Study of the Sealing and Antibacterial Properties of Bioceramic Root Canal Sealers Modified With Quaternary Ammonium Salt
Abstract
Objective
To modify the non-antibacterial bioceramic root canal sealant iRoot SP with the quaternary ammonium salt dimethylaminododecyl methacrylate (DMADDM) and to develop a new type of sealant.
Methods
The cytotoxicity of the modified root canal sealant was evaluated using the cell counting kit-8 (CCK-8). The solubility and flowability of the sealant were tested according to International Organization for Standardization (ISO) methods. The sealing ability and penetrability of the sealant were assessed by micro-computed tomography (micro-CT) and confocal laser scanning microscope (CLSM). The antibacterial activity of the sealant against Enterococcus faecalis biofilm was evaluated by colony-forming unit (CFU) counting, crystal violet staining, scanning electron microscope (SEM), and live/dead staining.
Results
When the DMADDM mass fraction was 0.625%, the modified sealant demonstrated good biocompatibility (P > 0.0125). The flowability (> 17 mm) and solubility (< 3%) of the sealant modified with 0.625% DMADDM met ISO standards and showed no significant difference compared with iRoot SP. DMADDM modification did not affect the sealing ability or penetrability of the sealant at different positions of the tooth root (P > 0.05). Antibacterial experiments showed that the modified sealant reduced the CFU count (0.518 ± 0.333 vs. 8.156 ± 0.011, P < 0.001) and the amount of biofilm (mean difference of 86.94%, 95% confidence interval: 74.82%-99.07%, P < 0.0001) of Enterococcus faecalis biofilm at the unaged stage. However, after 1 week of aging (7.327 ± 0.068 vs. 7.422 ± 0.035) or 4 weeks of aging (7.479 ± 0.065 vs. 7.581 ± 0.071), the CFU count of the modified sealant showed no significant difference from the iRoot SP group (P > 0.05). Live/dead staining and SEM also showed that the modified sealant could inhibit the formation of Enterococcus faecalis biofilm.
Conclusion
iRoot SP modified with 0.625% DMADDM exhibited good biocompatibility, sealing ability, and penetrability, and significantly improved resistance to Enterococcus faecalis biofilm, providing a new approach for the antibacterial modification of bioceramic root canal sealants.
Keywords: Root canal sealers, iRoot SP, DMADDM, Enterococcus faecalis
Full Text:
PDFReferences
KARAMIFAR K, TONDARI A, SAGHIRI M A. Endodontic periapical lesion: an overview on the etiology, diagnosis and current treatment modalities. Eur Endod J, 2020, 5(2): 54-67. doi: 10.14744/eej.2020.42714.
YE L, CAO L, SONG W, et al. Interaction between apical periodontitis and systemic disease (review). Int J Mol Med, 2023, 52(1): 60. doi: 10. 3892/ijmm.2023.5263.
PIRANI C, CAMILLERI J. Effectiveness of root canal filling materials and techniques for treatment of apical periodontitis: a systematic review. Int Endod J, 2023, 56(Suppl 3): 436-454. doi: 10.1111/iej.13787.
Al-ANI A M, ALI A H, KOLLER G. Assessment of bacterial load and post-endodontic pain after one-visit root canal treatment using two types of endodontic access openings: a randomized controlled clinical trial. Dent J (Basel), 2024, 12(4): 88. doi: 10.3390/dj12040088.
SINGH H, MARKAN S, KAUR M, et al. “Endodontic Sealers”: current concepts and comparative analysis. Dent Open J, 2015, 2(1): 32-37. doi: 10.17140/DOJ-2-107.
ORTEGA M A, RIOS L, FRAILE-MARTINEZ O, et al. Bioceramic versus traditional biomaterials for endodontic sealers according to the ideal properties. Histol Histopathol, 2023, 39(3): 18664. doi: 10.14670/HH-18-664.
ASHKAR I, SANZ J L, FORNER L, et al. Calcium silicate-based sealer dentinal tubule penetration-a systematic review of in vitro studies. Materials (Basel), 2023, 16(7): 2734. doi: 10.3390/ma16072734.
