Journal of Conservative Dentistry
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Year : 2015  |  Volume : 18  |  Issue : 1  |  Page : 44-46
Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement

1 Department of Conservative Dentistry and Endodontics, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India
2 Department of Conservative Dentistry and Endodontics, Saraswati Dhanawantari Dental College, Parbhani, Maharashtra, India
3 Department of Conservative Dentistry and Endodontics, Sri Venkata Sai Institute of Dental Sciences, Mahabubnagar, Telangana, India
4 Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India

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Date of Submission11-Jun-2014
Date of Decision08-Oct-2014
Date of Acceptance19-Oct-2014
Date of Web Publication8-Jan-2015


Objective: To evaluate the antibacterial and antifungal properties of calcium-based cement, Biodentine (Ca 3 SiO 2 ), compared to commercial glass ionomer cements (GICs) and mineral trioxide aggregate (MTA).
Materials and Methods: Pellets of GICs, ProRoot MTA, and Biodentine were prepared to test the influence of these cements on the growth of four oral microbial strains: Streptococcus mutans, Enterococcus faecalis, Escherichia coli, and Candida albicans; using agar diffusion method. Wells were formed by removing the agar and the manipulated materials were immediately placed in the wells. The pellets were lodged in seeded plates and the growth inhibition diameter around the material was measured after 24-72 h incubation at 37°C. The data were analyzed using analysis of variance (ANOVA) test to compare the differences among the three cements at different concentrations.
Results: Test indicates that the antimicrobial activity of Biodentine, on all the microorganisms tested, was very strong, showing a mean inhibition zone of 3.2 mm, which extends over time towards all the strains. For Biodentine, GIC, and MTA, the diameters of the inhibition zones for S. mutans were significantly larger than for E. faecalis, Candida, and E. coli (P < 0.05).
Conclusion: All materials showed antimicrobial activity against the tested strains except for GIC on Candida. Largest inhibition zone was observed for Streptococcus group. Biodentine created larger inhibition zones than MTA and GIC.

Keywords: Antibacterial activity; giodentine; inhibition zone; MTA

How to cite this article:
Bhavana V, Chaitanya KP, Gandi P, Patil J, Dola B, Reddy RB. Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement. J Conserv Dent 2015;18:44-6

How to cite this URL:
Bhavana V, Chaitanya KP, Gandi P, Patil J, Dola B, Reddy RB. Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement. J Conserv Dent [serial online] 2015 [cited 2023 Nov 30];18:44-6. Available from:

   Introduction Top

Microorganisms have great impact on the development and progression of pulpal and periapical diseases as well as in endodontic treatment failure. [1] The success of the root canal treatment depends on careful diagnosis and accurately performed cleaning, shaping, and compact filling of the root canal under aseptic conditions. Most pulpal and periapical disease is best managed nonsurgically. However, certain microorganisms are repeatedly recovered from previously root-filled teeth that have become infected. If nonsurgical endodontic therapy is unsuccessful, surgical endodontic therapy (apicoectomy and retrograde filling) is required to conserve the tooth. Most endodontic failures are attributable to inadequate cleansing of the root canal and egress of bacteria and other antigens into the periradicular tissues. When inflammation or infection persists in the bony area around the end of the tooth after a root canal procedure, then it is necessary to perform an apicoectomy and a root-end filling is placed to prevent reinfection of the root. Hence, in addition to sealing ability and biocompatibility, root-end filling materials should ideally have some antimicrobial activity to prevent bacterial and fungal growth. [2] One of the well-known root-end filling material is glass ionomer cement (GIC), which has unique properties such as, adhesion to moist tooth structure, low shrinkage and biological acceptance, but low antimicrobial efficacy. [3]

