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 degrees 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 (alpha=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.
Highlights
The endodontic infection in primary teeth with pulp necrosis and apical periodontitis is of polymicrobial nature with predominance of anaerobic bacteria [1], which are disseminated within the root canal system and physiological resorptive areas on the external apical root surface [2], pulpectomies being necessary to treat these cases [3]
This study evaluated the in vitro 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
ZOE showed antibacterial activity against all test microorganisms. This material produced the largest zones of bacterial growth inhibition against K. rhizophila and E. coli, and the smallest zones of bacterial growth inhibition against E. faecalis
Summary
The endodontic infection in primary teeth with pulp necrosis and apical periodontitis is of polymicrobial nature with predominance of anaerobic bacteria [1], which are disseminated within the root canal system (i.e., the dentinal tubules, lateral canals, accessory canals, secondary canals, apical delta ramifications, apical foramen and apical root cementum surface) and physiological resorptive areas on the external apical root surface (extraradicular infection) [2], pulpectomies being necessary to treat these cases [3]. Braz Dent J 20(4) 2009 these microorganisms may persist even after biomechanical preparation and use of intracanal dressing [4], root canal filling materials should be able to eliminate residual pathogens, neutralize their toxic products and prevent canal reinfection to in order to create a favorable environment for the healing process to proceed [5]. It is important that root canal filling materials used in primary teeth have antimicrobial activity [6,7,8,9,10,11] and the antimicrobial spectrum of action of these materials should be investigated. This study evaluated the in vitro 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 The agar diffusion test has been widely used for such purpose [5,6,7,8,9,10,12,13,14].
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