Calcium Hydroxide Paste Research Articles

Effect of mixing Calcium Hydroxide paste and 2% Chlorhexidine Gel in Comparison to pure Calcium Hydroxide Paste on Postoperative Pain in teeth with chronic periapical periodontitis: Randomized Clinical Trial

Effect of mixing Calcium Hydroxide paste and 2% Chlorhexidine Gel in Comparison to pure Calcium Hydroxide Paste on Postoperative Pain in teeth with chronic periapical periodontitis: Randomized Clinical Trial

The effect of calcium hydroxide and double antibiotic paste on radiographic outcomes and periapical MMP-8 levels in regenerative endodontic procedures: a randomized clinical trial.

The primary goal is to evaluate the effects of two different intracanal medicaments, calcium hydroxide [Ca(OH)2] and double antibiotic paste (DAP), on radiographic outcomes during regenerative endodontic procedures (REP) of immature permanent mandibular first molars with symptomatic irreversible pulpitis and symptomatic apical periodontitis (SIP/SAP). Additionally, the secondary goal was to evaluate MMP-8 levels during REP using two different intracanal medicaments. The study included 20 patients with immature mandibular first molars exhibiting SIP/SAP. Participants were randomly assigned into two groups based on the applied intracanal medicament. Ca(OH)2 (n=10) was prepared by mixing it with sterile distilled water, while the same amount of powdered metronidazole and ciprofloxacin were mixed and combined with sterile distilled water for DAP (n=10). MMP-8 in periapical samples were measured at baseline and on the 14th day using immunofluorometric assay. Image-J software with TurboReg plug-in was utilized to determine changes in root length, root width, radiographic root area (RRA) during the 12-month follow-up period. Data were analyzed by SPSS 25.0 (p<.05). Significant increase in MMP-8 on the 14th day compared to baseline in both groups (p<0.001). There was no significant difference between the two groups in terms of the increase in MMP-8 (p>0.05). Root length significantly increased in both groups (p=0.001), with Ca(OH)2 showing a greater increase (p=0.046). Root width and RRA increased similarly in both groups at 12th month. Both Ca(OH)2 and DAP applications resulted in a significant increase in periapical MMP-8 levels. Increase in radiographic root width and root area was similar between two groups, but Ca(OH)2 led to a significantly greater increase in root length. Further studies with larger sample sizes are necessary to validate our findings during REP of vital immature permanent mandibular molars. Clinical Trials database: NCT05581706.

Rheological properties and handling characteristics of four injectable calcium hydroxide pastes.

The aim of this study was to investigate the rheological properties and handling characteristics of four brands of injectable calcium hydroxide pastes (Calcipex II, CleaniCal, DiaPaste, Well-Paste). Shear viscosity was measured with a rotational rheometer. A universal mechanics analyzer assembled in the laboratory was used to quantify the force for extrusion and extruded weight of the materials. The apical pressure during injection into an artificial root canal was measured using a pressure sensor. All materials exhibited pseudoplastic behavior. The force for extrusion was highest for DiaPaste, and lowest for CleaniCal, while the extruded weight was lowest for DiaPaste and highest for CleaniCal (p<0.05), indicating a need for caution when using CleaniCal. However, the pressure generated at the apex may vary depending on the shape, and taper of the needle tip, as well as the viscosity of the materials.

Case series on two-stage disinfection in regenerative endodontics on permanent mandibular molar with blunderbuss canal

Background: Revascularization is a promising approach as it promotes root end closure forming healthy, thick root dentin at the apex which provides clinical and radiographic success due to the elimination of bacteria and disinfection of the canal which gives a 100% sterile environment to receive SCAP. Aim: To examine the effect of a regenerative endodontic procedure on immature necrotic teeth with apical periodontitis Method: An 8-year-old medically fit boy was referred to the department with a lingering type of pain in the immature permanent mandibular first right molar. Bleeding was induced in the root canals at the third appointment. The blood clots (scaffolds) were covered with MTA, and the tooth was restored with a composite filling. Recall sessions were scheduled after one month and 3 months, when the tooth appeared asymptomatic clinically and radiographically, with considerable periapical healing. Conclusion: An immature multirooted tooth with necrotic pulps and periapical radiolucency was managed with evident clinical and radiographic success, wherein non-setting calcium hydroxide paste and triple antibiotic paste were used sequentially to guarantee complete canal disinfection.

