Introduction: Coronal leakage and reinfection after root canal therapy is an important reason for endodontic failure. Zinc oxide-eugenol (ZOE) -based materials are often used as a coronal seal to prevent secondary infection. The antibacterial effect of ZOE cement is mainly due to leaching of eugenol from the material, but the effect is reported to decrease over time. Chitosan (CH) is a natural polymer with antibacterial properties. The aim of the study was to investigate if incorporation of (CH) and chitosan oligosaccharide (COS) in a ZOE-based material improved both the immediate and sustained antibacterial properties of the material.

Methods: Enterococcus faecalis, Streptococcus mutans and Staphylococcus epidermidis was used to investigate the antibacterial effect of the materials in a modified direct contact test (MDCT) immediately after setting and after storage for 18 weeks in water. Leaching per week of eugenol from the materials was quantified using gas chromatography–mass spectrometry (GC-MS). The effect of eugenol on growth of bacteria was measured by reading of optical density at 600 nm after 18 h growth. Mechanical properties were investigated in a compressive strength test according to ISO 3107.

Results: The present study showed that a ZOE-based material has antibacterial activity both as freshly prepared and after immersion in water for 18 weeks. Incorporating CH or COS may increase the antibacterial effect depending on the bacterial species investigated. The amount of leached eugenol did not differ between materials or during or after storage. S. mutans showed the highest susceptibility to eugenol of the three species investigated. Modification of the materials with CH or COS reduced the compressive strength, but the requirements in ISO 3017 were still met.

Investigation on the antimicrobial activity of chitosan-modified zinc oxide-eugenol cement.
Dragland IS, Wellendorf H, Kopperud H, Stenhagen I, Valen H.
Biomaterial Investigations in Dentistry, Volum 6, 2019-Issue 1, pages 99-106.