In Vitro Antimicrobial Effectiveness of Root Canal Sealers against Enterococcus faecalis: A Systematic Review.
BACKGROUND
The purpose of this systematic review was to summarize the outcomes of in vitro studies of root canal sealers for their antimicrobial effectiveness against Enterococcus faecalis on the basis of direct contact test.


METHODS
An exhaustive literature search was performed by using MEDLINE, Scopus, TRIP, and OpenThesis databases, followed by an extensive hand search of references of identified articles. Two independent reviewers evaluated the studies for eligibility against inclusion and exclusion criteria and performed data abstraction and risk of bias evaluations.


RESULTS
A total of 31 articles were assessed for eligibility. Of these, 24 met the inclusion criteria and were included in the systematic review. A considerable heterogeneity was found in the methodologies of included studies. Therefore, it was not feasible to perform meta-analysis. Majority of the studies reported that different categories of freshly prepared sealers possessed some form of positive antimicrobial activity against E. faecalis for up to 24 hours. Antimicrobial efficacy was lost as the material set. Moderate evidence was found for no antimicrobial activity of aged (2-day to 7-day set) sealer samples across all categories.


CONCLUSIONS
The evidence indicated positive antimicrobial activity of freshly mixed sealers against E. faecalis. Antimicrobial efficacy was lost as the material set, with no bacterial growth inhibition by 2-day to 7-day set sealer samples. However, the studies included in this review presented medium to high risk of bias. This review identified the need for the development of standardized methods to evaluate antimicrobial activity of root canal sealers in in vitro studies.
Endodontic Division, Restorative Dental Sciences Department, College of Dentistry, University of Dammam, Dammam, Saudi Arabia. Electronic address: ealshwaimi@uod.edu.sa.
Emad
E
AlShwaimi
Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Dania
D
Bogari
Biomaterial Division, Operative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Reem
R
Ajaj
Dental Department, Armed Forces Hospital, King Abdul-Aziz Airbase, Dhahran, Saudi Arabia.
Saad
S
Al-Shahrani
Division of Periodontics, Preventive Dental Sciences Department, College of Dentistry, University of Dammam, Dammam, Saudi Arabia.
Khalid
K
Almas
Endodontic Division, Restorative Dental Sciences Department, College of Dentistry, University of Dammam, Dammam, Saudi Arabia.
Abdul
A
Majeed
D000890:Anti-Infective Agents / Q000494:pharmacology*; D003786:Dental Pulp Cavity / Q000382:microbiology*; D013293:Enterococcus faecalis / Q000187:drug effects*; D066298:In Vitro Techniques; D012387:Root Canal Filling Materials / Q000494:pharmacology*; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement / Q000494:pharmacology*
D000890:Anti-Infective Agents; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C112894:canals sealer
Antimicrobial activity; E. faecalis; direct contact test; root canal sealer; systematic review