DOI: 10.4103/jcds.jcds_16_26 ISSN: 1658-8207

Intratubular Antibacterial Efficacy of Calcium Hydroxide and Bio-C Temp: An Ex Vivo Confocal Laser Scanning Microscopy Study

Yasser Saleh Alolayqi, Badi Alotaibi, Muhammad Qasim Javed, Waleed Almutairi
Show PDF Cite

Abstract

Background:

Calcium hydroxide (Ca[OH] 2 ) remains the gold standard intracanal medicament; however, its limited penetration into dentinal tubules and potential adverse effects on dentin structure necessitate evaluation of alternative materials. Calcium silicate-based bioceramics, such as Bio-C Temp, have been introduced with claims of enhanced antibacterial activity and bioactivity.

Objectives:

This ex vivo experimental study aimed to compare the antibacterial efficacy and intratubular bacterial viability of calcium hydroxide and Bio-C Temp using confocal laser scanning microscopy (CLSM).

Materials and Methods:

Sixty extracted single-rooted human teeth were prepared, sterilized, and inoculated with a dual-species biofilm of Enterococcus faecalis (ATCC 29212) and Streptococcus mutans (MTCC 890)for 21 days to establish a mature biofilm. Specimens were randomly assigned to four groups: calcium hydroxide ( n =20), Bio-C Temp ( n =20), positive control ( n =10), and negative control ( n =10). For the calcium hydroxide and Bio-C Temp groups, 10 samples were evaluated at Week 1 and 10 at Week 2. For the positive and negative control groups, 5 samples were evaluated at Week 1 and 5 at Week 2. Intracanal medicaments were applied and evaluated after 7 and 14 days. Dentin samples were stained and analyzed using CLSM to quantify percentages of live and dead bacteria. Live and dead bacterial counts were analysed using generalized linear models with Gamma distribution and log link function, including group, time, and interaction effects, followed by adjusted post hoc comparisons.

Results:

At week 1, Bio-C Temp demonstrated significantly higher antibacterial activity, with a greater percentage of dead bacteria and lower viable bacterial counts compared to Ca(OH) 2 ( P < 0.001). By week 2, both materials exhibited comparable levels of dead bacterial cells; however, Bio-C Temp maintained significantly lower percentages of viable bacteria than Ca(OH) 2 . A significant interaction between treatment group and time was observed ( P < 0.001), indicating differing antibacterial kinetics.

Conclusion:

Bio-C Temp exhibited rapid and sustained antibacterial effects compared to Ca(OH) 2 , particularly in reducing intratubular bacterial viability over time. Although both medicaments demonstrated comparable bactericidal effects after 2 weeks, Bio-C Temp showed superior ability in limiting bacterial survival and regrowth. These findings suggest that calcium silicate–based intracanal medicaments may represent a promising alternative to conventional Ca(OH) 2 .

More from our Archive