Temporary Root Canal Obturation with a Calcium Hydroxide-Based Dressing: A Randomized Controlled Clinical Trial.

Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.

Assessing the efficacy of jet dispenser versus direct syringe injection for calcium hydroxide paste placement in artificial root canals

This study aimed to evaluate the efficacy of a novel jet dispenser (JD) for filling simulated straight and curved canals with calcium hydroxide (Ca(OH)2) paste by comparing the level of intracanal medicament with traditional direct syringe delivery. The Ca(OH)2 paste was delivered into the canals using either a direct syringe with binding tip and unbinding tip or a JD. The analysis of the ratio of the canal filled area (RCFA) in the coronal, middle, and apical thirds was conducted using the Kruskal–Wallis and Mann–Whitney U tests (α = 0.05). The JD resulted in a significantly higher RCFA of 1.00 in the middle and apical thirds in both the straight and curved canals than the direct syringe method (p < 0.001). Voids were frequently observed in the direct syringe group, whereas JD showed no voids within the filled area. In the direct syringe groups, the apical area was more readily filled in both canal types when the tip was bound (p < 0.001). The JD was found to be more effective in filling the entire canal space than the binding and unbinding conditions of the direct injection method, particularly in the apical area.

Microstructural Evaluation of the Mineralized Apical Barrier Induced by a Calcium Hydroxide Paste Containing Iodoform: A Case Report

IntroductionA 65-year-old man had nonsurgical retreatment using an iodoform and calcium hydroxide paste in a maxillary left canine with persistent apical periodontitis. An apical mineralized barrier (AMB) was observed 3-months postoperatively. Unfortunately, the tooth was extracted due to a cementum tear. This provided an opportunity to analyze the AMB histologically, as there is a lack of previous reports on its microstructure. MethodsAfter extraction and removal of the granulation tissue from the root surface, the canine was processed, and observed using micro–computed tomography (μCT) and light microscopy. Thereafter, the specimen was resin-embedded specimen was evaluated by scanning electron microscopy, micro–X-ray fluorescence spectroscopy and Raman spectroscopy to understand the mechanism and nature of the AMB formation during apical healing. ResultsNonsurgical retreatment was clinically successful based on the absence of clinical symptoms of apical periodontitis and the radiographic presence of an AMB. The AMB was opaque and could be readily differentiated from dentin under a light microscope. Micro–computed tomography analysis revealed that the AMB had the same mineral density as dentin. Scanning electron microscopy revealed that the AMB had two distinct layers based on the size of the calcified particles. Elemental mapping using micro–X-ray fluorescence spectroscopy showed that the localization of calcium and phosphorus differed between AMB and other areas of biomineralization. Raman spectral mapping revealed that the surface layer of the AMB consisted of collagen, calcium carbonate, and hydroxyapatite. ConclusionsThis study explored new analytical methods for elucidating the apical wound-healing process and the nature of the mineralized repair. The findings provided detailed information on the AMB highlighting a bilaminar structure with high calcium components higher on the inside and a brightness similar to cementum not dentin and the presence of hydroxyapatite.

