An in vitro evaluation of the antibacterial properties of three mineral trioxide aggregate (MTA) against five oral bacteria
Introduction
Mineral trioxide aggregate (MTA) has become the material of choice in various endodontic procedures such as pulp capping, pulpotomy, apexogenesis/apexification, repair of root resorption and lateral or furcal perforations, and retrograde filling, because of its superior properties including sealability (Torabinejad, Rastegar, Kettering, & Pitt Ford, 1995), biocompatibility (Torabinejad, Hong, Pitt Ford, & Kettering, 1995a), and bioactivity (Enkel et al., 2008). However, the main drawbacks of MTA are difficulty in handling, long setting time, and discoloration potential (Parirokh & Torabinejad, 2010). The main ingredients are tricalcium silicate, dicalcium silicate, and bismuth oxide, with small quantities of iron and aluminum (Ferris & Baumgartner, 2004). Since the introduction of ProRoot MTA (Dentsply, Tulsa, OK, USA) in 1998, novel commercially available MTA-based products including MTA-Angelus (Angelus, Londrina, PR, Brazil) and Endocem MTA (Maruchi, Wonju, Korea) have been developed in an attempt to improve these shortcomings by modifying the composition and/or concentration of each ingredient. Endocem is an MTA-derived pozzolan cement with a lesser setting time (4 min ± 30 s) and similar biocompatibility and osteogenicity compared to conventional MTA (Choi et al., 2013). As the characteristics of a material may change along with composition modification, numerous studies have evaluated the biological and physical properties of these MTA products.
Considering the indispensable role of microorganisms in the development and progress of pulpal and periapical disease as well as the failure of endodontic treatment, the eradication of microorganisms from the root canal system in endodontic treatment and prevention of bacterial ingress to the root canal system during restorative treatment are the key factors in successful clinical outcome (Baumgartner & Falkler, 1991; Fabricius, Dahlen, Ohman, & Moller, 1982; Fouad, Zerella, Barry, & Spangberg, 2005; Kakehashi, Stanley, & Fitzgerald, 1965; Moller, Fabricius, Dahlen, Ohman, & Heyden, 1981; Siqueira, Rocas, Souto, de Uzeda, & Colombo, 2000; Sundqvist, 1992). Therefore, an ideal dental material should also possess antibacterial property, but not at the expense of its other biological and physical properties.
There is to date limited information, however, on the comparative antibacterial activity of MTA-based products against some of the predominant clinically relevant bacteria including Enterococcus faecalis in endodontic disease, Porphyromonas gingivalis in periodontal disease, Streptococcus mutans in the initiation of dental caries, Lactobacillus rhamnosus, and Lactobacillus paracasei in the progression of dental caries.
This study was conducted to compare the antibacterial effects of three MTA products (MTA-Angelus, Endocem MTA, and ProRoot MTA) against these five typical oral bacteria, and thereby to develop a clinical recommendation for their specific use based on their antibacterial activity.
Section snippets
Compositions of tested cements
The chemical composition of the tested materials (MTA-Angelus, Endocem MTA, and ProRoot MTA) were analyzed by X-ray fluorescence spectrometer (ZSX100e, Rigaku, Akishima, Japan). The powders of each material were pressed into rigid pellets, which were then evaluated twice qualitatively and quantitatively using the fundamental parameter method.
Disc diffusion test
The antibacterial activity was evaluated using five standard bacterial strains: S. mutans (ATCC 25175), E. faecalis (ATCC 4082), and P. gingivalis (ATCC
Compositions of the cements
The chemical compositions of the cements by X-ray fluorescence spectrometer are shown in Table 1. Main chemical compounds were calcium oxide (lime; CaO), silicon dioxide (silica; SiO2), and bismuth oxide (Bi2O3), accounting for approximately 95% of the total mass of MTA-Angelus and ProRoot MTA, and 83% of Endocem MTA. When compared with MTA-Angelus and ProRoot MTA, the amount of CaO was relatively lower, while aluminum oxide (Al2O3), magnesium oxide (MgO), ferric oxide (Fe2O3), and potassium
Discussion
The methods used in the present study for evaluation of antibacterial activity of MTA materials were disc diffusion test and antibacterial broth test. The results of the two tests were not consistent due to the difference in the application of MTA materials. For antibacterial broth test, fresh powder of each MTA material was added to the broth before incubation with bacteria. The growth of bacteria is inhibited if the compositions of the test materials have antibacterial properties, when in
Conflict of interest
There are no conflicts of interest to declare.