ProRoot mineral trioxide aggregate (MTA) is marketed as gray- and white-colored preparations, both of which are composed of 75% Portland cement clinker, 20% bismuth oxide, and 5% gypsum by weight. MTA is a powder is made of fine hydrophilic particles that in presence of water forms a colloidal gel which solidifies and forms hard cement within approximately 4 h. Although MTA has excellent biocompatibility, it has a delayed setting time and poor handling characteristics, as well as being an expensive material. [4] Recently, new endodontic material Biodentine (Septodont) was introduced. The powder mainly contains tricalcium and dicalcium silicate as well as calcium carbonate. The liquid consists of calcium chloride in aqueous solution with an admixture of polycarboxylate, which sets in 12 min. [5] The purpose of this study was to investigate and compare the antibacterial and antifungal effects of Biodentine, MTA, and GIC on Streptococcus mutans, Enterococcus faecalis,  Escherichia More Details coli, and Candida albicans microorganisms.

   Materials and Methods Top

The test materials - MTA (DENTSPLY, Tulsa Dental, OK, USA), Biodentine (Septodont), and GIC (GC Asia Dental Pte. Ltd) - Were manipulated strictly in accordance with the manufacturer's instructions. The antimicrobial activity of the endodontic cements was evaluated by the agar diffusion method against five reference strains: E. faecalis (ATCC 29212), E. coli (ATCC 33780), S. mutans (ATCC25175), and Candida (ATCC 10231). Each endodontic cement was evaluated at concentrations suggested by the manufacturer. Bacteria were diluted to obtain a suspension of approximately 5 × 10 8 colony forming units/ml, in sterile Trypticase Soy Broth (TSB). Microbial strains were confirmed by colony forming units and growth characteristics. E. faecalis, E. coli, and Candida suspensions were inoculated with sterile cotton swabs onto Meuller-Hinton agar plates and S. mutans was inoculated onto blood agar media. Wells 4 mm in diameter and 4 mm deep were prepared on plates with a copper puncher, and immediately filled with freshly manipulated test materials. After prediffusion of the test materials for 2 h at room temperature, all the plates were incubated at 37°C and evaluated at 24 h. Microbial inhibition zones were measured with a 0.5 mm precision ruler and the results were expressed as the mean and standard deviation. To compare the differences among MTA, Biodentine, and GIC; data were analyzed statistically by one-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post-hoc test, using Statistical Package for Social Sciences (SPSS) software version 21 (SPSS Inc, Chicago, IL, USA).

   Results Top

The antimicrobial activities of MTA, Biodentine, and GIC are shown in [Table 1]. The antimicrobial action of Biodentine on all the microorganisms tested was superior to that of MTA and GIC, showing a mean inhibition zone of 3.2 mm. This difference was significant for GIC (P < 0.05), but not for MTA (P > 0.05). All cements were significantly more effective against S. mutans than against Candida, E. faecalis, and E. coli (P < 0.05). Nevertheless, GIC was incapable of inhibiting the growth of Candida. For all three cements, the diameters of the inhibition zones for S. mutans were significantly larger than for E. faecalis, Candida, and E. coli (P < 0.05).
Table 1: Mean inhibition zones of three cements (in cm)

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   Discussion Top

In this study, the antimicrobial activity of MTA, Biodentine, and GIC were evaluated. Most commonly predominant microorganisms in persistent or refractory periapical lesions are facultative bacteria and yeast; hence, these microorganisms are included under the test group in this study. E. faecalis is more likely to be found in cases of failed endodontic therapy than in cases of primary infection. E. coli is sometimes recovered from root canals and represents a standard organism used in antimicrobial testing. [6] C. albicans has the ability to form biofilms on different surfaces, and may be involved in cases of persistent and secondary infection. [7] S. mutans may have a major influence on both the initial pulpal lesion and subsequent pulpal pathology.

