|Year : 2018 | Volume
| Issue : 1 | Page : 66-68
Comparative evaluation of the antibacterial activity of two Biocompatible materials i.e. Biodentine and MTA when used as a direct pulp capping agent against streptococcus mutans and Enterococcus faecalis- An in vitro study
Aditi Subodh Jain1, Asmita Singh Gupta2, Rupika Agarwal1
1 Department of Conservative Dentistry and Endodontics, Maitri College of Dentistry and Research Center, Durg, India
2 Department of Conservative Dentistry and Endodontics, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
|Date of Web Publication||4-Jun-2018|
Dr. Aditi Subodh Jain
D 13 Kailash Nagar, Rajnandgaon, Chhattisgarh - 491 441
Source of Support: None, Conflict of Interest: None
Aim: This study aims to evaluate and compare the antibacterial potential of biodentine and mineral trioxide aggregate (MTA) cement against Streptococcus mutans and Enterococcus faecalis.
Materials and Methods: Biodentine and MTA were used to assess the antibacterial efficacy against S. mutans and E. faecalis., using the agar well diffusion test. Agar plates were incubated at 37°C for 24 h in an incubator. The diameter of bacterial inhibition zones around each well was measured to the nearest size in mm with a digital caliper.
Results: Inhibition zones formed by Biodentine against S. mutans and E. faecalis were significantly larger than the zones formed by MTA (P < 0.05).
Conclusion: From the present study, it can be concluded that Biodentine and MTA have antimicrobial activity against S. mutans and E. faecalis, but higher mean zone of inhibition was recorded in biodentine.
Keywords: Agar diffusion test, antibacterial, biodentine, mineral trioxide aggregate
|How to cite this article:|
Jain AS, Gupta AS, Agarwal R. Comparative evaluation of the antibacterial activity of two Biocompatible materials i.e. Biodentine and MTA when used as a direct pulp capping agent against streptococcus mutans and Enterococcus faecalis- An in vitro study. Endodontology 2018;30:66-8
|How to cite this URL:|
Jain AS, Gupta AS, Agarwal R. Comparative evaluation of the antibacterial activity of two Biocompatible materials i.e. Biodentine and MTA when used as a direct pulp capping agent against streptococcus mutans and Enterococcus faecalis- An in vitro study. Endodontology [serial online] 2018 [cited 2018 Sep 26];30:66-8. Available from: http://www.endodontologyonweb.org/text.asp?2018/30/1/66/233746
| Introduction|| |
A vital, functioning pulp is capable of initiating many defense mechanisms to shield the body from microorganism invasion. Its advantageous to preserve the vitality of an exposed pulp rather replacing it with a biocompatible material following pulp exposure. Direct pulp capping in cariously exposed pulp of young teeth has yielded, especially high success rate.
Mineral trioxide aggregate (MTA) has excellent biocompatibility, which stimulates the formation of the hard tissue, which acts like a barrier and preserves the vitality of the damaged pulp, and thus eliminate the need of a root canal treatment. The composition includes CaSiO4, bismuth oxide, calcium carbonate, calcium sulfate, and calcium aluminate. It contains a hydrophilic powder that reacts with water and produces a calcium hydroxide and CaSiO4 hydrated gel. However, as its setting time is long (4–6 h), chances of staining of tooth structure, poor handling characteristics, low resistance to compression and high cost are some of its disadvantages. These disadvantages necessitate more ideal restorative material.
Recently, new bioactive material Biodentine was introduced by Septodont (Lancaster, PA, USA) in 2009. The powder consists of tricalcium, dicalcium silicate, and calcium carbonate act as a nucleation site in the hydrating mass, enhancing the hydration and leading to faster setting and zirconium oxide is a radiopacifier. The liquid contains calcium chloride in aqueous solution which accelerates the hydration reaction, with an admixture of polycarboxylate instead of water, which decreases setting time (9–12 min), also reduces the amount of water required for mixing by improving its handling properties., Biodentine has a limitation that it cannot be used in the presence of moisture, unlike MTA.
