Efficacy of Calcium Silicate-Based, Simvastatin, Levofloxacin and Calcium Hydroxide Intracanal Medicaments Against Mature Enterococcus faecalis Biofilm. An In Vitro Study.

This in vitro study investigated the antibiofilm efficacy of calcium silicate-based, Simvastatin, Levofloxacin and calcium hydroxide intracanal medicaments against mature Enterococcus faecalis biofilm. Ninety dentine specimens were inoculated with Enterococcus faecalis biofilm for three weeks and divided into five groups (n = 18): (1) calcium silicate-based; (2) Simvastatin; (3) Levofloxacin; (4) calcium hydroxide (CH); (5) positive control, no medicament. After two weeks of intracanal medicament application, live/dead bacterial cells were assessed using confocal laser scanning microscopy. The results revealed a statistically significant difference in the percentage of dead bacteria of the four tested groups compared to the positive control group (H = 30.45, p < 0.001). The calcium silicate-based group recorded the highest median (IQR) percentage of dead bacteria at 56.33 (10.03), followed by Simvastatin 44.88 (7.30), CH 41.70 (12.53), Levofloxacin 35.99 (3.78), and the positive control group 3.61 (1.01). These findings suggest that these intracanal medicaments demonstrate promising antibiofilm activity, with further investigations needed.