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

Autoři: Marija Šimundić Munitić aff001;  Tina Poklepović Peričić aff002;  Ana Utrobičić aff003;  Ivona Bago aff004;  Livia Puljak aff005
Působiště autorů: Department of Endodontics and Restorative Dentistry, Dental Polyclinic Split; School of Dental Medicine, University of Split, Split, Croatia aff001;  Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia aff002;  Cochrane Croatia, Central Medical Library, School of Medicine, University of Split, Split, Croatia aff003;  Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia aff004;  Department of Evidence Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Zagreb, Croatia aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



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.

Klíčová slova:

Antibacterials – Bacterial biofilms – Biofilms – Confocal laser microscopy – Database searching – Enterococcus faecalis – Staphylococcus aureus – Bioceramics


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