In vitro and ex vivo microbial leakage assessment in endodontics: A literature review

Abstract

The aim of this study was to perform a literature review of published in-vitro and ex-vivo studies, which evaluated microbial leakage in endodontics in the past 10 years. A comprehensive electronic literature search was carried out in PubMed database for English articles published from 2005 to 2016 using the keywords “endodontics,” “in vitro,” “ex vivo,” “microbial leakage,” “microbial penetration,” “saliva,” “Enterococcus faecalis,” “E. faecalis,” “endodontic sealers,” “temporary filling material,” “apical plug,” “mineral trioxide aggregate,” and “MTA.” The keywords were combined using Boolean operators AND/OR. Based on our search strategy, 33 relevant articles were included in the study. There are three main methods for assessment of bacterial microleakage, namely, (A) the dual-chamber leakage model, (B) detection of bacteria using a scanning electron microscope (SEM), and (C) polymerase chain reaction. All bacterial leakage models have some limitations and may yield different results compared to other microleakage evaluation techniques (i.e., dye penetration, fluid filtration, or electrochemical tests). The results of SEM correlated with those of microbial leakage test in most studies. Microbial leakage test using saliva better simulates the clinical setting for assessment of the leakage of single or mixed bacterial species.

Comparative evaluation of the apical sealing ability of a ceramic based sealer and MTA as root-end filling materials -An in-vitro study

“…It provides data that are more biologically significant and clinically relevant than other methods ( 13 - 15 ). There are three methods available for assessment of bacterial microleakage, namely, the dual-chamber leakage model, detection of bacteria using a scanning electron microscope (SEM), and polymerase chain reaction (PCR) ( 14 , 15 ).…”

“…In the dual-chambered or the split-chambered model, the tooth to be tested is sealed in between the upper and lower chamber ( 15 ). Turbidity or a color change in the sterile broth in the lower chamber will show the microleakage of viable microorganisms from the upper chamber ( 14 , 15 ) The model used in this study was patterned after that designed by Torabinejad et al ( 17 - 19 ). In the upper chamber, a nonselective, non discolouring broth was chosen to prevent false positive results from the leakage of dye molecules rather than bacteria.…”

“…The interface between the upper and lower chamber was completely eliminated in order to provide only one route for micro-leakage: through the tested obturated material. This was done through the placement of growth medium broth containing E. faecalis directly in the access cavity of the experimental teeth ( 14 , 15 ). The success of the negative controls in showing no leakage and the failure of positive controls in showing any leakage has validated the successful experimental design of the apparatus.…”

Evaluation of Microleakage by Gas Permeability and Marginal Adaptation of MTA and Biodentine™ Apical Plugs: In Vitro Study

“…Several weaknesses for these models have been reported by important dental journals (42), and some authors strongly suggest to avoid the publication of studies using this method as the only test to measure microleakage (43). As reported by Savadkouhi et.al., bacterial leakage also shows important limitations that should be considered (44), especially the management of controls and possible bacterial penetration through secondary pathways (45). The validity of the employed system (EMA system) was tested by using positive and negative controls (open roots and roots sealed with light-cured composite respectively).…”

Tomada de decisão de estudantes frente a um case scenario de Endodontia

“…Um canal pode ser recontaminado e reinfectado entre as sessões de tratamento por meio de microinfiltração através do material selador temporário, por sua degradação ou fratura, podendo acarretar o insucesso da terapia endodôntica 20 . Neste sentido, estudos concluíram que a resina composta e o ionômero de vidro se mostraram efetivos para minimizar a micro infiltração coronária [21][22][23][24] .…”