Ex vivo microbial leakage analysis of polytetrafluoroethylene tape and cotton pellet as endodontic access cavity spacers

Abstract

Background:The endodontic spacers are placed between the endodontic appointments or after completion of the endodontic therapy, and until the placement of a definitive restoration.Aims:The aim of this study was to evaluate the sealing ability of polytetrafluoroethylene (PTFE) access spacer against microbial leakage and to compare it with that of a cotton pellet.Materials and Methods:Fifty-two extracted human single-rooted premolars were divided into two experimental groups (n = 20) according to the endodontic spacer; cotton pellet or PTFE tape, and two control groups (n = 6). Following standardized access cavity, cleaning, and shaping procedures, the access cavities received a standardized thickness of the spacer material followed by a Cavit restoration in all the teeth except for the positive controls, which were left empty. Negative controls had the root surfaces completely sealed with nail polish. A dual-chamber microbial leakage model was used with Enterococcus faecalis as the test strain. At days 7 and 30, samples of the lower chambers' solution were obtained and subjected to the quantitative real-time polymerase chain reaction (qPCR) analysis to quantify bacterial levels. Furthermore, broth turbidity in the lower chambers was recorded weekly. The Mann–Whitney U test and Wilcoxon test were used to compare E. faecalis counts between and within groups, respectively.Results:At days 7 and 14, the experimental groups leaked similarly as determined by broth turbidity. However, at days 21 and 30, a significantly higher number of cotton pellet samples exhibited microbial leakage. Analysis by qPCR revealed higher levels of E. faecalis counts in cotton pellet samples compared with PTFE samples. This difference was statistically significant at day 7, but not at day 30.Conclusions:PTFE spacer showed improved sealing ability compared with the commonly used cotton pellet and may serve as an alternative endodontic access cavity spacer.

Microbial contamination comparison between cotton pellet and polytetrafluoroethylene tape endodontic spacers: a systematic review

“…Six articles were selected for full-text retrieval. Three laboratory studies ( 6 , 9 , 15 ) and three clinical studies ( 7 , 16 , 17 ) fulfilled the inclusion criteria and were included in the review. Due to heterogeneity among the included studies, quantitative synthesis was not performed…”

“…One study included two negative control groups, one for each spacer material ( 6 ). One study included both positive and negative control groups ( 9 ). One study had no positive or negative control groups ( 15 ).…”

“…One study had no positive or negative control groups ( 15 ). Only one study described a rationale for their sample sizes ( 9 ). The period of evaluation ranged from 7 to 30 days.…”

“…Under each item, the included studies were scored ‘1’ when adequately reported and ‘0’ when inadequately reported or information was missing. The included studies were categorized into high ( 1 - 3 ), moderate ( 4 - 6 ) or low ( 7 – 9 ) risk of bias. Reliability scores for the checklists were analyzed for agreement between the two independent reviewers by Cohen’s kappa coefficient ( 13 ).…”

“…PTFE tape is a versatile material that has been increasingly used for various purposes in dentistry ( 3 ). It is an inert, non-biodegradable, non-fibrous polymer and has been considered a suitable alternative spacer material with the potential to overcome the disadvantages of using cotton pellets ( 6 , 8 , 9 ). Its inorganic nature reduces the potential for it to act as a wick, and its non-spongy nature better supports the provisional restoration ( 7 ).…”