Agar diffusion method was used, which is the most commonly employed technique for evaluation of antimicrobial activity. [8] Several antimicrobial studies have employed this technique; however, variations in agar medium, bacterial strains, diffusion capacity of inhibitory agents, and cellular density may interfere with the formation of inhibition zones around materials used in antimicrobial testing. [9]

The present study revealed that the diameter of the inhibition zone varied significantly according to the microorganism tested. For all three cements, the largest inhibition zones formed around S. mutans. The results showed that Biodentine had higher antimicrobial activity than MTA, and the antimicrobial activities of MTA and Biodentine were significantly higher than that of GIC. This result suggests that Biodentine contains more potent antibacterial and antifungal inhibitors than MTA.

Biodentine shares both its indications and mode of action with calcium hydroxide, but does not have its disadvantages. Three major disadvantages of calcium hydroxide, higher material resorption rate, mechanical instability, and failure to prevent microleakages are therefore avoided. Biodentine is mechanically stronger, less soluble, and gives a tighter seal. Compared to other materials such as MTA, Biodentine handles easily and needs much less time for setting. [5] Hence, in this study; Biodentine had a significantly more pronounced antibacterial 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.

No previous studies have evaluated the antifungal activity of MTA, Biodentine, and GIC. Both Biodentine and MTA showed inhibition zones formed around Candida, but not GIC. Therefore, the results suggested that Candida is resistant to GIC, as there is no significant zone of inhibition formed around it.

Estrela et al., demonstrated that MTA had no antimicrobial activity against E. faecalis, but this study proved its antimicrobial efficacy against E. faecalis. [9] The results of this study also differed from the study by Torabinejad et al., [8] in which there was no inhibitory effect of MTA against E. coli, but in the present study MTA showed good antimicrobial activity against E. coli. Al-Nazhan and Al-Judai demonstrated antifungal activity of MTA, [10] which was in agreement with this study. However, available nutrients, level of oxygen tension, incubation period, methods of evaluation, and different laboratory set-ups employed; influenced the study results.

   Conclusion Top

1. All materials showed antimicrobial activity against the tested strains except for GIC on Candida.

2. Largest inhibition zone was observed for Streptococcus group.

3. Biodentine created larger inhibition zones than MTA and GIC.

   References Top

Fouad AF, Zerella J, Barry J, Spangberg LS. Molecular detection of Enterococcus species in root canals of therapy-resistant endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:112-8.  Back to cited text no. 1
Hasan Zarrabi M, Javidi M, Naderinasab M, Gharechahi M. Comparative evaluation of antimicrobial activity of three cements: New endodontic cement (NEC), mineral trioxide aggregate (MTA) and Portland. J Oral Sci 2009;51:437-42.  Back to cited text no. 2
Tobias RS. Antibacterial properties of dental restorative materials: A review. Int Endod J 1988;21:155-60.  Back to cited text no. 3
Asgary S, Kamrani FA. Antibacterial effects of five different root canal sealing materials. J Oral Sci 2008;50:469-74.  Back to cited text no. 4
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.  Back to cited text no. 5
Heling I, Chandler NP. Antimicrobial effect of irrigant combinations within dentinal tubules. Int Endod J 1998;31:8-14.  Back to cited text no. 6
Siqueira JF, Sen BH. Fungi in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:632-41.  Back to cited text no. 7
Torabinejad M, Hong CU, Pitt Ford TR, Kettering JD. Antibacterial effects of some root end filling materials. J Endod 1995;21:403-6.  Back to cited text no. 8
Estrela C, Bammann LL, Estrela CR, Silva RS, Pécora JD. Antimicrobial and chemical study of MTA, Portland cement, calcium hidroxide paste, Sealapex and Dycal. Braz Dent J 2000;11:3-9.  Back to cited text no. 9
Al-Nazhan S, Al-Judai A. Evaluation of antifungal activity of mineral trioxide aggregate. J Endod 2003;29:826-7.  Back to cited text no. 10

Correspondence Address:
Dr. Vankayala Bhavana
Department of Conservative Dentistry and Endodontics, Sri Sai College of dental Surgery, Vikarabad - 501 101, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-0707.148892

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