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| LETTER TO EDITOR |
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| Year : 2023 | Volume
: 13
| Issue : 1 | Page : 120-121 |
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Effect of bioceramic sealers against planktonic Enterococcus faecalis
Saravana Karthikeyan Balasubramanian1, VC Divya2
1 Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science and Technology, Ramapuram Campus, Chennai, Tamil Nadu, India
2 Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| Date of Submission | 21-Jul-2022 |
| Date of Decision | 06-Aug-2022 |
| Date of Acceptance | 07-Aug-2022 |
| Date of Web Publication | 11-Jan-2023 |
Correspondence Address:
Dr. Saravana Karthikeyan Balasubramanian
Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science and Technology, Ramapuram, Chennai, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sej.sej_138_22
How to cite this article:
Balasubramanian SK, Divya V C. Effect of bioceramic sealers against planktonic Enterococcus faecalis. Saudi Endod J 2023;13:120-1 |
Sir,
We read with interest the article titled “Antibacterial efficacy of bioceramic root canal sealers (RCS) against planktonic Enterococcus faecalis after different contact and setting time: An in vitro study” by Munitic et al. published recently in your esteemed journal.[1] The study evaluated the antimicrobial efficacy of four RCS, namely, TotalFill, BioRoot RCS, mineral trioxide aggregate (MTA) Fillapex, and AH Plus against E. faecalis. The authors' efforts are highly commendable; however, we would like to express our views regarding a few observations pertaining to this clinically significant study.
The authors had assessed the antibacterial efficacy of the sealers against ATCC29212 strain of E. faecalis. However, literature evidence suggests the use of wild-type strains of E. faecalis for assessing antimicrobial activity because they are less susceptible to sealers as compared to the commonly used ATCC strain.[2] In addition, the type of bacteria also influences the study results.[2] Since planktonic bacteria do not represent a real clinical situation, especially in infected root canals, the use of older biofilms that express high resistance is recommended which adds to the scope of this study, as rightly mentioned by the authors.[2] Further, the antibacterial efficacy was tested for freshly set sealers set for 1 and 3 days following different contact times such as 2, 5, 20, and 60 min using direct contact test (DCT), respectively. However, it is well reported earlier that durations <60 min proved to be too short to affect resistant bacteria like E. faecalis.[3]
Based on the results of this study, all the tested sealers showed significant antibacterial efficacy when compared to the control group. The authors reported no statistical differences between the antibacterial effects of TotalFill and BioRoot RCS at different time intervals. However, it has been reported in literature that BioRoot RCS has an average short-term but superior long-term antimicrobial and antibiofilm effects. This is probably because BioRoot RCS is able to sustain a high alkaline environment for a longer time which is quite clinically significant.[4] Further, MTA Fillapex depicted a superior antibacterial effect than AH plus in the present study. The authors had attributed the therapeutic effects of all the bioceramic sealers to the high pH, hydrophilicity, and active calcium hydroxide, which is released during the setting process. In addition, the presence of salicylate resin in MTA Fillapex may also play a significant role in killing E. faecalis.[4]
In this study, the authors had employed the DCT method to assess the antibacterial efficacy of the sealers. However, DCT does not take into account the presence of dentin as well as the potential effect as part of the root canal complexities and/or biofilm formation.[5] Recent modifications were introduced to assess the antimicrobial effect of materials under conditions that simulate the clinical scenario using viability staining and confocal laser scanning microscopy inside root canals.[5] Hence, all the aforementioned observations can be potentially considered by the authors for conducting future investigations to validate the results of the current study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Munitic MS, Marijan S, Kero D, Bago I. Antibacterial efficacy of bioceramic root canal sealers against planktonic Enterococcus faecalis after different contact and setting time: An in vitro study. Saudi Endod J 2022;12:56-60.  [Full text] |
| 2. | Nirupama DN, Nainan MT, Ramaswamy R, Muralidharan S, Usha HH, Sharma R, et al. In vitro evaluation of the antimicrobial efficacy of four endodontic biomaterials against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. Int J Biomater 2014;2014:383756. |
| 3. | Kayaoglu G, Erten H, Alaçam T, Ørstavik D. Short-term antibacterial activity of root canal sealers towards Enterococcus faecalis. Int Endod J 2005;38:483-8. |
| 4. | Wang Z, Shen Y, Haapasalo M. Antimicrobial and antibiofilm properties of bioceramic materials in endodontics. Materials (Basel) 2021;14:7594. |
| 5. | Janini AC, Bombarda GF, Pelepenko LE, Marciano MA. Antimicrobial activity of calcium silicate-based dental materials: A literature review. Antibiotics (Basel) 2021;10:865. |
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