Changing the biofilm of the root canals using a paste of calcium hydroxide

Aim. To evaluate the environmental change of root canal biofilm during primary endodontic treatment under the influence of paste containing calcium hydroxide. Materials and methods. Twenty-nine patients with 68 root canals diagnosed with Chronic Apical Periodontitis were included in the study. Treatment was carried out according to clinical recommendations (treatment regimen) for the diagnosis: "Diseases of periapical tissues", approved by Resolution No. 18 of the Council of the Association of Public Association "Stomatological Association of Russia" of September 30, 2014, updated on August 02, 2018. Biological material of the root canal contents was taken before and after injection of calcium hydroxide paste into the root canal for 14 days. The following methods were used: clinical, microbiological – plate count, gram-positive and gram-negative microorganisms, fungi were determined, and polymerase chain reaction (PCR) was performed at the same time. Statistical analysis of data included description of accounting features, assessment of statistical significance of changes in the studied indicators. The critical level of statistical significance of differences (p) was chosen with a value of p &lt; 0.05. Results. According to the conducted studies, statistical analysis showed statistically significant negative dynamics for all studied microbiological indicators. Conclusions. The obtained data allow us to conclude that preparations containing calcium hydroxide can be used in the treatment of patients diagnosed with chronic apical periodontitis as an intracanalicular drug, because it has a bactericidal effect on a limited area.

Scanning Electron Microscopy Analysis of the Intratubular Radicular Dentin Penetration of Calcium Hydroxide, Triple Antibiotic Paste, and Nitrofurantoin.

The aim of this study is to assess and analyze the intratubular penetration of the intracanal medications nitrofurantoin (Nit), triple antibiotic paste (TAP), and calcium hydroxide (CH). Sixty freshly extracted single-rooted teeth were acquired and decoronated to a standard length of 15 mm. To prepare specimens up to size F3, rotary ProTaper instrumentation was employed. The prepared teeth were divided into three groups, each of which received one of the tested intracanal medicaments: Group I (calcium hydroxide), Group II (triple antibiotic paste), and Group III (nitrofurantoin). Using a size #30 Lentulo spiral, a freshly prepared therapeutic paste was placed into the canals, and the intracanal medicaments were allowed to set in the incubator at 100% humidity. The samples were subsequently sliced perpendicularly to their long axis using a precision saw and assessed under a scanning electron microscope to assess the depth of penetration of intracanal medicaments at the coronal, middle, and apical portions of the root canal dentin. The data were analyzed using one-way ANOVA and Tukey's post hoc test. The statistical analysis revealed a significant difference between the experimental groups in the quantity and depth of sealer penetration (p < 0.05). In particular, as compared to the Nit group, both the CH and TAP groups had significantly smaller penetration areas (p < 0.05). In conclusion, this ongoing investigation indicates that nitrofurantoin penetrated dentinal tubules better than calcium hydroxide or triple antibiotic paste.

Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study.

Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested on pathogens found in both the root canal and the periodontal pocket. Exposure to 0.5% and 1% CHX-loaded ICMs decreased the growth of Porphyromonas gingivalis and was effective in eradicating or inhibiting an Enterococcus faecalis biofilm. CH was injected into the root canal of extracted human teeth immersed in deionized water. CHX-loaded ICMs resulted in the transradicular diffusion of active components outside the tooth through the apex and the lateral dentinal tubules, as shown by the release of CHX (from 3.99 µg/mL to 51.28 µg/mL) and changes in pH (from 6.63 to 8.18) and calcium concentrations (from 2.42 ppm to 14.67 ppm) after 7 days. The 0.5% CHX-loaded ICM was non-toxic and reduced the release of IL-6 by periodontal cells stimulated by P. gingivalis lipopolysaccharides. Results indicate that the root canal may serve as a reservoir for periodontal drug delivery and that CHX-based ICMs can be an adjuvant for the control of infections and inflammation in endo-periodontal lesions.

Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities

Aim: To compare the efficacy of shockwave-enhanced emission photoacoustic streaming (SWEEPS), sonic activation with EDDY, and passive ultrasonic irrigation (PUI) in the removal of calcium hydroxide medicaments from artificial internal resorption cavities. Methodology: Ninety mandibular premolars with single oval canals were prepared to size 50/0.04 and split longitudinally. Standardized cavities were prepared in the apical third of the root canal and filled with calcium hydroxide. The root halves were reassembled and divided into three groups (n = 30) according to the removal methods used. The amount of residual calcium hydroxide was evaluated using a four-grade scoring system. The differences between the groups were analyzed using the Kruskal–Wallis H test (p &lt; 0.05). Results: SWEEPS removed significantly more calcium hydroxide than PUI (p &lt; 0.003) and EDDY (p &lt; 0.035). There was no significant difference between the EDDY and PUI groups (p = 1.000). Conclusion: None of the systems tested were able to completely remove the calcium hydroxide paste from the simulated internal resorption cavities; however, SWEEPS removed more calcium hydroxide than the EDDY and PUI techniques. How to cite this article: Erkan E, Aydın RN, Falakaloğlu S, Yeniçeri Özata M, Gündoğar M. Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities. Int Dent Res 2023;13(2):48-53. https://doi.org/10.5577/idr.2023.vol13.no2.1 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Removal of Calcium Hydroxide Paste Leaked Into the Maxillary Sinus.

Calcium hydroxide is a widely used endodontic medicament with antibacterial activity. When excessive pressure is applied during injection of calcium hydroxide paste or apical perforation occurs, calcium hydroxide can leak into the maxillary sinus and is adsorbed onto the sinus membrane. Although a leakage of calcium hydroxide may not usually cause clinical symptoms, when a large amount of leakage occurs, it can cause degeneration of adjacent tissue and functional disorder, requiring immediate surgical removal. However, due to adsorption to the sinus membrane, calcium hydroxide leaked into the maxillary sinus is difficult to remove completely. Here, we describe the case of a 47-year-old patient in whom a large amount of calcium hydroxide leaked into the maxillary sinus and was successfully removed using modified endoscopic-assisted sinus surgery, and favorable bone regeneration and sinus membrane regeneration were achieved. In addition, histological and ultrastructural changes of the membrane resulted from the calcium hydroxide were presented.

Non-Surgical Management of Periapical Lesion with Antibiotic Paste and Water Based Calcium Hydroxide Paste: A Case Report

Non-Surgical Management of Periapical Lesion with Antibiotic Paste and Water Based Calcium Hydroxide Paste: A Case Report

Inter-appointment endodontic pain comparison between calcium hydroxide and triple antibiotic paste

One of the biggest sources of dread for patients and a top concern for dentists is the anticipation and reality of root canal-related pain.1 Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential damage or described in terms of such damage" by the International Associates for the Study of Pain.2 The imbalance in the host-bacteria connection brought on by intra canal operations is the main cause of inter appointment pain. Objectives: The goal of current study was to associate the outcomes of these intracanal medications on pain experienced between endodontic appointments. This would make it easier for us to find better medications to treat discomfort between appointments. Methodology: For a period of six months, from January 6, 2022, to January 1, 2023, this randomized controlled study was carried out in the Dept. of Operative Dentistry at the MIHS in Islamabad, Pakistan. With a 5% level of significance, an 85% power of the trial, and a fraction of effectiveness of 72% with triple antibiotic paste and 38% with calcium hydroxide, a sample size of 80 people, 40 in each group, was estimated.

Microleakage of Restorative Materials Used for Temporization of Endodontic Access Cavities.

A tight temporary seal applied to an access cavity is thought to improve endodontic outcomes. This study aims to assess the bacterial and glucose microleakage of different types and combinations of temporary restorations. Human-extracted incisors were instrumented, dressed with a calcium hydroxide paste, and sealed with Cavit W (CW), CW/Ketac Molar (CW/KM), CW/Smart Dentin Replacement (CW/SDR), Intermediate restorative material/KM (IRM/KM), or Clip F (CF). Standardized 3D-printed hollow test specimens were manufactured and temporized in the same manner. The specimens were examined for bacterial and glucose leakage for 28 days. Data were analyzed using a Kaplan-Meier survival analysis. CW/SDR and CF showed the least bacterial and glucose leakage over time. CW, CW/KM, and IRM/KM had similarly high levels of glucose leakage, but CW/KM and IRM/KM provided a tighter seal against bacterial penetration than CW. CW/SDR and CF should be considered for the sealing of access cavities of teeth previously restored with methacrylate-based materials.

Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial.

To compare and evaluate the antimicrobial efficacy against Enterococcus faecalis (E. faecalis) between a mix of calcium hydroxide [Ca(OH)2] powder and normal saline, a mix of Ca(OH)2 powder and 2% chlorhexidine (CHX) gluconate solution, a mix of triple antibiotic powder (TAP) and normal saline, and mix of TAP and 2% CHX gluconate solution. A total of 60 teeth were included in the study. The first sample (S1) was collected after access opening from the widest canal of the tooth by inserting sterile absorbable paper point no 20 up to the full length of the canal for 1 minute. The second sample (S2) was collected after the chemomechanical preparation and irrigation. After that, subjects were randomly divided into four groups-group I-a mix of Ca(OH)2 and normal saline; group II-a mix of Ca(OH)2 and 2% CHX; group III-a mix of TAP and normal saline; and group IV-a mix of TAP and 2% CHX. Assigned intracanal medicaments were placed in the canals, and the teeth were temporarily sealed with a temporary restorative material. On the 7th day, canals were reopened and irrigated, and a third bacteriological sample (S3) was taken out. Later, canals were filled with suitable obturating material, followed by the placement of the permanent restoration. There was a very highly significant (p < 0.005) difference in E. faecalis count in all the groups on day 7 after placement of intracanal medicament, being highest in group IV followed by group II, group III, and group I. Triple antibiotic powder (TAP) mixed with 2% CHX gluconate solution has superior antimicrobial efficacy against E. faecalis in primary teeth. Qamar S, Jayanna R, Ahuja VR. Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(3):448-452.

Effect of separated instruments on periapical pH using calcium hydroxide as an intracanal medicament in curved root canals

Objective: To evaluate the effect of intracanal separated instruments with different lengths on periapical pH levels using calcium hydroxide (CH) as an intracanal medicament in curved root canals.&#x0D; Materials and Methods: 120 teeth (root canal curvature &gt;25˚) were divided into six groups following the root canal preparation. In Group 1, 2 mm and in Group 2, 4 mm NiTi instruments were separated in the apical portion of the root canals and CH paste was applied. In Groups 3 and 4, no separated instrument but CH was applied. In Groups 5 and 6, neither a separated instrument nor CH. The samples were placed inside a glass tubes with distilled water. pH of this distilled water was measured at different time-points.&#x0D; Results: At all-time points, pH values between the experimental groups were similar except at 1-day (Group 1 &lt; Group 2, P&lt;0.05). At the 2-day and 30-day time points, Group 3 showed higher pH values than Group 1 (P&lt;0.05). At 7-day and 14-day points, pH values were similar.&#x0D; Conclusions: The presence of a separated instrument with different lengths in curved root canals did not have a significant effect on the pH increase caused by CH used as an intracanal medicament.

Management of external cervical resorption with internal approach: 18 months of follow-up

Introduction: External cervical resorption (ECR) in advance stages may have a probable pulp involvement. In some of these cases, the accessibility of the resorptive process can be performed by an intraradicular approach. Aim: To report the management of an ECR, classified as Class 2cp according to Patel classification, with an internal approach. Case report: A 22-year-old male patient presented a complaint of dentin hypersensitivity related to left maxillary lateral incisor and reported a history of previous dental trauma. Based on the clinical, radiographic and tomographic findings, the left maxillary lateral incisor was diagnosed as symptomatic irreversible pulpitis with ECR class 2cp of Patel classification. The patient was scheduled for endodontic treatment, with an internal approach, and repair of the resorbed area. Intracanal dressing of calcium hydroxide paste was used in the root canal and resorption gaps. The root canal filling was performed in two steps: obturation of the apical and middle third with gutta-percha by lateral condensation technique and obturation of the cervical third and filling the resorbed area with MTA. After 18 months signs and symptoms compatible with success were observed, and the tomographic and radiographic images suggested a successful endodontic treatment and evolutionary process of repair of bone and mineralized dental tissues. Conclusion: Patel class 2cp ECR treatment through an internal approach, including conventional endodontic treatment and recovery of the reabsorbed area with calcium hydroxide and MTA is a viable treatment option, but may cause tooth discoloration.

