Objective. The aim of this study was to evaluate the antimicrobial activity and pH changes induced by Portland cement (PC) alone and in association with radiopacifiers. Methods. The materials tested were pure PC, PC + bismuth oxide, PC + zirconium oxide, PC + calcium tungstate, and zinc oxide and eugenol cement (ZOE). Antimicrobial activity was evaluated by agar diffusion test using the following strains: Micrococcus luteus, Streptococcus mutans, Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans. After 24 hours of incubation at 37°C, inhibition of bacterial growth was observed and measured. For pH analysis, material samples ( ) were placed in polyethylene tubes and immersed in 10？mL of distilled water. After 12, 24, 48, and 72 hours, the pH of the solutions was determined using a pH meter. Results. All microbial species were inhibited by the cements evaluated. All materials composed of PC with radiopacifying agents promoted pH increase similar to pure Portland cement. ZOE had the lowest pH values throughout all experimental periods. Conclusions. All Portland cement-based materials with the addition of different radiopacifiers (bismuth oxide, calcium tungstate, and zirconium oxide) presented antimicrobial activity and pH similar to pure Portland cement. 1. Introduction The ideal root-end filling material should present certain characteristics, such as ability to seal the root canal system, dimensional stability in the presence of humidity, and radiopacity. Equally important are its ability to induce repair, antimicrobial action, and biocompatibility. All these properties contribute towards the success of endodontic surgery [1]. Since its introduction as a root-end filling material in 1993, the clinical applications of mineral trioxide aggregate (MTA) have been expanded. Presently, MTA is also used as a reparative cement due to its alkaline pH [2]. The mechanism of action of MTA is similar to that of calcium hydroxide. However, the manipulation and insertion of this cement into retrograde preparations are extremely difficult. Yet another disadvantage of MTA is its high cost [3]. Several studies have evaluated Portland cement (PC) as an alternative to MTA [4, 5]. One of the limitations of PC is its low radiopacity, requiring addition of a radiopacifier prior to use. Bismuth oxide, the radiopacifying agent present in MTA, is not considered ideal by some authors. A number of studies have shown that this radiopacifier interferes with the mechanical stability of the cement by increasing its porosity [6] and also that it may negatively affect
References
[1]
M. Torabinejad and T. R. Pitt Ford, “Root end filling materials: a review,” Endodontics and Dental Traumatology, vol. 12, no. 4, pp. 161–178, 1996.
[2]
M. Parirokh and M. Torabinejad, “Mineral trioxide aggregate: a comprehensive literature review—part I: chemical, physical, and antibacterial properties,” Journal of Endodontics, vol. 36, no. 1, pp. 16–27, 2010.
[3]
M. Parirokh and M. Torabinejad, “Mineral trioxide aggregate: a comprehensive literature review—part III: clinical applications, drawbacks, and mechanism of action,” Journal of Endodontics, vol. 36, no. 3, pp. 400–413, 2010.
[4]
L. A. Dreger, W. T. Felippe, J. F. Reyes-Carmona, G. S. Felippe, E. A. Bortoluzzi, and M. C. Felippe, “Mineral trioxide aggregate and portland cement promote biomineralization in vivo,” Journal of Endodontics, vol. 38, no. 3, pp. 324–329, 2012.
[5]
M. G. de Oliveira, C. B. Xavier, F. F. Demarco, A. L. B. Pinheiro, A. T. Costa, and D. H. Pozza, “Comparative chemical study of MTA and Portland cements,” Brazilian Dental Journal, vol. 18, no. 1, pp. 3–7, 2007.
[6]
K. S. Coomaraswamy, P. J. Lumley, and M. P. Hofmann, “Effect of bismuth oxide radioopacifier content on the material properties of an endodontic Portland cement-based (MTA-like) system,” Journal of Endodontics, vol. 33, no. 3, pp. 295–298, 2007.
[7]
K. Asakura, H. Satoh, M. Chiba et al., “Genotoxicity studies of heavy metals: lead, bismuth, indium, silver and antimony,” Journal of Occupational Health, vol. 51, no. 6, pp. 498–512, 2009.
[8]
E. A. Bortoluzzi, J. M. Guerreiro-Tanomaru, M. Tanomaru-Filho, and M. A. H. Duarte, “Radiographic effect of different radiopacifiers on a potential retrograde filling material,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 108, no. 4, pp. 628–632, 2009.
[9]
A. L. Gomes Cornélio, L. P. Salles, M. Campos Da Paz, J. A. Cirelli, J. M. Guerreiro-Tanomaru, and M. Tanomaru Filho, “Cytotoxicity of Portland cement with different radiopacifying agents: a cell death study,” Journal of Endodontics, vol. 37, no. 2, pp. 203–210, 2011.
[10]
G. De-Deus, V. Petruccelli, E. Gurgel-Filho, and T. Coutinho-Filho, “MTA versus Portland cement as repair material for furcal perforations: a laboratory study using a polymicrobial leakage model,” International Endodontic Journal, vol. 39, no. 4, pp. 293–298, 2006.
[11]
M. Hasan Zarrabi, M. Javidi, M. Naderinasab, and M. Gharechahi, “Comparative evaluation of antimicrobial activity of three cements: new endodontic cement (NEC), mineral trioxide aggregate (MTA) and Portland,” Journal of Oral Science, vol. 51, no. 3, pp. 437–442, 2009.
