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Abstract

Objectives: A number of bioceramic root canals sealers are commercially available; however, it’s challenging to compare their ability to eliminate bacteria due to variations in methodology in existing literature. The aim of this study was to compare the long-term antibacterial effect of five bioceramic sealers against multispecies dental biofilm in dentinal tubules in a standardized method using a novel ex vivo model. This study also investigated whether the method of sealer application using the model versus open-faced specimens influenced the antibacterial effect of bioceramic sealers. Methods: A standardized slot was prepared in the apical root of an artificial tooth model with simulated root canal. Precisely cut dentin blocks were fitted into the slot and clinical process of obturation was replicated using this ex vivo model. Forty-eight dentin blocks were prepared, and multispecies bacteria were introduced into dentinal tubules by centrifugation. After three weeks of incubation, thirty-six samples were subjected to EndoSequence BC Sealer (BC), AH Plus Bioceramic Sealer (AHBC), Bio-C Sealer (BIOC), BioRoot Flow (BRF), and C-root SP (CR) in the model. After 1, 4, and 8 weeks of sealer exposure, antibacterial efficacy was determined by live/dead bacterial viability staining and confocal laser scanning microscopy. Twelve samples were subjected to BC and AHBC as open-faced specimens. Antibacterial efficacy was determined after 1 and 4 weeks of sealer exposure. Data were analyzed using one-way ANOVA and Tukey’s post hoc test (p.05). At week 8 of sealer exposure, CR and BC yielded significantly more killed bacteria than AHBC, BIOC and BRF with no significant difference among them. There was no significant difference in the antibacterial activity of BC and AHBC on model specimens compared to open-faced specimens. Conclusions: The antibacterial activity of bioceramic sealers were dynamic and all tested sealers had long-lasting antibacterial effect against multispecies biofilm in dentinal tubules. The method of sealer application had no influence on its antibacterial effect.