A Comparative Evaluation of the Sealing Ability, Adaptability and Antibacterial Effect of Nano MTA Plus Versus Conventional MTA Fillapex: An In-Vitro Study

Marina S. Fahmy; Maged M. Negm; Noha A. Hassuna; Mohammed Turky

doi:10.3889/oamjms.2024.11847

Authors

Marina S. Fahmy Departmemt of Endodontics, Faculty of Dentistry, Minia University, Minya, Egypt
Maged M. Negm Department of Endodontics, Faculty of Dentistry, Cairo University, Giza, Egypt
Noha A. Hassuna Associate Professor of Microbiology and Immunology, Faculty of Medicine, Minia University, Minya, Egypt https://orcid.org/0000-0001-6702-2341
Mohammed Turky Department of Endodontics, Faculty of Dentistry, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2024.11847

Keywords:

apical sealing ability, antibacterial effect, bacterial leakage, nanotechnology, scanning electron microscopy

Abstract

AIM: To compare nano-mineral trioxide aggregate (MTA) Plus with MTA Fillapex sealers regarding their sealing ability, adaptability, and antibacterial effect.

METHODS: Forty freshly extracted sound single-rooted permanent maxillary central incisors were used. Following access cavity preparation and root canal preparation. All the samples (n = 40) were randomly and equally categorized into two groups (n = 20 each) according to the sealer employed: group I, in which MTA Fillapex was utilized, and group II, in which nano-MTA Plus was applied. Obturation of root canals was accomplished using the lateral compaction technique. Decoronation of all teeth was performed for standardization of the root length at 12 mm. Roots were submerged in a 2% methylene blue dye solution for 72 h. The roots were divided lengthwise. Linear apical dye penetration and gaps between gutta-percha and dentin were measured under a stereomicroscope at 30× magnification to determine the sealing ability and adaptability, respectively. While the antibacterial activity against Enterococcus faecalis was tested using the Agar Diffusion Test (ADT). Data were statistically estimated utilizing the Mann-Whitney test, Spearman’s correlation coefficient examination, and the independent T-test.

RESULTS: Although Nano-MTA Plus showed higher sealing ability and lower antibacterial action than MTA Fillapex, we didn’t record any statistically substantial variation (2.05 ± 1.43 mm and 11.00 ± 9.42 mm, respectively), (2.10 ± 1.17 mm and 14.25 ± 6.70 mm, respectively). While statistical significance was reported in adaptability, Nano-MTA Plus showed a statistically significant lower adaptability compared with MTA Fillapex (57.89 ± 23.45 μm and 26.82 ± 16.55 μm, respectively).

CONCLUSION: Nano-MTA Plus and MTA Fillapex have comparable sealing abilities, and antibacterial effects. While MTA Fillapex was superior to Nano-MTA Plus regarding adaptability.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biography

Maged M. Negm, Department of Endodontics, Faculty of Dentistry, Cairo University, Giza, Egypt

Professor of Endodontics, Faculty of Dentistry, Cairo University

References

Al-Hezaimi K, Al-Shalan TA, Naghshbandi J, Oglesby S, Simon JH, Rotstein I. Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro. J Endod. 2006;32(11):1053- 6. https://doi.org/10.1016/j.joen.2006.06.004 PMid:17055905 DOI: https://doi.org/10.1016/j.joen.2006.06.004

Prestegaard H, Portenier I, Orstavik D, Kayaoglu G, Haapasalo M, Endal U. Antibacterial activity of various root canal sealers and root-end filling materials in dentin blocks infected ex vivo with Enterococcus faecalis. Acta Odontol Scand. 2014;72(8):970-6. https://doi.org/10.3109/00016357.2014.931462 PMid:25005627 DOI: https://doi.org/10.3109/00016357.2014.931462