[12]
X. Zhu, Q. Wang, C. Zhang, G. S. P. Cheung, and Y. Shen, “Prevalence, phenotype, and genotype of Enterococcus faecalis isolated from saliva and root canals in patients with persistent apical periodontitis,” Journal of Endodontics, vol. 36, no. 12, pp. 1950–1955, 2010.
[13]
M. Nagayoshi, T. Nishihara, K. Nakashima, S. Iwaki, K. K. Chen, and M. Terashita, “Bactericidal effects of diode laser irradiation on Enterococcus faecalis using periapical lesion defect model,” ISRN Dentistry, vol. 2011, Article ID 870364, 2011.
[14]
S. M. Ozbek, A. Ozbek, and A. S. Erdogan, “Analysis of Enterococcus faecalis in samples from Turkish patients with primary endodontic infections and failed endodontic treatment by real-time PCR SYBR green method,” Journal of Applied Oral Science, vol. 17, no. 5, pp. 370–374, 2009.
[15]
F. K. ？obankara, H. C. Altin？z, O. Ergani？, K. Kav, and S. Belli, “In vitro antibacterial activities of root-canal sealers by using two different methods,” Journal of Endodontics, vol. 30, no. 1, pp. 57–60, 2004.
[16]
C. Estrela, L. L. Bammann, F. C. Pimenta, and J. D. Pécora, “Control of microorganisms in vitro by calcium hydroxide pastes,” International Endodontic Journal, vol. 34, no. 5, pp. 341–345, 2001.
[17]
E. Bodrumlu and T. Ala？am, “Evaluation of antimicrobial and antifungal effects of iodoform-integrating gutta-percha,” Journal of the Canadian Dental Association, vol. 72, no. 8, pp. 733–733, 2006.
[18]
R. S. Tobias, “Antibacterial properties of dental restorative materials: a review,” International Endodontic Journal, vol. 21, no. 2, pp. 155–160, 1988.
[19]
J. M. Tanomaru, M. Tanomaru-Filho, J. Hotta, E. Watanabe, and I. Y. Ito, “Antimicrobial activity of endodontic sealers based on calcium hydroxide and MTA,” Acta Odontológica Latinoamericana, vol. 21, no. 2, pp. 147–151, 2008.
[20]
W. J. Begue and R. M. Kline, “The use of tetrazolium salts in bioauthographic procedures,” Journal of Chromatography A, vol. 64, no. 1, pp. 182–184, 1972.
[21]
M. R. Leonardo, L. A. B. Da Silva, M. Tanomaru Filho, K. C. Bonifácio, and I. Y. Ito, “In vitro evaluation of antimicrobial activity of sealers and pastes used in endodontics,” Journal of Endodontics, vol. 26, no. 7, pp. 391–394, 2000.
[22]
C. R. Sipert, R. P. Hussne, C. K. Nishiyama, and S. A. Torres, “In vitro antimicrobial activity of Fill Canal, Sealapex, Mineral Trioxide Aggregate, Portland cement and EndoRez,” International Endodontic Journal, vol. 38, no. 8, pp. 539–543, 2005.
[23]
M. A. Hungaro Duarte, A. C. C. De Oliveira Demarchi, J. C. Yamashita, M. C. Kuga, and S. De Campos Fraga, “pH and calcium ion release of 2 root-end filling materials,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 95, no. 3, pp. 345–347, 2003.
[24]
K. Al-Hezaimi, T. A. Al-Shalan, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Antibacterial effect of two Mineral Trioxide Aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro,” Journal of Endodontics, vol. 32, no. 11, pp. 1053–1056, 2006.
[25]
M. Zehnder, E. S？derling, J. Salonen, and T. Waltimo, “Preliminary evaluation of bioactive glass S53P4 as an endodontic medication in vitro,” Journal of Endodontics, vol. 30, no. 4, pp. 220–224, 2004.
[26]
J. Camilleri, “Evaluation of the physical properties of an endodontic Portland cement incorporating alternative radiopacifiers used as root-end filling material,” International Endodontic Journal, vol. 43, no. 3, pp. 231–240, 2010.
[27]
C. P. McHugh, P. Zhang, S. Michalek, and P. D. Eleazer, “pH required to kill Enterococcus faecalis in vitro,” Journal of Endodontics, vol. 30, no. 4, pp. 218–219, 2004.
[28]
C. Estrela, L. L. Bammann, C. R. Estrela, R. S. Silva, and J. D. Pécora, “Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, Sealapex and Dycal,” Brazilian Dental Journal, vol. 11, no. 1, pp. 3–9, 2000.
[29]
C. S. Ribeiro, F. A. Kuteken, R. Hirata, and M. F. Z. Scelza, “Comparative evaluation of antimicrobial action of MTA, calcium hydroxide and portland cement,” Journal of Applied Oral Science, vol. 14, no. 5, pp. 330–333, 2006.
[30]
D. M. Holt, J. D. Watts, T. J. Beeson, T. C. Kirkpatrick, and R. E. Rutledge, “The anti-microbial effect against Enterococcus faecalis and the compressive strength of two types of Mineral Trioxide Aggregate mixed with sterile water or 2% chlorhexidine liquid,” Journal of Endodontics, vol. 33, no. 7, pp. 844–847, 2007.
[31]
M. E. Odaba？, ？. ？inar, G. Ak？a, I. Araz, T. Ulusu, and H. Yücel, “Short-term antimicrobial properties of mineral trioxide aggregate with incorporated silver-zeolite,” Dental Traumatology, vol. 27, no. 3, pp. 189–194, 2011.
