Evaluation of Antibacterial Efficacy and pH of Titanium Tetrafluoride-incorporated Mineral Trioxide Aggregate

Microorganisms play an important role in causing inflammation in the pulp and periapical regions. Even after undergoing chemo-mechanical procedures during root canal treatment, bacteria may persist within dentinal tubules, posing a risk of disease recurrence. Mineral trioxide aggregate (MTA), introduced in 1993, has been investigated as a potential antibacterial material since 1995. The MTA material is composed of minute hydrophilic particles that, when exposed to water, undergo a process called colloidal gelation, which builds a solid cement. Calcium and phosphorus are the primary ions in MTA, and their antibacterial characteristics are attributed to the release of calcium hydroxide through surface hydrolysis of calcium silicate components. Previous studies have shown that MTA has limited antimicrobial properties. Several alterations have been made to enhance the biological properties of MTA, such as incorporating nanoparticles made from silver, zinc, gold and titanium. Therefore, in this study, TiF4 was added to MTA in an effort to enhance its antimicrobial properties. Titanium tetrafluoride (TiF4) has been extensively examined in the field of dentistry for its potential applications: prevention of dental caries, sealing of dentinal tubules in root canals, erosion prevention, mitigation of dentinal hypersensitivity, and as an antibacterial agent. This study compares and evaluates the antibacterial efficacy of MTA after the incorporation of TiF 4. A green and fast synthesis method is used to synthesize TiF 4. A total of 56 samples were made by mixing MTA with different weight proportions of TiF4(1wt%, 2wt% and 3wt%).28 samples were taken to test each of the following properties: antibacterial efficacy and pH. The specimens were prepared using stainless steel molds of recommended dimensions for testing the pH. The pH was evaluated using the pH meter and the antibacterial efficacy using the direct contact test.

Data regarding antibacterial efficacy and pH of MTA with various proportions of TiF4 were investigated for normality using the Kolmogorov Smirnov test and assessed a normal distribution. The antibacterial properties between the four groups were analyzed using One-way analysis of variance (ANOVA) followed by pairwise multiple comparisons using Tukey’s Honest significant difference test. The level of statistical significance was determined at p
0.05.MTA when incorporated TiF4 showed enhanced antibacterial properties. The group treated with MTA with 3% TiF4 had the highest mean values of antimicrobial efficacy on day 1, with a mean of 4.67
0.04 CFU/mL × 10^8. The findings indicated that the incorporation of 3% TiF4 into MTA demonstrated the most pronounced antibacterial effectiveness on both day 1 and day 7, with notable variations observed among the different groups.

MTA incorporating TiF4 can be considered a promising material for improving antibacterial efficacy.