The aim of this study was to investigate and compare the antibacterial effects of Biodentine and MTA on Streptococcus mutans and Enterococcus faecalis.
| Materials and Methods|| |
The experimental materials include 50 mg Biodentine (Septodont) and 50 mg MTA (DENTSPLY, Tulsa Dental, OK, USA), were manipulated according to the manufacturer's instructions.The antibacterial activity of Biodentine and MTA was evaluated by the agar diffusion method against E. faecalis and S. mutans.
The bacterial stock culture E. faecalis was obtained and culture was grown overnight in brain heart infusion broth and inoculated in Mueller-Hinton agar plates. S. mutans was inoculated onto blood agar media. Inoculation was performed by utilizing sterile cotton swab brushed over the media. Wells 4 mm in diameter and 4 mm deep were prepared on plates with a copper puncher, and under aseptic conditions according to the instructions of the manufacturing company. Immediately filled with freshly manipulated test materials. Then, all the Agar plates were incubated at 37°C in an incubator and evaluated at 24 h. The diameter of microbial inhibition zones around each well was measured to the closest size in mm with a digital caliper. The results were expressed as the mean and standard deviation and data were analyzed statistically by one-way analysis of variance.
| Results|| |
The means and the standard deviation values of the measurements (in mm) of the inhibition zones formed by the tested direct pulp capping materials, i.e., MTA and biodentine against S. mutans and E. faecalis within 24 h are recorded [Table 1].
|Table 1: Comparative evaluation of the antibacterial activity of two biocompatible materials i.e., biodentine and mta when used as a direct pulp capping agent against Streptococcus mutans rococcus faecalis - an in vitro study|
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| Discussion|| |
Pulp integrity of the tooth should be maintained for long-term survival of tooth, to retain the tooth as functional unit and to withstand heavy masticatory forces. The significance of pulp vitality preservation can never be exaggerated.
In this study, the antibacterial activities of MTA and Biodentine were evaluated. In the present study, S. mutans and E. faecalis were included because S. mutans have a major influence on both the initial pulpal lesion and subsequent pulpal pathology. Moreover, E. faecalis is more likely to be found in cases of failed endodontic therapy.
Agar diffusion test is the most commonly employed technique for evaluation of antibacterial activity that is why it was used in the present study. It is able to demonstrate the activity of freshly mixed materials, which makes its inclusion interesting for comparative reasons with previous studies. Moreover, the culture plate diffusion method is not appropriate to determine the minimum inhibitory concentration (MIC), as it is impossible to quantify the amount of the antimicrobial agent diffused into the medium. Nevertheless, an approximate MIC can be calculated for some microorganisms and antibiotics by comparing the inhibition zones with stored algorithms.
Parirokh and Torabinejad et al. evaluated antibacterial effect of MTA and found that MTA showed an antibacterial effect on some of the facultative bacteria but no effect on strictly anaerobic bacteria. The previous authors have shown controversial results regarding the antimicrobial efficacy of pulp capping agents. For instance, while in some studies MTA was effective against E. faecalis, in the others its antimicrobial activity was limited. Estrela et al. concluded that MTA had no antimicrobial activity against E. faecalis, but the present study proved its antimicrobial efficacy against E. faecalis. Calcium hydroxide showed significantly better antibacterial effect than MTA according to Asgary et al. Zhang et al. investigated the antimicrobial effect of gray MTA and white MTA, and they found gray MTA showed greater E. faecalis growth inhibition than white MTA.
MTA is hydrophilic biocompatible cement with dentin-like mechanical properties which can be utilized as a dentin substitute. It is a positive result on vital pulp cells and stimulates tertiary dentin formation. MTA encompasses a comparative mechanism of action to Calcium Hydroxide therein the principle element of the material, calcium oxide when in contact with a humid environment, is changed into calcium hydroxide. This outcome in a high pH of 12.5, creating its surroundings inhospitable for microorganism development and making a hostile to bacterial impact for a long period.
