Antimicrobial and physicochemical characterization of endodontic sealers after exposure to chlorhexidine digluconate

Vasileios Kapralos, Håkon Valen Rukke, Dag Ørstavik, Andreas Koutroulis, Josette Camilleri, Pia Titterud Sunde

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Objectives: Assess the antibacterial, physical and chemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) in contact with 2% chlorhexidine digluconate (CHX) used as final irrigant prior to root canal obturation.

Methods: The antimicrobial properties were investigated by direct contact tests for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus in vitro. The setting time, wettability, microhardness and surface roughness were also assessed. The sealers were studied in no contact, 1-minute (short-term) and continuous contact (long-term) with CHX. Chemical characterization of sealers was performed by scanning electron microscopy, X-ray diffraction analysis and Fourier-transform infrared spectroscopy after CHX or saline used as the last irrigant in an ex vivo tooth model and in endo training blocks.

Results: CHX increased the antibacterial activity of all the sealers investigated against planktonic bacteria and biofilms with PCS exerting the highest antimicrobial activity with and without the presence of CHX. The setting of AH Plus and BioRoot RCS was retarded, while for PCS accelerated in the presence of CHX. AH Plus and PCS were more hydrophilic after contact with CHX, whilst BioRoot RCS was hydrophobic in a time-dependent manner. The microhardness of sealers was compromised and the surface roughness increased after CHX exposure for AH Plus and BioRoot RCS, and decreased for PCS. CHX did not affect the sealers’ chemistry, but PCS that exhibited two extra phases.

Significance: CHX improved the antibacterial efficacy of endodontic sealers but further evidence is needed to confirm its suitability as a final irrigant prior to root canal obturation.
Original languageEnglish
Pages (from-to)249-263
Number of pages14
JournalDental Materials
Issue number2
Early online date5 Dec 2020
Publication statusPublished - Feb 2021

Bibliographical note

Funding Information:
The technician Dr Jianguo Liu, Dr Richard Shelton, and Dr Changxiang Wang from School of Dentistry, University of Birmingham for their technical support in scanning electron microscopy, contact angle measurements and profilometry respectively. Dr David Wragg, senior engineer in the Department of Chemistry at University of Oslo, for his assistance with X-ray diffraction spectroscopy.

Publisher Copyright:
© 2020 The Academy of Dental Materials


  • antibacterial activity
  • biofilm
  • chlorhexidine
  • endodontic sealer
  • physicochemical properties
  • planktonic bacteria
  • surface characterization

ASJC Scopus subject areas

  • Mechanics of Materials
  • Materials Science(all)
  • Dentistry(all)


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