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

Objective 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 . Materials and Methods 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. Results 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. Conclusion 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 .