YAN Y, LI Y, CHI Y, et al. A comparative study of biological properties of three root canal sealers. Clin Oral Investig, 2023, 28(1): 11. doi: 10.1007/s00784-023-05402-7.
DENG Z, LIN B, LIU F, et al. Role of Enterococcus faecalis in refractory apical periodontitis: from pathogenicity to host cell response. J Oral Microbiol, 2023, 15(1): 2184924. doi: 10.1080/20002297.2023.2184924.
KARKEHABADI H, KHOSHBIN E, GHASEMI N, et al. Deep learning for determining the difficulty of endodontic treatment: a pilot study. BMC Oral Health, 2024, 24(1): 574. doi: 10.1186/s12903-024-04235-4.
LI Y, LI B, GUO X, et al. Applications of quaternary ammonium compounds in the prevention and treatment of oral diseases: state-of-the-art and future directions. J Dent, 2023, 137: 104678. doi: 10.1016/j.jdent. 2023.104678.
ALKHALIFA S, JENNINGS M C, GRANATA D, et al. Analysis of the destabilization of bacterial membranes by quaternary ammonium compounds: a combined experimental and computational study. Chembiochem, 2020, 21(10): 1510-1516. doi: 10.1002/cbic.201900698.
HUANG Y, LI H, ZHU C G, et al. Anti-bacterial and anti-microbial aging effects of resin-based sealant modified by quaternary ammonium monomers. J Dent, 2021, 112: 103767. doi: 10.1016/j.jdent.2021.103767.
CHENG L, WEIR M D, ZHANG K, et al. Dental primer and adhesive containing a new antibacterial quaternary ammonium monomer dimethylaminododecyl methacrylate. J Dent, 2013, 41(4): 345-355. doi: 10.1016/j.jdent.2013.01.004.
International Organization for Standardization (ISO). ISO 6876: 2012 Dental root canal sealing materials. Geneva: ISO, 2012.
SIQUEIRA J F, RÔÇAS I N. Present status and future directions: microbiology of endodontic infections. Int Endodontic J, 2022, 55(S3): 512-530. doi: 10.1111/iej.13677.
COPE A L, FRANCIS N, WOOD F, et al. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database Syst Rev, 2024, 5(5): CD010136. doi: 10.1002/ 14651858.CD010136.pub4.
LIU X, GAO M, BAI Q, et al. Evaluation of palatal furcation groove and root canal anatomy of maxillary first premolar: a CBCT and micro-CT study. Biomed Res Int, 2021, 2021: 8862956. doi: 10.1155/2021/8862956.
KOMABAYASHI T, COLMENAR D, CVACH N, et al. Comprehensive review of current endodontic sealers. Dent Mater J, 2020, 39(5): 703-720. doi: 10.4012/dmj.2019-288.
TABASSUM S, KHAN F R. Failure of endodontic treatment: the usual suspects. Eur J Dent, 2016, 10(1): 144-147. doi: 10.4103/1305-7456. 175682.
SAH S, MANGAT P, KUMAR A, et al. Stereomicroscopic evaluation of sealing ability of four different root canal sealers: an in-vitro study. BMC Oral Health, 2024, 24(1): 258. doi: 10.1186/s12903-024-03913-7.
JAHA H S. Hydraulic (single cone) versus thermogenic (warm vertical compaction) obturation techniques: a systematic review. Cureus, 2024, 16(6): e62925. doi: 10.7759/cureus.62925.
TEKINARSLAN D, ER K, EĞIN M, et al. The effect of various irrigants on mixed biofilms in dentinal tubules: a confocal laser scanning microscopy study. Microsc Res Tech, 2025, 88(9): 2586-2593. doi: 10. 1002/jemt.24877.
EĞEMEN A, BELLI S. The effect of primary root canal treatment on dentinal tubule penetration of calcium silicate-based sealers during endodontic retreatment. J Endod, 2022, 48(9): 1169-1177. doi: 10.1016/j. joen.2022.05.008.
Refbacks
- There are currently no refbacks.



