Antimicrobial activity and physicochemical performance of a modified endodontic sealer
DOI:
https://doi.org/10.33448/rsd-v9i11.9401Keywords:
AH-Plus; Antimicrobial activity; Chlorhexidine; Metronidazole.Abstract
Introduction: this study aimed to evaluate the antimicrobial and physicochemical properties of a commercial endodontic sealer modified by the addition of montmorillonite (MMT) nanoparticles loaded with two different drugs: chlorhexidine (CHX) or metronidazole (MET). Methods: 5 wt% MMT/CHX or MMT/MET nanoparticles were added to the sealer AH-Plus. The experimental materials were evaluated for drug release, antimicrobial activity, flow, flexural strength, and flexural modulus. Data were subjected to one-way ANOVA, Kruskal-Wallis, and Mann-Whitney tests. Results: The drug incorporation into MMT particles was 9% and 10% for CHX and MET, respectively. At 20 days after manipulation, 16.5% of the drug was released by the sealer with MMT/MET and 0.4% by MMT/CHX. The addition of both nanoparticles decreased the flow of materials, but they were still in compliance with ISO 6876-2012. The conversion, flexural strength, and flexural modulus of MMT/MET (87%, 37±7 MPa, 2.3 GPa) and MMT/CHX (78%, 29±2 MPa, 2.7 GPa) were similar in both groups but lower than in the control group (100%, 54±7 MPa, 4.0±0.7 GPa). Both experimental materials were able to form an inhibition halo for E. faecalis bacteria (CHX: 4.8±1.4 and MET: 4.0±1.6 mm), whereas the control group did not inhibit the microorganism. Conclusion: both formulations proposed as endodontic sealer presented effective antimicrobial activity and acceptable flow. The addition of MMT/CHX and MMT/MET particles decreased the conversion and mechanical properties, but further studies are required to clarify the clinical relevance of these properties.
References
AlShwaimi, E., Bogari, D., Ajaj, R., Al-Shahrani, S., Almas, K., & Majeed, A. (2016). In Vitro Antimicrobial Effectiveness of Root Canal Sealers against Enterococcus faecalis: A Systematic Review. J Endod, 42(11), 1588-1597.
Baer, J., & Maki, J. S. (2010). In vitro evaluation of the antimicrobial effect of three endodontic sealers mixed with amoxicillin. J Endod, 36(7), 1170-1173.
Bailon-Sanchez, M. E., Baca, P., Ruiz-Linares, M., & Ferrer-Luque, C. M. (2014). Antibacterial and anti-biofilm activity of AH plus with chlorhexidine and cetrimide. J Endod, 40(7), 977-981.
Baldi, J. V., Bernardes, R. A., Duarte, M. A., Ordinola-Zapata, R., Cavenago, B. C., Moraes, J. C., & de Moraes, I. G. (2012). Variability of physicochemical properties of an epoxy resin sealer taken from different parts of the same tube. Int Endod J, 45(10), 915-920.
Ballal, N. V., Sona, M., & Tay, F. R. (2017). Effects of smear layer removal agents on the physical properties and microstructure of mineral trioxide aggregate cement. J Dent, 66, 32-36.
Bouillaguet, S., Shaw, L., Barthelemy, J., Krejci, I., & Wataha, J. C. (2008). Long-term sealing ability of Pulp Canal Sealer, AH-Plus, GuttaFlow and Epiphany. Int Endod J, 41(3),
Cobankara, F. K., Altinoz, H. C., Ergani, O., Kav, K., & Belli, S. (2004). In vitro antibacterial activities of root-canal sealers by using two different methods. J Endod, 30(1), 57-60.
Collares, F. M., Leitune, V. C. B., Portella, F. F., Santos, P. D., Balbinot, G. S., Dos Santos, L. A., Samuel, S. M. W. (2018). Methacrylate-based root canal sealer containing chlorexidine and alpha-tricalcium phosphate. J Biomed Mater Res B Appl Biomater, 106(4), 1439-1443.
de Souza, M. O., Branco Leitune, V. C., Bohn, P. V., Werner Samuel, S. M., & Collares, F. M. (2015). Physical-mechanical properties of Bis-EMA based root canal sealer with different fillers addition. J Conserv Dent, 18(3), 227-231.