Mohamed El Sayed MA, Al Husseini H. Apical dye leakage of two single-cone root canal core materials (hydrophilic core material and gutta-percha) sealed by different types of endodontic sealers: An in vitro study. J Conserv Dent. 2018;21(2):147-52. https://doi.org/10.4103/JCD.JCD_154_17 PMid:29674815 DOI: https://doi.org/10.4103/JCD.JCD_154_17

Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germfree and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340-9. https://doi.org/10.1016/0030-4220(65)90166-0 PMid:14342926 DOI: https://doi.org/10.1016/0030-4220(65)90166-0

Solanki NP, Venkappa KK, Shah NC. Biocompatibility and sealing ability of mineral trioxide aggregate and biodentine as root-end filling material: A systematic review. J Conserv Dent. 2018;21(1):10-5. https://doi.org/10.4103/JCD.JCD_45_17 PMid:29628640

Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review--part III: Clinical applications, drawbacks, and mechanism of action. J Endod. 2010;36(3):400- 13. https://doi.org/10.1016/j.joen.2009.09.009 PMid:20171353 DOI: https://doi.org/10.1016/j.joen.2009.09.009

Omar N, Abdelraouf RM, Hamdy TM. Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials. BMC Oral Health. 2023;23(1):193. https://doi.org/10.1186/s12903-023-02858-7 PMid:37009885 DOI: https://doi.org/10.1186/s12903-023-02858-7

Al-Hezaimi K, Naghshbandi J, Oglesby S, Simon JH, Rotstein I. Human saliva penetration of root canals obturated with two types of mineral trioxide aggregate cements. J Endod. 2005;31(6):453- 6. https://doi.org/10.1097/01.don.0000145429.04231.e2 PMid:15917686 DOI: https://doi.org/10.1097/01.don.0000145429.04231.e2

Tabassum S, Khan FR. Failure of endodontic treatment: The usual suspects. Eur J Dent. 2016;10(1):144-7. https://doi.org/10.4103/1305-7456.175682 PMid:27011754 DOI: https://doi.org/10.4103/1305-7456.175682

Endo MS, Ferraz CC, Zaia AA, Almeida JF, Gomes BP. Quantitative and qualitative analysis of microorganisms in root-filled teeth with persistent infection: Monitoring of the endodontic retreatment. Eur J Dent. 2013;7(3):302-9. https://doi.org/10.4103/1305-7456.115414 PMid:24926210 DOI: https://doi.org/10.4103/1305-7456.115414

Al-Haddad A, Che Ab Aziz ZA. Bioceramic-based root canal sealers: A review. Int J Biomater. 2016;2016:9753210. https://doi.org/10.1155/2016/9753210 PMid:27242904 DOI: https://doi.org/10.1155/2016/9753210

Amoroso-Silva PA, Guimarães BM, Marciano MA, Duarte MA, Cavenago BC, Ordinola-Zapata R, et al. Microscopic analysis of the quality of obturation and physical properties of MTA fillapex. Microsc Res Tech. 2014;77(12):1031-6. https://doi.org/10.1002/jemt.22432 PMid:25209870 DOI: https://doi.org/10.1002/jemt.22432

Salz U, Poppe D, Sbicego S, Roulet JF. Sealing properties of a new root canal sealer. Int Endod J. 2009;42(12):1084-9. https:// doi.org/10.1111/j.1365-2591.2009.01635.x PMid:19912379 DOI: https://doi.org/10.1111/j.1365-2591.2009.01635.x

Arikatla SK, Chalasani U, Mandava J, Yelisela RK. Interfacial adaptation and penetration depth of bioceramic endodontic sealers. J Conserv Dent. 2018;21(4):373-7. https://doi.org/10.4103/JCD.JCD_64_18 PMid:30122816 DOI: https://doi.org/10.4103/JCD.JCD_64_18

Pizzo G, Giammanco GM, Cumbo E, Nicolosi G, Gallina G. In vitro antibacterial activity of endodontic sealers. J Dent. 2006;34(1):35-40. https://doi.org/10.1016/j.jdent.2005.03.001 PMid:15907357 DOI: https://doi.org/10.1016/j.jdent.2005.03.001

Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod. 1993;19(11):541-4. https://doi.org/10.1016/S0099-2399(06)81282-3 PMid:8151240 DOI: https://doi.org/10.1016/S0099-2399(06)81282-3

Lolayekar N, Bhat SS, Hegde S. Sealing ability of ProRoot MTA and MTA-angelus simulating a one-step apical barrier technique--an in vitro study. J Clin Pediatr Dent. 2009;33(4):305- 10. https://doi.org/10.17796/jcpd.33.4.gp472416163h7818 PMid:19725236 DOI: https://doi.org/10.17796/jcpd.33.4.gp472416163h7818

De Leimburg ML, Angeretti A, Ceruti P, Lendini M, Pasqualini D, Berutti E. MTA obturation of pulpless teeth with open apices: Bacterial leakage as detected by polymerase chain reaction assay. J Endod. 2004;30(12):883-6. https://doi.org/10.1097/01.don.0000128749.50151.24 PMid:15564870 DOI: https://doi.org/10.1097/01.DON.0000128749.50151.24

Giuliani V, Baccetti T, Pace R, Pagavino G. The use of MTA in teeth with necrotic pulps and open apices. Dent Traumatol. 2002;18(4):217-21. https://doi.org/10.1034/j.1600-9657.2002.02107.x PMid:12442832 DOI: https://doi.org/10.1034/j.1600-9657.2002.02107.x

Altammar KA. A review on nanoparticles: Characteristics, synthesis, applications, and challenges. Front Microbiol. 2023;14:1155622. https://doi.org/10.3389/fmicb.2023.1155622 PMid:37180257 DOI: https://doi.org/10.3389/fmicb.2023.1155622

Pai S, Pai AR, Thomas MS, Bhat V. Effect of calcium hydroxide paste as intracanal medicaments on the incidence of inter-appointment flare-up in diabetic patients: An in vivo study. J Conserv Dent. 2014;17(3):208-11. https://doi.org/10.4103/0972-0707.131776 PMid:24944440 DOI: https://doi.org/10.4103/0972-0707.131776

Inan U, Aydin C, Tunca YM, Basak F. In vitro evaluation of matched-taper single-cone obturation with a fluid filtration method. J Can Dent Assoc. 2009;75(2):123. PMid:19267963

Economides N, Liolios E, Kolokuris I, Beltes P. Long-term evaluation of the influence of smear layer removal on the sealing ability of different sealers. J Endod. 1999;25(2):123-5. https://doi.org/10.1016/S0099-2399(99)80010-7 PMid:10204470 DOI: https://doi.org/10.1016/S0099-2399(99)80010-7

Crumpton BJ, Goodell GG, McClanahan SB. Effects on smear layer and debris removal with varying volumes of 17% REDTA after rotary instrumentation. J Endod. 2005;31(7):536-8. https://doi.org/10.1097/01.don.0000148871.72896.1d PMid:15980717 DOI: https://doi.org/10.1097/01.don.0000148871.72896.1d

Taylor JK, Jeansonne BG, Lemon RR. Coronal leakage: Effects of smear layer, obturation technique, and sealer. J Endod. 1997;23(8):508-12. https://doi.org/10.1016/S0099-2399(97)80311-1 PMid:9587321 DOI: https://doi.org/10.1016/S0099-2399(97)80311-1

Shipper G, Orstavik D, Teixeira FB, Trope M. An evaluation of microbial leakage in roots filled with a thermoplastic synthetic polymer-based root canal filling material (resilon). J Endod. 2004;30(5):342-7. https://doi.org/10.1097/00004770-200405000-00009 PMid:15107647 DOI: https://doi.org/10.1097/00004770-200405000-00009

