Microbial leakage of MTA, Portland cement, Sealapex and zinc oxide-eugenol as root-end filling materials

Abstract

The aim of this study was to compare the microbial leakage of mineral trioxide aggregate (MTA), Portland cement (PC), Sealapex and zinc oxide-eugenol (ZOE) as root-end filling materials. An in vitro microbial leakage test (MLT) with a split chamber was used in this study. A mixture of facultative bacteria and one yeast (S. aureus+E. faecalis+P. aeruginosa+B. subtilis+C. albicans) was placed in the upper chamber and it could only reach the lower chamber containing Brain Heart Infusion broth by way of leakage through the root-end filling. Microbial leakage was observed daily for 60 days. Sixty maxillary anterior human teeth were randomly assigned to different groups--MTA and PC (gray and white), Sealapex+zinc oxide and ZOE, control groups and subgroups to evaluate the influence of EDTA for smear layer removal. These materials were further evaluated by an agar diffusion test (ADT) to verify their antimicrobial efficacy. Data were analyzed statistically by Kruskal-Wallis and Mann-Whitney test. In the MLT, Sealapex+zinc oxide and ZOE did not show evidence of microbial leakage over the 60-day experimental period. The other materials showed leakage from the 15th day. The presence of smear layer influenced microbial leakage. Microbial inhibition zones were not observed in all samples tested by ADT. Sealapex+zinc oxide and ZOE did not show microbial leakage over the experimental period, whereas it was verified within 15 to 45 days in MTA and Portland cement.