Dickens, S. H., Stansbury, J. W., Choi, K. M., & Floyd, C. J. E. (2003). Photopolymerization Kinetics of Methacrylate Dental Resins. Macromolecules, 36, 6046-6053.
Elbourne, A., Crawford, R. J., & Ivanova, E. P. (2017). Nano-structured antimicrobial surfaces: From nature to synthetic analogues. J Colloid Interface Sci, 508, 603-616.
Ercan, E., Dalli, M., Yavuz, İ., & Özekinci, T. (2006). Investigation of Microorganisms in Infected Dental Root Canals. Biotechnology & Biotechnological Equipment, 20(2), 166-172.
Ghivari, S. B., Bhattacharya, H., Bhat, K. G., & Pujar, M. A. (2017). Antimicrobial activity of root canal irrigants against biofilm forming pathogens- An in vitro study. J Conserv Dent, 20(3), 147-151.
Grande, N. M., Plotino, G., Lavorgna, L., Ioppolo, P., Bedini, R., Pameijer, C. H., & Somma, F. (2007). Influence of different root canal-filling materials on the mechanical properties of root canal dentin. J Endod, 33(7), 859-863.
Hasan, J., Crawford, R. J., & Ivanova, E. P. (2013). Antibacterial surfaces: the quest for a new generation of biomaterials. Trends Biotechnol, 31(5), 295-304.
Hoelscher, A. A., Bahcall, J. K., & Maki, J. S. (2006). In vitro evaluation of the antimicrobial effects of a root canal sealer-antibiotic combination against Enterococcus faecalis. J Endod, 32(2), 145-147.
Kapralos, V., Koutroulis, A., Orstavik, D., Sunde, P. T., & Rukke, H. V. (2018). Antibacterial Activity of Endodontic Sealers against Planktonic Bacteria and Bacteria in Biofilms. J Endod, 44(1), 149-154.
Kim, H. R., Kim, Y. K., & Kwon, T. Y. (2017). Post space preparation timing of root canals sealed with AH Plus sealer. Restor Dent Endod, 42(1), 27-33.
Kim, Y. K., Grandini, S., Ames, J. M., Gu, L. S., Kim, S. K., Pashley, D. H., . . . Tay, F. R. (2010). Critical review on methacrylate resin-based root canal sealers. J Endod, 36(3), 383-399.
Lacey, S., Pitt Ford, T. R., Yuan, X. F., Sherriff, M., & Watson, T. (2006). The effect of temperature on viscosity of root canal sealers. Int Endod J, 39(11), 860-866.
Lee, B. S., Wang, C. Y., Fang, Y. Y., Hsieh, K. H., & Lin, C. P. (2011). A novel urethane acrylate-based root canal sealer with improved degree of conversion, cytotoxicity, bond strengths, solubility, and dimensional stability. J Endod, 37(2), 246-249.
Mohammadi, Z., Jafarzadeh, H., & Shalavi, S. (2014). Antimicrobial efficacy of chlorhexidine as a root canal irrigant: a literature review. J Oral Sci, 56(2), 99-103.
Morgental, R. D., Vier-Pelisser, F. V., Oliveira, S. D., Antunes, F. C., Cogo, D. M., & Kopper, P. M. (2011). Antibacterial activity of two MTA-based root canal sealers. Int Endod J, 44(12), 1128-1133.
Nambu, T. (1984). Study on antibacterial root canal sealer containing chlorhexidine dihydrochloride. II. Investigation of antibacterial activity and follow-up study on clinical usage. Dent Mater J, 3(2), 288-311.
Pawinska, M., Szczurko, G., Kierklo, A., & Sidun, J. (2017). A laboratory study evaluating the pH of various modern root canal filling materials. Adv Clin Exp Med, 26(3), 387-392.