Acknowledgment
This study was supported by research grant No. O1500051 from Korea University Medical Center Guro Hospital, Seoul, Korea.
References (50)
- et al.
Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro
Journal of Endodontics
(2006) - et al.
Comparison of antifungal activity of white-colored and gray-colored mineral trioxide aggregate (MTA) at similar concentrations against Candida albicans
Journal of Endodontics
(2006) - et al.
Chemical differences between white and gray mineral trioxide aggregate
Journal of Endodontics
(2005) - et al.
Direct pulp capping with mineral trioxide aggregate: an observational study
Journal of the American Dental Association
(2008) - et al.
The constitution of mineral trioxide aggregate
Dental Materials
(2005) - et al.
Biological effects and washout resistance of a newly developed fast-setting pozzolan cement
Journal of Endodontics
(2013) - et al.
Chemical and physical surface and bulk material characterization of white ProRoot MTA and two Portland cements
Dental Materials
(2005) - et al.
Perforation repair comparing two types of mineral trioxide aggregate
Journal of Endodontics
(2004) - et al.
Molecular detection of Enterococcus species in root canals of therapy-resistant endodontic infections
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics
(2005) - et al.
MTA solubility: a long term study
Journal of Endodontics
(2005)
Tooth discoloration after the use of new pozzolan cement (Endocem) and mineral trioxide aggregate and the effects of internal bleaching
Journal of Endodontics
The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats
Oral Surgery, Oral Medicine, Oral Pathology
Comparison of the biological properties of ProRoot MTA, OrthoMTA, and Endocem MTA cements
Journal of Endodontics
pH required to kill Enterococcus faecalis in vitro
Journal of Endodontics
Treatment outcome of mineral trioxide aggregate or calcium hydroxide direct pulp capping: long-term results
Journal of Endodontics
Effectiveness of stannous fluoride and calcium hydroxide against Enterococcus faecalis
Journal of Endodontics
Effects of gray and white mineral trioxide aggregate on the proliferation of oral keratinocytes and cementoblasts
Journal of Endodontics
Mineral trioxide aggregate: a comprehensive literature review—part III. Clinical applications, drawbacks, and mechanism of action
Journal of Endodontics
Setting time and thermal expansion of two endodontic cements
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics
Physicochemical basis of the biologic properties of mineral trioxide aggregate
Journal of Endodontics
Checkerboard hybridization analysis of endodontic infections
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics
The effects of chlorhexidine gluconate (0.12%) on the antimicrobial properties of tooth-colored ProRoot mineral trioxide aggregate
Journal of Endodontics
Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment
Journal of Endodontics
Ecology of the root canal flora
Journal of Endodontics
Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics
Cited by (41)
Low concentration zinc oxide nanoparticles enrichment enhances bacterial and pro-inflammatory resistance of calcium silicate-based cements
2024, Journal of the Mechanical Behavior of Biomedical MaterialsPhysico-chemical, mechanical and antibacterial properties of the boron modified biphasic larnite/bredigite cements for potential use in dentistry
2023, Ceramics InternationalCitation Excerpt :In accordance with our results, the authors showed that the E. faecalis was the most resistant bacteria to powder and eluates in comparison with other microorganisms. Recent studies showed that the pH required to inhibit the growth of E. faecalis should be between 10.5 and 11.0, whereas above 11.5 the bacteria were not able to survive at all [67]. The results of our study showed, that there was no additional effect of boron incorporation on the antibacterial activity of the tested cements.
The antibacterial activity of mineral trioxide aggregate containing calcium fluoride
2022, Journal of Dental SciencesCitation Excerpt :Even though there are various calcium silicate-based root canal sealers commercially available on the market, some are still early stages, requiring further laboratory and clinical study, therefore, MTA was used in this study.12 Previous studies have reported conflicting results about the antibacterial activity of MTA.13–15 The antibacterial property of MTA is related to the release of calcium hydroxide and the alkalinizing activity.16
- 1
These authors contributed equally to this work.