The principal advantages of biodentine over MTA are its greater viscosity and its shorter setting time. A long setting time of MTA is inconvenient to both dentist and patient, because for direct pulp-capping with MTA it requires two visits: application of MTA in the first visit and seating of the permanent restoration over the sufficiently hardened MTA in the second visit. Moreover, it may increase the risk of bacterial contamination. Finer particles in the powder with larger surface areas contribute to the short setting time of Biodentine that will make it possible for treatment to be performed in single visit.
Complete dentinal bridge formation, an absence of inflammatory pulp response and layers of well-arranged odontoblasts and odontoblast-like cells were observed when Biodentine is used as direct pulp capping agent. These properties make Biodentine a substitution material for dentine. Biodentine had a significantly more pronounced antimicrobial effect than MTA. The antimicrobial action of MTA is attributed to its high initial pH of 10.2, which rises to 12.5 in 3 h.
The present study revealed that the diameter of the largest inhibition zone formed around Biodentine. This result suggests that biodentine contains more potent antibacterial inhibitors than MTA.
| Conclusion|| |
MTA and biodentine both being bioactive dental materials can be successfully used for direct pulp capping. However, biodentine showed higher inhibition zones than MTA.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Holland R, de Souza V, Nery MJ, Otoboni Filho JA, Bernabé PF, Dezan Júnior E, et al.
Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydroxide. J Endod 1999;25:161-6.
Torabinejad M, Hong CU, Pitt Ford TR, Kaiyawasam SP. Tissue reaction to implanted super-EBA and mineral trioxide aggregate in the mandible of guinea pigs: A preliminary report. J Endod 1995;21:569-71.
Pérard M, Le Clerc J, Watrin T, Meary F, Pérez F, Tricot-Doleux S, et al.
Spheroid model study comparing the biocompatibility of biodentine and MTA. J Mater Sci Mater Med 2013;24:1527-34.
Nowicka A, Lipski M, Parafiniuk M, Sporniak-Tutak K, Lichota D, Kosierkiewicz A, et al.
Response of human dental pulp capped with biodentine and mineral trioxide aggregate. J Endod 2013;39:743-7.
Dammaschke T. A new bioactive cement for direct pulp capping. Int Dent Afr 2010;2:64.
Tran XV, Gorin C, Willig C, Baroukh B, Pellat B, Decup F, et al.
Effect of a calcium-silicate-based restorative cement on pulp repair. J Dent Res 2012;91:1166-71.
Koruyucu M, Topcuoglu N, Tuna EB, Ozel S, Gencay K, Kulekci G, et al.
An assessment of antibacterial activity of three pulp capping materials on Enterococcus faecalis
by a direct contact test: An in vitro
study. Eur J Dent 2015;9:240-5.
] [Full text]
Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review – Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 2010;36:400-13.
Morgental RD, Vier-Pelisser FV, Oliveira SD, Antunes FC, Cogo DM, Kopper PM, et al.
Antibacterial activity of two MTA-based root canal sealers. Int Endod J 2011;44:1128-33.
Estrela C, Bammann LL, Estrela CR, Silva RS, Pécora JD. Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, sealapex and dycal. Braz Dent J 2000;11:3-9.
Asgary S, Akbari Kamrani F, Taheri S. Evaluation of antimicrobial effect of MTA, calcium hydroxide, and CEM cement. Iran Endod J 2007;2:105-9.
Zhang H, Pappen FG, Haapasalo M. Dentin enhances the antibacterial effect of mineral trioxide aggregate and bioaggregate. J Endod 2009;35:221-4.
Chang SW. Chemical characteristics of mineral trioxide aggregate and its hydration reaction. Restor Dent Endod 2012;37:188-93.
Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 2005;31:97-100.