Effect of a calcium hydroxide-based intracanal medicament containing N-2-methyl pyrrolidone as a vehicle against Enterococcus faecalis biofilm

Taegun Kim, Mi-Ah Kim, Yun-Chan Hwang, Vinicius Rosa, Massimo Del Fabbro, Kyung-San Min

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: This study investigated the effect of a calcium hydroxide (CH) paste (CleaniCal®) containing N-2-methyl pyrrolidone (NMP) as a vehicle on Enterococcus faecalis (E. faecalis) biofilms compared with other products containing saline (Calasept Plus™) or propylene glycol (PG) (Calcipex II®).

METHODOLOGY: Standardized bovine root canal specimens were used. The antibacterial effects were measured by colony-forming unit counting. The thickness of bacterial microcolonies and exopolysaccharides was assessed using confocal laser scanning microscopy. Morphological features of the biofilms were observed using field-emission scanning electron microscopy (FE-SEM). Bovine tooth blocks covered with nail polish were immersed into the vehicles and dispelling was observed. The data were analyzed using one-way analysis of variance and Tukey tests (p<0.05).

RESULTS: CleaniCal® showed the highest antibacterial activity, followed by Calcipex II® (p<0.05). Moreover, NMP showed a higher antibacterial effect compared with PG (p<0.05). The thickness of bacteria and EPS in the CleaniCal® group was significantly lower than that of other materials tested (p<0.05). FE-SEM images showed the specimens treated with Calasept Plus™ were covered with biofilms, whereas the specimens treated with other medicaments were not. Notably, the specimen treated with CleaniCal® was cleaner than the one treated with Calcipex II®. Furthermore, the nail polish on the bovine tooth block immersed in NMP was completely dispelled.

CONCLUSIONS: CleaniCal® performed better than Calasept Plus™ and Calcipex II® in the removal efficacy of E. faecalis biofilms. The results suggest the effect might be due to the potent dissolving effect of NMP on organic substances.

Original languageEnglish
Pages (from-to)e20190516
JournalJournal of applied oral science : revista FOB
Publication statusPublished - 2020


  • Analysis of Variance
  • Animals
  • Anti-Bacterial Agents/pharmacology
  • Biofilms/drug effects
  • Calcium Chloride/chemistry
  • Calcium Hydroxide/chemistry
  • Cattle
  • Colony Count, Microbial
  • Drug Combinations
  • Enterococcus faecalis/drug effects
  • Materials Testing
  • Microscopy, Confocal
  • Microscopy, Electron, Scanning
  • Potassium Chloride/chemistry
  • Pyrrolidinones/chemistry
  • Reproducibility of Results
  • Root Canal Irrigants/chemistry
  • Sodium Bicarbonate/chemistry
  • Sodium Chloride/chemistry
  • Statistics, Nonparametric


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