# In vitro Comparison of Anti-microbial and Anti-adherence Activities of Three New Mineral Trioxide Aggregate Formulations against Species Associated with Failed Endodontic Treatment

## TL;DR

This study compares three new types of MTA materials to see how well they fight bacteria and fungi in dental treatments.

## Contribution

The study introduces a direct in vitro comparison of three new MTA formulations for their antimicrobial and anti-adherence properties.

## Key findings

- All three MTA types showed strong antibacterial activity against E. faecalis.
- All three MTA types demonstrated antifungal activity against C. albicans after 72 hours.
- A.G.M MTA had the highest antibacterial effect, while Ultradent MTA Flow and Ortho MTA had stronger antifungal effects.

## Abstract

Root canal treatment is one of the most critical dental treatments that help to maintain teeth.
However, the growth of microorganisms leads to treatment failure. Considering the widespread use of mineral trioxide
aggregate (MTA) in endodontic treatment, in vitro comparison of antibacterial, antifungal and anti-adherence activities of new types of MTA materials is indispensable.

This study aimed to investigate and compare the antibacterial, antifungal, and anti-adhesion properties
of three types of MTA, including A.G.M MTA (Andishe Gostar Masud, Tehran, Iran), Ortho MTA
(BioMTA, South Korea), and Ultradent™ MTA Flow (Ultradent MTA Flow, USA).

In this laboratory study, the antibacterial activity of three MTA substances against the strain
of Enterococcus faecalis (E. faecalis) was carried out by the modified direct contact test (MDCT)
method in 1, 3, 7, and 14 days. Antifungal activity of MTA against Candida albicans (C. albicans)
was performed using a tube-dilution test in 1, 24, and 72 hours. The antibiofilm property of
three MTA substances against E. faecalis strain was determined using the crystal violet
staining method and measurement by ELISA.

Ortho MTA, A.G.M MTA, and MTA Flow showed intense antibacterial activity. The difference in the
antibacterial effect of the three types of MTA was not statistically significant in all periods
(p Value> 0.05). In the investigation of antifungal properties after 72 hours, all three
types of MTA had antifungal properties (p< 0.050). Comparing the anti-adhesion properties
of three MTA substances on E. faecalis, it is not significant (p< 0.05).

A.G.M MTA showed the highest antibacterial activity, and Ultradent MTA Flow and Ortho MTA showed stronger antifungal activity than A.G.M MTA. The highest anti-bacterial property was related to A.G.M MTA.