# Antibacterialativity of Endodontic Gutta-Percha--A Systematic Review
## 3 Results
### General Characteristics of the Included Studies  
The studies incorporated into this systematic review exhibited heterogeneity regarding the specific type of gutta-percha material tested and the microorganisms assessed. The objectives of the included studies focused on the antimicrobial assessment of gutta-percha. Given that the alkalizing potential of the material used for canal obturation exerts a direct influence on microbiota inactivation and tissue healing, this paper measured pH changes after root canal filling with different materials, satisfying the requirements of this systematic review. Most researchers directed their antibacterial evaluations towards _Enterococcus faecalis_[1; 2; 3; 4; 5; 6; 7; 8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20; 21; 22; 25; 27; 29], as it remains the most frequently isolated bacteria from a root canal [30]. Nevertheless, other bacteria underwent analysis, including _Staphylococcus aureus_[4; 5; 8; 13; 14; 22; 23; 26; 24; 25], _Escherichia coli_[5; 13; 22; 23; 26], _Pseudomonas aeruginosa_[4; 5; 13; 14; 22; 26], _Streptococcus mutans_[4; 23; 25], _Fusobacterium nucleatum_[18; 22; 25], _Actinomyces naslundii_[4; 18], _Porphyromonas gingivalis_[4; 25], as well as _Peptostreptococcus micros_[16], _Prevotella intermedia_[25], _Porphyromonas endodontalis_[14],Streptococcus pyogenes_[23], _Streptococcus gordoni_[4], _Streptococcus sanguis_[26], _Streptococcus intermedius_[16], _Actinomyces israelili_[18], and _Actinomyces odontolyticus_[22]. Additionally, antimicrobial activity was assessed against fungi, particularly _Candida albicans_[3; 4; 5; 14; 25]. However, [PERSON] et al. conducted examinations targeting various _Candida_ species, including _Candida glabrata_, _Candida parapsilosis_, _Candida Krusei_, and _Candida tropicalis_[21]. [PERSON] et al. [6] did not specify the bacteria tested in the study. The direct contact between bacteria and the filling material was evaluated in two ways--either inside the root canal system of extracted teeth [1; 2; 6; 7; 15; 17; 29] or under laboratory conditions on inoculated plates and Petri dishes [3; 4; 5; 8; 9; 10; 11; 12; 13; 14; 16; 18; 19; 20; 21; 22; 23; 25; 26], specifically fabricated material disks [9], and glass capillaries simulating root canals [27]. It is important to note that, in all the single-canalled teeth used for the experiments (except [PERSON] et al. [7], who did not specify the number of canals in the root system per tooth), Enterococcus faecalis was the only microorganism examined. In compliance with the authors' expectations, most of the articles compared traditional gutta-percha with other root canal fillers or materials based on gutta-percha supplemented with an additional substance/substances. [PERSON] et al., instead of comparing obturation materials with each other, compared the antibacterial effectiveness of different gutta-percha root canal filling techniques [17]. Additionally, the study by [PERSON] et al. also did not compare the antimicrobial properties of certain final obturation materials with each other; instead, it measured the impact of a temporary chlorhexidine or calcium hydroxide filling on the final gutta-percha antibacterial properties [29]. In the majority of cases, substances incorporated into gutta-percha included chlorhexidine [3; 6; 7; 13; 16; 21; 25; 26; 27] and calcium hydroxide [3; 6; 13; 16; 21; 25; 26; 27], with a consistent simultaneous comparison, except in the studies by [PERSON] et al. [7], where calcium hydroxide was utilized as an independent material in paste form, and [PERSON] et al. [13], where calcium hydroxide was both blended with gutta-percha and applied separately as a paste. All cones were procured in prefabricated form across all instances. Other substances combined with gutta-percha comprised iodoform [5; 18; 22] in the form of MGP, tetracycline in the form of TGP [14; 18], and zinc oxide [8; 11; 16].