Sönmez IS, Oba AA, Sönmez D, Almaz ME. In vitro evaluation of apical microleakage of a new MTA-based sealer. Eur Arch Paediatr Dent. 2012;13(5):252-5. https://doi.org/10.1007/ BF03262880 PMid:23043882 DOI: https://doi.org/10.1007/BF03262880

Boussetta F, Bal S, Romeas A, Boivin G, Magloire H, Farge P. In vitro evaluation of apical microleakage following canal filling with a coated carrier system compared with lateral and thermomechanical gutta-percha condensation techniques. Int Endod J. 2003;36(5):367-71. https://doi.org/10.1046/j.1365-2591.2003.00665.x PMid:12752651 DOI: https://doi.org/10.1046/j.1365-2591.2003.00665.x

Haragushiku GA, Teixeira CS, Furuse AY, Sousa YT, De Sousa Neto MD, Silva RG. Analysis of the interface and bond strength of resin-based endodontic cements to root dentin. Microsc Res Tech. 2012;75(5):655-61. https://doi.org/10.1002/jemt.21107 PMid:22505186 DOI: https://doi.org/10.1002/jemt.21107

Leonardo MR, da Silva LA, Tanomaru Filho M, Bonifácio KC, Ito IY. In vitro evaluation of antimicrobial activity of sealers and pastes used in endodontics. J Endod. 2000;7(26):391-4. https://doi.org/10.1097/00004770-200007000-00003 PMid:11199762 DOI: https://doi.org/10.1097/00004770-200007000-00003

Cobankara FK, Altinöz HC, Ergani O, Kav K, Belli S. In vitro antibacterial activities of root-canal sealers by using two different methods. J Endod. 2004;1(30):57-60. https://doi.org/10.1097/00004770-200401000-00013 PMid:14760911 DOI: https://doi.org/10.1097/00004770-200401000-00013

Camilleri J. Hydration mechanisms of mineral trioxide aggregate. Int Endod J. 2007;40(6):462-70. https://doi.org/10.1111/j.1365-2591.2007.01248.x PMid:17459120 DOI: https://doi.org/10.1111/j.1365-2591.2007.01248.x

Singh R, Pushpa S, Arunagiri D, Sawhny A, Misra A, Sujatha R. The effect of irrigating solutions on the apical sealing ability of MTA fillapex and adseal root canal sealers. J Dent Res Dent Clin Dent Prospects. 2016;10(4):251-6. https://doi.org/10.15171/joddd.2016.040 PMid:28096952 DOI: https://doi.org/10.15171/joddd.2016.040

Hasheminia M, Razavian H, Mosleh H, Shakerian B. In vitro evaluation of the antibacterial activity of five sealers used in root canal therapy. Dent Res J (Isfahan). 2017;14(1):62-7. https://doi.org/10.4103/1735-3327.201141 PMid:28348620 DOI: https://doi.org/10.4103/1735-3327.201141

Estrela C, Sydney GB, Bammann LL, Felippe Júnior O. Mechanism of action of calcium and hydroxyl ions of calcium hydroxide on tissue and bacteria. Braz Dent J. 1995;6(2):85-90. PMid:8688662

Ramezani G, Savadkouhi ST, Sayahpour S. The effect of chlorhexidine mixed with mineral trioxide aggregate on bacterial leakage of apical plug in simulated immature teeth using human fresh saliva. J Int Soc Prev Community Dent. 2017;7(5):247-51. https://doi.org/10.4103/jispcd.JISPCD_198_17 PMid:29026696 DOI: https://doi.org/10.4103/jispcd.JISPCD_198_17

Yousra MN, Ahmed HL, Nada O, Mostafa S, Neveen AH. Comparative study of the antibacterial effect of MTA, nano-MTA, Portland cement, and nano-Portland cement. Egypt Dent J. 2019;65(1):701-6. https://doi.org/10.21608/edj.2019.72834 DOI: https://doi.org/10.21608/edj.2019.72834