Analysis of antimicrobial activity of root canal sealers against endodontic pathogens using agar diffusion test (In vitro study)

Abstract

Background: Antibacterial action of root canal filling is an important factor for successful root canal treatment, so theaim of the study was to identify and to compare the antimicrobial effect of new sealer (GuttaFlow) to commonlyused endodontic sealers (AH Plus, Apexit and EndoFill) against four endodontic microbes.Materials and methods: Twenty patients aged (30-40) years with infected root canals were selected. Four types ofmicroorganisms were isolated from root canals (E faecalis, Staphylococcus aureus, E coli and Candida albicans) andcultured on Mueller Hinton agar Petri-dishes. After identification and isolation of bacterial species, agar diffusionmethod was used to assess the antibacterial action of four contemporary endodontic sealers used in root canalobturation (AH Plus, Apexit, EndoFill and GuttafFlow). Four wells measuring (5mm depth and 4mm diameter) werecreated in each Petri dish and sealer was applied into them incubated overnight at 37 C° for bacterial species and48 hr. at 37 C° for Candida albicans prior to determination of results. Zones of inhibition (no growth of bacteria) wereexamined around the wells containing sealer & diameters of the zones were measured in mm. The mean of inhibitionzones for each group was measured and statistically analyzed among groups using ANOVA and between groupsusing LSD tests.Results: There was a highly significant difference (P<0.001) among all the tested groups. EndoFill showed themaximum antibacterial action against tested microorganisms. GuttaFlow showed moderate to weak antimicrobialeffect, Apexit had weak effect, while AH Plus had no antibacterial action.Conclusion: All the tested materials except AH Plus had antibacterial efficacy against E faecalis, Staphylococcusaureus, E coli and Candida albicans. EndoFill had favorable results among tested sealers and E faecalis was the mostresistant bacteria, but none of the materials totally inhibited microbial growth. Thus, endodontic treatment must beperformed under aseptic conditions