contemp Dent Pract. 2018;19(6):680–3. https://doi.org/10.5005/jp-journals-10024-2319 DOI: https://doi.org/10.5005/jp-journals-10024-2319

Moreno Villagrana AP, Gomez Clavel JFG. Terapia antibiótica en odontología de práctica general. Revista ADM. 2012;64(4):168–75.

Arias-Moliz MT, Ferrer-Luque CM, González-Rodríguez MP, Navarro-Escobar E, de Freitas MFA, Baca P. Antimicrobial activity and Enterococcus faecalis biofilm formation on chlorhexidine varnishes. Med Oral Patol Oral Cir Bucal. 2012;17(4):e705–9. https://doi.org/10.4317/medoral.17680 DOI: https://doi.org/10.4317/medoral.17680

Castillo-Villagomez P, et al. Antimicrobial effectiveness of root canal sealers against Enterococcus faecalis. Biomater Investig Dent. 2022;9(1):47–51. https://doi.org/10.1080/26415275.2022.2071719 DOI: https://doi.org/10.1080/26415275.2022.2071719

Kapralos V, Koutroulis A, Ørstavik D, Sunde PT, Rukke HV. Antibacterial activity of Endodontic Sealers against Planktonic Bacteria and bacteria in biofilms. J Endod. 2018;44(1):149–54. https://doi.org/10.1016/j.joen.2017.08.023 DOI: https://doi.org/10.1016/j.joen.2017.08.023

Huang Y, et al. The in vitro antimicrobial activities of four endodontic sealers. BMC Oral Health. 2019;19(1):118. https://doi.org/10.1186/s12903-019-0817-2 DOI: https://doi.org/10.1186/s12903-019-0817-2

Kangarlou A, Neshandar R, Matini N, Dianat O. Antibacterial efficacy of AH Plus and AH26 sealers mixed with amoxicillin, triple antibiotic paste and nanosilver. J Dent Res Dent Clin Dent Prospects. 2016;10(4):220–5. https://doi.org/10.15171/joddd.2016.035 DOI: https://doi.org/10.15171/joddd.2016.035

Jiao Y, Tay FR, Niu LN, Chen JH. Advancing antimicrobial strategies for managing oral biofilm infections. Int J Oral Sci. 2019;11(3):28. https://doi.org/10.1038/s41368-019-0062-1 DOI: https://doi.org/10.1038/s41368-019-0062-1