Antimicrobial efficacy of commercially available endodontic bioceramic root canal sealers: A systematic review

Recently, a new generation of bioceramic root canal sealers has been introduced onto the market. Many in vitro studies have investigated the antimicrobial properties of these sealers, but their comparative efficacy in antimicrobial activity is still unknown. Three electronic databases were searched:...

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Bibliographic Details
Published in:PloS one 2019-10, Vol.14 (10), p.e0223575-e0223575
Main Authors: Šimundić Munitić, Marija, Poklepović Peričić, Tina, Utrobičić, Ana, Bago, Ivona, Puljak, Livia
Format: Article
Language:English
Subjects:
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Animals
Anti-Bacterial Agents - chemistry
Anti-Bacterial Agents - pharmacology
Anti-Infective Agents - chemistry
Anti-Infective Agents - pharmacology
Antifungal Agents - chemistry
Antifungal Agents - pharmacology
Antiinfectives and antibacterials
Antimicrobial activity
Antimicrobial agents
Bacteria
Bioceramics
Biofilms
Biofilms - drug effects
Biology and Life Sciences
Ceramics - chemistry
Ceramics - pharmacology
Dentistry
Effectiveness
Endodontics
Engineering and Technology
Humans
Materials Testing
Medical libraries
Medicine
Medicine and Health Sciences
Microorganisms
Microscopy
Odontology
Physical Sciences
Quality assessment
Research and Analysis Methods
Root Canal Filling Materials - chemistry
Root Canal Filling Materials - pharmacology
Root canals
Sealers
Sealing compounds
Studies
Systematic review
Teeth
Ultrasonic testing
Zinc oxides
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Summary:Recently, a new generation of bioceramic root canal sealers has been introduced onto the market. Many in vitro studies have investigated the antimicrobial properties of these sealers, but their comparative efficacy in antimicrobial activity is still unknown. Three electronic databases were searched: MEDLINE and Embase via the OvidSP platform, and Web of Science, up to June 25, 2019. Studies were included irrespective of study design, type of publication and language. Reporting quality was assessed by two authors independently. Meta-analysis was not performed due to studies being highly heterogeneous. We included 37 studies that analysed the antimicrobial effects of bioceramic sealers. Most of them used a planktonic cell model, with the exception of nine studies which used biofilms. It was not possible to make direct comparison of results from studies and to give a clear conclusion about the comparative antimicrobial activity of these materials because the studies used heterogeneous sources and ages of microorganisms, setting and contact times of sealers, and antimicrobial tests. Furthermore, some materials showed completely different results when tested with different methods. In conclusion, multiple in vitro studies have shown that bioceramic sealers may have various degrees of antimicrobial activity. However, it is still impossible to make conclusions about their comparative efficacy and to recommend the use of one over another in clinical practice because the studies available were conducted in different ways, which makes meta-analysis futile. A uniform methodological approach, consistent definitions and studies on humans are urgently needed in this field of research so that recommendations for practice can be made.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0223575