Comparative Evaluation of Antibacterial Efficacy of Two Bioceramic Root Canal Sealers Incorporated with Novel Silica Doped TiO2 Nanoparticles: An In-vitro Study

Introduction: The success of Root Canal Treatment (RCT), depends on the complete elimination of microorganisms in combination with complete root canal system closure. Complete elimination of bacteria cannot be done by cleaning and shaping alone from lateral canals, isthmuses, and apical deltas. Thus, root canal sealers with ideal physical, biological, and improved antimicrobial characteristics are thus, necessary to avoid reinfections.

Aim: To evaluate the antibacterial efficacy of two Bioceramic (Bio-C) modified root canal sealers, using Silica Doped Titanium Dioxide Nanoparticles (SiTiO2), a unique, extremely effective antibacterial agent on root canal dentin infected with Enterococcus faecalis (E. faecalis).

Materials and Methods: This in-vitro study was conducted in the Department of Conservative Dentistry and Endodontics in collaboration with the Department of Microbiology at Sree Sai Dental College and Research Institute, Andhra Pradesh, India. The study was done in August 2022. The antibacterial efficacy of the two Bio-C sealers was evaluated by counting Colony Forming Units (CFU) and the percentage of live bacteria by a confocal laser scanning microscope. A total of 60 middle thirds of single-rooted teeth incubated with E.faecalis were chosen. Gutta-percha (GP) was used to fill the canals along with sealers in all six groups (group I-VI), namely Mineral Trioxide Aggregate based (MTA Fillapex); MTA Fillapex+SiTiO2 NPs (1% wt); MTA Fillapex +2% wt SiTiO2 NPs; Bio-C; Bio-C+ 1% wt SiTiO2 NPs; Bio-C+ 2% wt SiTiO2 NPs respectively, and incubated for seven days, each tooth was divided into two halves longitudinally. Microbiological analysis was conducted on one half, and microscopic analysis on the other half. The six groups were compared using a one-way Analysis of Variance (ANOVA) and intergroup comparison with Tukey’s post-hoc tests.

Results: The addition of SiTiO2 NPs to Bio-C and MTA Fillapex significantly reduced the bacteria, compared to an unmodified sealer (p-value<0.001). MTA Fillapex with SiTiO2 NPs showed higher bacterial viability compared with Bio-C with SiTiO2 NPs.

Conclusion: Loading endodontic sealers with SiTiO2 NPs has a material-dependent impact on the antibacterial properties, that could lower the frequency of secondary infections.