Evaluation of antimicrobial action and push-out bond strength and compressive strength using mineral trioxide aggregate and triple antibiotic medicament combination as root-end filling material: A novel in vitro study

Aim: The study aims to evaluate the antimicrobial properties and push-out bond and compressive strength of mineral trioxide aggregate (MTA) mixed with different ratios of triple antibiotic paste (TAP) against Enterococcus faecalis. Methodology: Antimicrobial effect was evaluated using agar well diffusion method. Materials were divided into three groups. Group 1: MTA, Group 2: MTA + TAP (2:1 ratio), and Group 3: MTA + TAP (1:1 ratio) zone of inhibition were determined after 24 h of incubation at 37°C. To evaluate push-out bond strength, 30 extracted teeth were decoronated to a length of 13 mm, followed by root canal treatment, the root resected at 3 mm from the apex, and root-end cavity was prepared and filled. Cylindrical specimens (n = 10 per group) of size 3 mm × 6 mm were prepared of MTA, MTA plus triple antibiotic 2:1 and 1:1 ratio and tested for compressive strength using Instron Universal testing machine. All the data were statistically analysed using Krusal-Wallis test (P < 0.05). Results: MTA + TAP (1:1 ratio) exhibited highest antimicrobial activity than MTA + TAP (2:1 ratio) and MTA alone. The push-out bond and compressive strength of Group 1 (MTA alone) was better compared to two groups containing MTA in combination with TAP; however, no statistical significant difference was found between the three groups. Conclusion: Combination of TAP with MTA increases the antimicrobial activity against E. faecalis without compromising much of the compressive and push-out bond strength, hence can be advocated for root-end filling.