Super-Rapid In Situ Formation of a Silver Ion-Induced Supramolecular Hydrogel with Efficient Antibacterial Activity for Root Canal Disinfection.

Supramolecular hydrogels prepared using low-molecular-weight gelators have attracted considerable attention for biomedical applications. However, in situ supramolecular hydrogels are limited in terms of their prolonged gelation time and/or unstable nature at high temperatures. In this study, we constructed a stable supramolecular Ag-isoG hydrogel through super-rapid in situ formation, wherein hydrogelation process occurred instantaneously upon mixing isoG and Ag+ within 1 s under ambient conditions. Interestingly, unlike most nucleoside-based supramolecular hydrogels, this Ag-isoG hydrogel remains stable even at a high temperature (100 °C). Moreover, the as-designed hydrogel demonstrated significant antibacterial activity against Staphylococcus aureus and the oral bacterium Streptococcus mutans owing to the strong chelating ability of Ag ions, and the hydrogel exhibited relatively low cytotoxicity in root canal and an easy removal feature by saline. The hydrogel was then applied to a root canal infection model, which demonstrated strong antibacterial activity against Enterococcus faecalis, with performance even better than that of the regular calcium hydroxide paste. This feature makes the Ag-isoG hydrogel a prospective alternative material as intracanal medicaments for root canal treatment.

Antibacterial effectiveness of multi-strain probiotics supernatants intracanal medication on Enterococcus faecalis biofilm in a tooth model

BackgroundTo assess the antibacterial activity of multi-strain probiotics supernatants (MSP); Lactobacillus plantarum, Lactobacillus rhamnosus, and Lactobacillus acidophilus as an intracanal medication on Enterococcus faecalis (E. faecalis) biofilm in a tooth model.MethodsSixty extracted human single-rooted teeth with single canals were instrumented, sterilized, and inoculated with E. faecalis. After 21 days of incubation, four specimens were randomly selected to validate the biofilm formation by scanning electron microscope (SEM). The remaining specimens were randomly divided (n = 14), according to the intracanal medication (ICM) received into: Ca(OH)2: calcium hydroxide paste (35% Ultra Cal XS Ca(OH)2), Probiotics supernatants: MSP in poloxamer gel vehicle Poloxamer: poloxamer gel vehicle and, Control: E. faecalis biofilm only. The tested groups were further subdivided into two equal subgroups (n = 7) according to the incubation period (24 h and 7 days). Shaved dentin chips were obtained and collected by H-files and paper points, respectively for bacterial culture. The antibacterial activity was assessed after each incubation period quantitatively and qualitatively using bacterial colony-forming units per milliliter (CFUs/ml) and SEM, respectively.ResultsThe lowest CFUs/ml was found in Ca (OH)2 with a significant difference compared to other groups after 24 h. After 7 days, a similar outcome was found with a further significant reduction of CFUs/ml in all groups with no statistical difference between Ca(OH)2 and probiotics supernatants groups. Ca (OH)2 and Probiotics supernatants groups showed a significant (p < 0.05) percentage of overall bacterial reduction (100.00 ± 0.00% and 70.30 ± 12.95%, respectively) compared to poloxamer and control groups (27.80 ± 14.45 and 28.29 ± 19.79). SEM images showed a bacteria-free state in the Ca(OH)2 group after 7 days while few bacteria were found in the probiotics supernatants group. An extensive invasion of bacteria was found in poloxamer and controls groups.ConclusionMSP has a potential antibacterial effect on E. faecalis growth closely similar to the routinely used Ca (OH)2.