Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ

Abstract

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth -zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer -against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1% chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37 o C for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (α=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1% CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains commonly found in endodontic infections can be presented in a decreasing order of efficacy as follows: ZOE>Calen/ZO>Sealapex>EndoREZ.

Histopathological evaluation of root canal filling materials for primary teeth

“…In spite of presenting high antimicrobial activity (12), it appear to be no published reports investigating the biocompatibility of the Calen paste thickened with zinc oxide. The lack of peer-reviewed scientific data hinders a reliable comparison between the outcomes of this work and those of the previous researches.…”

“…Among the beneficial properties of calcium hydroxide are its biocompatibility (10,11), antibacterial activity (12), induction of mineralized tissue formation (13)(14)(15), activation of alkaline phosphatase and collagen synthesis (16) and ability to produce hydrolysis of bacterial endotoxin (17).…”

“…The properties of Calen paste thickened with zinc oxide as a possible root canal filling material for primary teeth has recently been investigated (12). However, there are no published studies evaluating the biocompatibility of this material.…”

An in vivo Evaluation of Root Canal Filling Materials used in Primary Teeth

“…The lowest success rate of ZOE paste in this study can be attributed to the fact that ZO powder has no significant antibacterial properties, due to lack of acidity and lack of release of antibacterial agents, which was reported by Daugela et al 20 Also, Alexandra et al reported least antibacterial activity of ZOE in an in vitro study comparing the antibacterial activity of four root canal filling materials for primary teeth. 21 Iodoform is another material, which is commonly used in root canals of primary teeth. It is used either in pure form or is combined with other materials like ZOE and calcium hydroxide.…”

Comparative Evaluation of Push-out bond Strength of Three Endodontic Sealers with and without Amoxicillin-An Invitro Study

“…However, it is impossible to completely eradicate all microbes from root canal system as bacteria can obstinate in areas such as lateral canals, dentinal tubules and apical ramifications [6]. Consequently, the use of root canal filling materials with anti-microbial activity is considered beneficial in an effort to further reduce the number of remaining microorganisms and to eradicate the infection [7,8].…”