The Influence of Root Canal Sealer on Extended Intracanal Survival of Enterococcus faecalis With and Without Gelatinase Production Ability in Obturated Root Canals

Enterococcus faecalis can survive for extended periods in obturated root canals. In this study, the hypotheses tested were that long-term survival of E. faecalis is dependent on (1) the type of endodontic sealer and (2) the capacity for microbial gelatinase activity, a potential "virulence" trait identified previously in clinical isolates. Root canals of extracted human canines (n = 95) were inoculated with either E. faecalis OG1RF or its gelatinase-negative mutant E. faecalis TX5128. After 48 hours of incubation at 37°C, canals were obturated with gutta-percha and either the epoxy-resin-based AH-Plus (Dentsply, De Trey, Konstanz, Germany), the silicone-based RoekoSeal (Coltène/Whaledent, Langenau, Germany), or zinc oxide eugenol-based Roth's sealer (Root Canal Cement Type 801; Roth International Ltd, Chicago, IL). Access cavities were sealed. After 8 months of incubation at 37°C, viable E. faecalis was recovered from more teeth sealed with RoekoSeal (95%) compared with AH-Plus (40%) (p = 0.0004, Fisher's exact test) and Roth's sealer (45%) (p = 0.0012, Fisher's exact test). In the RoekoSeal groups, viable counts of E. faecalis OG1RF were higher than E. faecalis TX5128 (p = 0.03, Mann-Whitney U test) suggesting that gelatinase activity plays a role in long-term survival of E. faecalis in obturated root canals.