The effect of benzalkonium chloride additions to AH Plus sealer. Antimicrobial, physical and chemical properties

M. T. Arias-Moliz, M. Ruiz-Linares, G. Cassar, C. M. Ferrer-Luque, P. Baca, R. Ordinola-Zapata, J. Camilleri

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objectives: The aim of this study was to determine the antimicrobial and antibiofilm activities and physicochemical properties of AH Plus sealer mixed with different concentrations of benzalkonium chloride (BC). Methods: AH Plus was tested alone and mixed with 1%, 2% and 3% of BC. The antimicrobial and antibiofilm activities of the sealers against Enterococcus faecalis were evaluated by the direct contact test (DCT) and by confocal laser scanning microscopy, respectively. Setting time, flow and solubility were assessed according to ANSI/ADA specifications. Microhardness and contact angle tests were also performed. The chemical changes of the sealers were evaluated by X-ray diffraction analysis, and both Fourier transform infrared spectroscopy (FT-IR) and attenuated total reflectance Fourier transform infrared (ATR FT-IR). Results: AH Plus + 3% BC was the only sealer to promote total elimination of E. faecalis and the biovolume in this group was significantly lower than in the rest of the sealers (p > 0.05). The physical properties of the sealers were according to the ANSI/ADA specifications. The microhardness decreased significantly when BC was added and a significant reduction in contact angle was obtained when incorporating 2% and 3% BC (p < 0.05). No phase changes were observed with the modified sealers. Conclusions: The addition of 2% or higher concentrations BC to AH Plus showed antimicrobial and antibiofilm activities without affecting the properties specified in ANSI/ADA standards. However, additives to the root canal sealer altered other physical and chemical properties that are not commonly found in the literature to evaluate filling materials. Clinical significance: The present study highlights that the antimicrobial properties of AH Plus can be significantly improved with the addition of BC. Testing beyond what is specified in standards may be indicated.

Original languageEnglish (US)
Pages (from-to)846-854
Number of pages9
JournalJournal of Dentistry
Issue number7
StatePublished - Jul 1 2015
Externally publishedYes

Bibliographical note

Funding Information:
The authors thank Francisca Castillo Pérez, Yudi Gómez Villaescusa and Ana Santos Carro of the University of Granada for their technical assistance and Ing. James Camilleri of the Department of Metallurgy and Materials Engineering, Faculty of Engineering, University of Malta for his technical expertise. This study was partially financed by CEI BioTic Granada (grant CEI2014-MPBS1 , Ministerio de Educación, Consejería de Economía, Innovación, Ciencia y Empleo and University of Granada), Research Group CTS-167 (Junta de Andalucía, Spain) and the ERDF (Malta) through the project: “Developing an Interdisciplinary Material Testing and Rapid Prototyping R&D Facility” (Ref. no. 012).

Publisher Copyright:
© 2015 Elsevier Ltd. All rights reserved.


  • AH Plus
  • Antimicrobial activity
  • Benzalkonium chloride
  • Sealer properties


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