Antimicrobial Activity of Bioceramic Root Canal Sealers: A Systematic Review

Abstract

ABSTRACT: Actually, bioceramic endodontic sealers represent an advantageous option for root canals sealing due to their multiple properties. There are several in vitro studies about their antimicrobial properties, however, their comparative antimicrobial potential, compared with other types of endodontic sealers is not entirely clear. The aim of the present research was to perform a systematic review to assess the antimicrobial effectiveness of commercially available bioceramic root canal sealers against Enterococcus faecalis in accordance with the PRISMA statement. A literature search was made in four electronic databases: MEDLINE, ClinicalKey, ScienceDirect and EBSCO. Were included in vitro studies, published in English, between 2015 and 2019. The evaluation of the selected studies was performed by two authors, independently. Four studies were included in the review. EndoSequence™ (Brasseler USA, Savannah, GA) also available on the market as TotalFill™ (Brasseler USA, Savannah, GA) and BioRoot™ were the bioceramic root canal sealers evaluated. The risk of bias was assessed according to the modified CONSORT checklist for preclinical studies. Selected studies reported positive antimicrobial activity against Enterococ cus faecalis in the bioceramic sealers evaluated. The less activity was observed on BioRoot™ sealer. All studies used a planktonic form of Enterococcus faecalis and in vitro laboratory methods of evaluation. The antimicrobial activity reported varies accordi ng to the laboratory method used, even for the same sealer, so the existence of false negatives is suggested. This systematic review identified the need for more research into the antimicrobial activity of bioceramic sealers, ideally with models using bacterial biofilms and studies in humans.