Evaluation of the Antimicrobial Effect of Mineral Trioxide Aggregate Mixed with Fluorohydroxyapatite against E. faecalis In Vitro

Abstract

Enterococcus faecalis is the dominant microorganism in chronic apical periodontitis. It is more resistant to local antiseptic agents than other endodontic microorganisms. Currently, mineral trioxide aggregate (MTA) is considered as an ideal material in many endodontic procedures. Some studies have shown that MTA has good antibacterial activity against E. faecalis. However, some studies have investigated the effect of incorporating some materials into MTA on its antibacterial activity against E. faecalis. No study has evaluated the effect of incorporating fluorohydroxyapatite nanoparticles (nano-FHA) on the antimicrobial activity of MTA. Therefore, the present study evaluated the antimicrobial effect of MTA mixed with nano-FHA on E. faecalis in vitro. The study was carried out on 18 samples in three groups: pure MTA, MTA mixed with 10 wt% of nano-FHA, and MTA mixed with 15 wt% of nan-FHA. The effect of nano-FHA on the antibacterial activity of MTA on E. faecalis was evaluated by evaluating the growth inhibition zone around each sample. The antimicrobial effect of samples on inhibiting E. faecalis biofilm formation and inhibiting microbial growth of E. faecalis in the planktonic phase was evaluated by disk agar diffusion (DAD), biofilm inhibition assay (BIA), and direct contact assay (DCA) tests, respectively. All the above tests were analyzed after 24 and 72 hours. Factorial designs were used for statistical analyses. Tukey tests were used for two-by-two comparisons. All the statistical analyses were carried out with SPSS 26. DAD results showed no formation of the growth inhibition zone in all the samples after 24 and 72 hours. The microbial colony counts in the BIA and DCA tests in the groups modified with FHA nanoparticles were significantly lower than the pure MTA group ( P < 0.05 ). The microbial colony counts increased in all the groups over time ( P < 0.05 ). Incorporating nano-FHA into MTA improved the antimicrobial activity of MTA against E. faecalis compared to pure MTA. The highest antimicrobial activity was achieved after incorporating 15 wt% of nano-FHA into MTA at the 72-hour interval.

Evaluation and Comparison of Four Types of Bio-Ceramic Materials AGM MTA, Ortho MTA, Pro root MTA and Cem cement in Oral and Dental Health

“…In a cross-sectional study titled the evaluation of the antimicrobial effect of MTA mixed with uorohydroxyapatite on Enterococcus faecalis bacteria, conducted by Bolhari et al in 2021 in Tehran, to investigate the evaluation of the antimicrobial effect of pure MTA, MTA mixed with 10% (W/V) of nano FHA and MTA mixed with 15% (W/V) nano FHA. In the results of the antimicrobial test, the diffusion of agar disk showed the absence of growth-inhibiting areas in all samples after 24 hours [21], which is inconsistent with the results of the present study. It seems that this difference was due to the difference in the method of doing the work and the type of cultivation environment.…”

Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates

“…The acknowledgment of low to moderate antimicrobial activity against E. faecalis in conventional MTA underscores the importance of addressing this limitation [ 12 ]. The addition of agents like calcium fluoride and fluorohydroxyapatite to enhance the antimicrobial activity of MTA is a well-founded strategy [ 13 , 14 ]. The inclusion of 5 wt% of doxycycline and metronidazole in groups 2 and 3, respectively, in the present study reflects a targeted approach to improving the antimicrobial properties of the modified MTA.…”

The Addition of Copper Nanoparticles to Mineral Trioxide Aggregate for Improving the Physical and Antibacterial Properties

“…CuNP, an antibacterial agent [34], is still active even though combined with MTA. The antibacterial performance mechanism is probably different from MTA modified with CaF 2 [14] and fluorohydroxiapatite [15], in which the higher pH leads to bacterial death. The CuNP on the MTA surface may interact with the bacterial cells causing bacterial cell leakage and leading to lysed and death [35].…”

“…Lim and Yoo [14] reported the modification of MTA with calcium fluoride (CaF 2 ) to give antibacterial activity against Enterococcus faecalis, Porphyromonas endodontalis, and Porphyromonas gingivalis. Bolhari et al [15] improved the antibacterial activity of MTA by mixing MTA with fluorohydroxyapatite against E. faecalis. However, the effect of the modification on the mechanical properties was not investigated.…”