Biocompatibility and Antibacterial Action of Salvadora persica Extract as Intracanal Medication (In Vitro and Ex Vivo Experiment).

Samah Samir Abdeltawab,Ensanya A Abou Neel,Tariq S Abu Haimed,Laila Ahmed Bahammam,Wafaa Talat Arab,Hammam Ahmed Bahammam

doi:10.3390/ma15041373

Abstract

This study aimed to test the biocompatibility and antibacterial properties of Salvadora persica (S. persica) extract, a natural product, as an intracanal medication in comparison with calcium hydroxide (Metapaste, META BIOMED, Cheongju, Korea). The pH values of both materials were tested. The biocompatibility of S. persica extract and Metapaste was determined using light microscopy and MTT assays. The antibacterial action was tested using the zone of bacterial inhibition on four common bacterial species. In addition, intracanal medication was administered using 68 extracted single-rooted teeth contaminated with Enterococcus faecalis (E. faecalis), and the percentage reduction in colony count (% RCC) at 1, 3, and 7 days was measured. The extension of activity for both materials was assessed using histological sections and scanning electron microscopy. S. persica was found to be acidic in nature. Both materials showed significantly lower cell viability than the positive control cells on days 1 and 3 but not on day 7. S. persica showed better antibacterial effects against E. faecalis and S. mutans. S. persica extract showed 97.6%, 98.9%, and 99.3% RCC values at 1, 3, and 7 days, respectively, which are comparable to those of Metapaste. S. persica herbal extract is a promising material that can be utilized as an intracanal medication, but its use requires further research.

Highlights

During root canal treatment, the conventional mechanistic approach of cleaning and shaping cannot achieve the desired removal of bacteria penetrating the dentinal tubules [1]
The null hypothesis (HO) is that there would be no significant difference between S. persica and Metapaste in terms of pH, biocompatibility, antimicrobial properties, and extension of dentin disinfection activity
For S. persica, our findings are in agreement with the study conducted by Tabatabaei et al, who found that, within 24–48 h of applying an increasing concentration of ethanolic extract, the cell viability was reduced to 70% compared to the cells with medium only [50]

Summary

Introduction

The conventional mechanistic approach of cleaning and shaping cannot achieve the desired removal of bacteria penetrating the dentinal tubules [1]. Phytotherapeutics are elements of CAM that rely on the use of herbal extracts to enhance the wellness of the individual [12] The introduction of these herbs is related to their biocompatibility, antioxidant, anti-inflammatory, and antibacterial activities. Other valid ingredients that are present in S. persica include calcium, chloride, fluoride, vitamin C, N-benzyl-2-phenylacetamide, and flavonoids [14,21]. The presence of vitamin C helps in healing and repair of the oral tissues; the vitamin acts as an antioxidant [14,22] This plant contains N-benzyl-2-phenylacetamide, which has shown efficacy against Escherichia coli [23]. The endodontics literature elucidates the mutable uses of S. persica for root canal irrigation [24], smear layer removal [25], and intracanal medication [26]. No study in the literature has used S. persica extract at 100% concentration

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