the success of the root canal treatment depends on careful diagnosis and accurately performed cleaning , shaping , and compact filling of the root canal under aseptic conditions . however , certain microorganisms are repeatedly recovered from previously root - filled teeth that have become infected . if nonsurgical endodontic therapy is unsuccessful , surgical endodontic therapy ( apicoectomy and retrograde filling ) is required to conserve the tooth . most endodontic failures are attributable to inadequate cleansing of the root canal and egress of bacteria and other antigens into the periradicular tissues . when inflammation or infection persists in the bony area around the end of the tooth after a root canal procedure , then it is necessary to perform an apicoectomy and a root - end filling is placed to prevent reinfection of the root . hence , in addition to sealing ability and biocompatibility , root - end filling materials should ideally have some antimicrobial activity to prevent bacterial and fungal growth . one of the well - known root - end filling material is glass ionomer cement ( gic ) , which has unique properties such as , adhesion to moist tooth structure , low shrinkage and biological acceptance , but low antimicrobial efficacy . proroot mineral trioxide aggregate ( mta ) is marketed as gray- and white - colored preparations , both of which are composed of 75% portland cement clinker , 20% bismuth oxide , and 5% gypsum by weight . mta is a powder is made of fine hydrophilic particles that in presence of water forms a colloidal gel which solidifies and forms hard cement within approximately 4 h. although mta has excellent biocompatibility , it has a delayed setting time and poor handling characteristics , as well as being an expensive material . the liquid consists of calcium chloride in aqueous solution with an admixture of polycarboxylate , which sets in 12 min . the purpose of this study was to investigate and compare the antibacterial and antifungal effects of biodentine , mta , and gic on streptococcus mutans , enterococcus faecalis , escherichia coli , and candida albicans microorganisms . the test materials  mta ( dentsply , tulsa dental , ok , usa ) , biodentine ( septodont ) , and gic ( gc asia dental pte . ltd )  were manipulated strictly in accordance with the manufacturer 's instructions . the antimicrobial activity of the endodontic cements was evaluated by the agar diffusion method against five reference strains : e. faecalis ( atcc 29212 ) , e. coli ( atcc 33780 ) , s. mutans ( atcc25175 ) , and candida ( atcc 10231 ) . bacteria were diluted to obtain a suspension of approximately 5  10 colony forming units / ml , in sterile trypticase soy broth ( tsb ) . e. faecalis , e. coli , and candida suspensions were inoculated with sterile cotton swabs onto meuller - hinton agar plates and s. mutans was inoculated onto blood agar media . wells 4 mm in diameter and 4 mm deep were prepared on plates with a copper puncher , and immediately filled with freshly manipulated test materials . after prediffusion of the test materials for 2 h at room temperature , all the plates were incubated at 37c and evaluated at 24 h. microbial inhibition zones were measured with a 0.5 mm precision ruler and the results were expressed as the mean and standard deviation . to compare the differences among mta , biodentine , and gic ; data were analyzed statistically by one - way analysis of variance ( anova ) and tukey 's honest significant difference ( hsd ) post - hoc test , using statistical package for social sciences ( spss ) software version 21 ( spss inc , chicago , il , usa ) . the antimicrobial activities of mta , biodentine , and gic are shown in table 1 . the antimicrobial action of biodentine on all the microorganisms tested was superior to that of mta and gic , showing a mean inhibition zone of 3.2 mm . this difference was significant for gic ( p < 0.05 ) , but not for mta ( p > 0.05 ) . all cements were significantly more effective against s. mutans than against candida , e. faecalis , and e. coli ( p < 0.05 ) . nevertheless , gic was incapable of inhibiting the growth of candida . for all three cements , the diameters of the inhibition zones for s. mutans were significantly larger than for e. faecalis , candida , and e. coli ( p < 0.05 ) . in this study , the antimicrobial activity of mta , biodentine , and gic were evaluated . most commonly predominant microorganisms in persistent or refractory periapical lesions are facultative bacteria and yeast ; hence , these microorganisms are included under the test group in this study . e. faecalis is more likely to be found in cases of failed endodontic therapy than in cases of primary infection . e. coli is sometimes recovered from root canals and represents a standard organism used in antimicrobial testing . c. albicans has the ability to form biofilms on different surfaces , and may be involved in cases of persistent and secondary infection . s. mutans may have a major influence on both the initial pulpal lesion and subsequent pulpal pathology . agar diffusion method was used , which is the most commonly employed technique for evaluation of antimicrobial activity . several antimicrobial studies have employed this technique ; however , variations in agar medium , bacterial strains , diffusion capacity of inhibitory agents , and cellular density may interfere with the formation of inhibition zones around materials used in antimicrobial testing . the present study revealed that the diameter of the inhibition zone varied significantly according to the microorganism tested . the results showed that biodentine had higher antimicrobial activity than mta , and the antimicrobial activities of mta and biodentine were significantly higher than that of gic . biodentine shares both its indications and mode of action with calcium hydroxide , but does not have its disadvantages . three major disadvantages of calcium hydroxide , higher material resorption rate , mechanical instability , and failure to prevent microleakages are therefore avoided . compared to other materials such as mta , biodentine handles easily and needs much less time for setting . hence , in this study ; biodentine had a significantly more pronounced antibacterial effect than mta . the antimicrobial action of mta is attributed to its high initial ph of 10.2 , which rises to 12.5 in 3 h. no previous studies have evaluated the antifungal activity of mta , biodentine , and gic . therefore , the results suggested that candida is resistant to gic , as there is no significant zone of inhibition formed around it . estrela et al . , demonstrated that mta had no antimicrobial activity against e. faecalis , but this study proved its antimicrobial efficacy against e. faecalis . , in which there was no inhibitory effect of mta against e. coli , but in the present study mta showed good antimicrobial activity against e. coli . al - nazhan and al - judai demonstrated antifungal activity of mta , which was in agreement with this study . however , available nutrients , level of oxygen tension , incubation period , methods of evaluation , and different laboratory set - ups employed ; influenced the study results . all materials showed antimicrobial activity against the tested strains except for gic on candida.largest inhibition zone was observed for streptococcus group.biodentine created larger inhibition zones than mta and gic .
objective : to evaluate the antibacterial and antifungal properties of calcium - based cement , biodentine ( ca3sio2 ) , compared to commercial glass ionomer cements ( gics ) and mineral trioxide aggregate ( mta).materials and methods : pellets of gics , proroot mta , and biodentine were prepared to test the influence of these cements on the growth of four oral microbial strains : streptococcus mutans , enterococcus faecalis , escherichia coli , and candida albicans ; using agar diffusion method . 
 wells were formed by removing the agar and the manipulated materials were immediately placed in the wells . 
 the pellets were lodged in seeded plates and the growth inhibition diameter around the material was measured after 24 - 72 h incubation at 37c . 
 the data were analyzed using analysis of variance ( anova ) test to compare the differences among the three cements at different concentrations.results:test indicates that the antimicrobial activity of biodentine , on all the microorganisms tested , was very strong , showing a mean inhibition zone of 3.2 mm , which extends over time towards all the strains . 
 for biodentine , gic , and mta , the diameters of the inhibition zones for s. mutans were significantly larger than for e. faecalis , candida , and e. coli ( p < 0.05).conclusion : all materials showed antimicrobial activity against the tested strains except for gic on candida . largest inhibition zone was observed for streptococcus group . 
 biodentine created larger inhibition zones than mta and gic .