Antifungal Effectiveness between Tricalcium Silicate-White Portland Cements Added Bi₂O₃ and Mineral Trioxide Aggregate Against Candida albicans

Candida albicans is the most dominant fungus found in root canal reinfection cases. This microorganism can withstand extreme pH, low oxygen levels, lack of nutrients, and penetrate the dentinal tubules so that it can resist the intracanal medicament. Root canal cement helps prevent microorganisms and causing root canal reinfection. MTA is one of the root canals cement which is widely used and has an excellent antifungal activity, but it is less beneficial economically. Tricalcium silicate-white Portland cement (WPC) has a similar main composition as MTA, except there is no Bi₂O₃ content that functions as a radiopacifier.

To fabricate a mixture of tricalcium silicate-WPC with Bi₂O₃ through a simple solution method and investigate antifungal activity's effectiveness between tricalcium silicate-WPC added Bi₂O₃ and MTA to C. albicans.

The 80 g of tricalcium silicate-WPC was mixed with 20 g of Bi₂O₃ through the simple solution method using 99.9% isopropanol as a solution. This sample solution is stirred until homogeneous, then centrifuged. The precipitate was dried until a dry powder was obtained. The powder was analyzed using X-Ray fluorescence spectrometry to identify its chemical composition and concentration. A total of 30 samples were divided into two experimental groups of tricalcium silicate-WPC added Bi₂O₃ and ProRoot MTA. The vials, which contain cement and C. albicans, respectively, were incubated at 37°C for 24 hours and diluted to obtain a suspension 10⁴, 10⁶ (0.5 in McFarland’s nephelometer) and then inoculated with sterile cotton swabs onto Saboroud Dextrose Agar Plates. The plates were incubated at 37°C for 24 hours. The measurement of colony number of C. albicans was counted by colony counter (CFU/ml).

The Bi₂O₃ was revealed in tricalcium silicate-WPC based on XRF characterization, and the antifungal test showed that both materials were effective against C. albicans. There was no statistically significant difference in the number of C. albicans colonies between tricalcium-WPC added Bi₂O₃ and MTA (p>0.05).

The mixture of Bi₂O₃ in tricalcium silicate-WPC was successfully fabricated through a simple solution method, and both samples were effective against the C. albicans.