Aim: To evaluate the hypothesis that food-borne viable Enterococcus faecalis cells could enter the root canal space via coronal leakage.
Methodology: In a simulated oral environment under mastication the capacity of a calcium sulphate-based temporary filling material (Cavit W) to prevent leakage of E. faecalis from a cheese through the endodontic access cavity into the pulp chamber was assessed. Standardized class I access cavities were prepared in human maxillary molars. These were filled with Cavit of either 2 or 4 mm thickness (n=16, each). Empty access cavities served as positive, teeth filled with a light-curing composite material acted as negative controls (n=8, each). A cheese containing viable E. faecalis cells was placed on the occlusal aspects of test and control teeth, which were subsequently subjected to 680 mastication loads per day for 1 week in a masticator device perfused with artificial saliva at 37 degrees C. Leakage of E. faecalis from the cheese into the pulp chamber was assessed by culture on a kanamycin aesculin azide agar and compared between groups using Fisher's exact test.
Results: All of the positive controls showed pure growth of E. faecalis. In addition, one of the negative control teeth leaked. The 4 mm application of Cavit prevented leakage of E. faecalis significantly better than the corresponding 2 mm application: 1 of 16 specimens compared with 6 of 16 specimens had leakage, respectively (P<0.05).
Conclusions: The current results substantiate the suspicion that food-derived microbiota could enter the necrotic root canal system via microleakage.