Comparative evaluation of the antifungal activity of mineral trioxide aggregate, calcium enriched mixture and biodentine by modified direct contact test – an in vitro study

Objective: To evaluate and compare the antifungal efficacy of Mineral trioxide aggregate (MTA), Calcium enriched mixture (CEM) & Biodentine against Candida albicans by modified direct contact test (DCT) at 1, 3 and 7day intervals. Study design: The study materials selected were MTA (Group1), CEM (Group 2) and Biodentine (Group 3). The cements were mixed in strict compliance with the manufacturer’s recommendations. The modified DCT performed was based on turbidometric determination of fungal growth in 96-well microtiter plates. Sidewalls of the microtiter plate wells were coated with freshly mixed test material and a 10 μL fungal suspension was placed. After 1 hr of incubation at 37oC, Sabouraud’s dextrose agar (SDA) (245 μL) was added. These were designated as ‘Row A’ wells. 15 μL was then transferred from row A wells to an adjacent set of 4 wells containing fresh SDA medium (215 μL), designated as ‘Row B’ wells. Fungal outgrowth was monitored both in the presence (Row A wells) and in the absence (Row B wells) of the test materials. The plates were then placed in the spectrophotometer with optical density measured at 630 nm. The readings were taken hourly for 15 hours on the 1st day, 3rd day and the 7th day. Experiments were triplicated. Data was analysed using the Friedman’s test. Conclusion: All the cements showed antifungal activity against C.albicans on 1st day, which gradually declined over a period of 7 days. MTA exhibited the most efficient antifungal activity as compared to Biodentine and CEM over a period of 7 days.