The Effect of Various Water-soluble Chitosan Concentrations on Physical Properties and Antibiofilm Ability of Mineral Trioxide Aggregate

Using Mineral Trioxide Aggregate (MTA) has several challenges as an apex closure material, such as a long hardening time, making it susceptible to dissolution and being washed away by blood flow, a gritty consistency that is difficult to manipulate, and low compression resistance. In addition, the antibacterial properties of MTA against E. faecalis, the bacteria persisting in periapical lesions, have shown controversial results. This study aimed to analyze the effect of adding various concentrations of water-soluble chitosan to MTA on the setting time, compression strength, and antibiofilm ability of E. faecalis.

There were three groups in this study, namely, MTA without water-soluble chitosan (MTA), MTA with 5% (MTA-CW5), and MTA with 10% (MTA-CW10) water-soluble chitosan. 0.5 g MTA powder (ProRoot MTA, Dentsply Tulsa Dental, Tulsa, OK, USA) was stirred in the MTA group with 0.166 ml of distilled water. In the MTA-CW5 and MTA-CW10 groups, 40 µl of 5% and 10% water-soluble chitosan was added to the mixture of 0.5 g MTA powder and 0.166 ml distilled water. Then, the three groups were tested for setting time, compression strength, and antibiofilm activity against E. faecalis. Setting time and compression strength values were analyzed by parametric statistics (ANOVA). Bacterial cell viability values on a numerical scale were statistically analyzed using the Kruskal–Wallis non-parametric analysis. The level of significance used was p < 0.05.

There was a significant difference in setting time among the three groups, from the fastest to the slowest setting time, respectively: MTA-CW5, MTA, and MTA-CW10. The same thing happened in the compression strength test, with the lowest mean value shown in the MTA group at 50.53 + 6.18 MPa. The viability of E. faecalis between the MTA and MTA-CW5 groups did not have a statistically significant difference.

The setting time of MTA with 5% water-soluble chitosan was fast, but adding 10% water-soluble chitosan slowed the setting time of MTA. Meanwhile, increased water-soluble chitosan concentration led to increased compression strength and antibiofilm activity of MTA against E. faecalis.