Pinheiro, S. L., da Silva, C. C., da Silva, L. A., Cicotti, M. P., Bueno, C., Fontana, C. E., de Campos, F. U. (2018). Antimicrobial efficacy of 2.5% sodium hypochlorite, 2% chlorhexidine, and ozonated water as irrigants in mesiobuccal root canals with severe curvature of mandibular molars. Eur J Dent, 12(1), 94-99.
Prullage, R. K., Urban, K., Schafer, E., & Dammaschke, T. (2016). Material Properties of a Tricalcium Silicate-containing, a Mineral Trioxide Aggregate-containing, and an Epoxy Resin-based Root Canal Sealer. J Endod, 42(12), 1784-1788.
Schwartz, R. S. (2006). Adhesive dentistry and endodontics. Part 2: bonding in the root canal system-the promise and the problems: a review. J Endod, 32(12), 1125-1134.
Sideridou, I., Tserki, V., & Papanastasiou, G. (2002). Effect of chemical structure on degree of conversion in light-cured dimethacrylate-based dental resins. Biomaterials, 23(8), 1819-1829.
Siqueira, J. F., Jr., Favieri, A., Gahyva, S. M., Moraes, S. R., Lima, K. C., & Lopes, H. P. (2000). Antimicrobial activity and flow rate of newer and established root canal sealers. J Endod, 26(5), 274-277.
Stuart, C. H., Schwartz, S. A., Beeson, T. J., & Owatz, C. B. (2006). Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment. J Endod, 32(2), 93-98.
Thosar, N. R., Chandak, M., Bhat, M., & Basak, S. (2018). Evaluation of Antimicrobial Activity of Two Endodontic Sealers: Zinc Oxide with Thyme Oil and Zinc Oxide Eugenol against Root Canal Microorganisms- An in vitro Study. Int J Clin Pediatr Dent, 11(2), 79-82.
Versiani, M. A., Carvalho-Junior, J. R., Padilha, M. I., Lacey, S., Pascon, E. A., & Sousa-Neto, M. D. (2006). A comparative study of physicochemical properties of AH Plus and Epiphany root canal sealants. Int Endod J, 39(6), 464-471.
Wainstein, M., Morgental, R. D., Waltrick, S. B., Oliveira, S. D., Vier-Pelisser, F. V., Figueiredo, J. A., Scarparo, R. K. (2016). In vitro antibacterial activity of a silicone-based endodontic sealer and two conventional sealers. Braz Oral Res, 30, e18.
Webster, D. M., Sundaram, P., & Byrne, M. E. (2013). Injectable nanomaterials for drug delivery: carriers, targeting moieties, and therapeutics. Eur J Pharm Biopharm, 84(1), 1-20.
Wu, Y., Zhou, N., Li, W., Gu, H., Fan, Y., & Yuan, J. (2013). Long-term and controlled release of chlorhexidine-copper(II) from organically modified montmorillonite (OMMT) nanocomposites. Mater Sci Eng C Mater Biol Appl, 33(2), 752-757.
Zhang, C., Du, J., & Peng, Z. (2015). Correlation between Enterococcus faecalis and Persistent Intraradicular Infection Compared with Primary Intraradicular Infection: A Systematic Review. J Endod, 41(8), 1207-1213.
Zhang, H., Shen, Y., Ruse, N. D., & Haapasalo, M. (2009). Antibacterial Activity of Endodontic Sealers by Modified Direct Contact Test Against Enterococcus faecalis. Journal of Endodontics, 35(7), 1051-1055.
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Copyright (c) 2020 Flávia Gonçalves; Luiza Mello de Paiva Campos; Luciana Katty Figueiredo Sanches; Larissa Tavares Sampaio Silva; Tamiris Martins Ribeiro dos Santos; Gustavo Henrique Costa Varca; Diana Pereira Lopes; Karina Cogo-Muller; Duclerc Fernandes Parra; Roberto Ruggiero Braga; Marcelo dos Santos; Leticia Cristina Cidreira Boaro
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