Comparative evaluation of antimicrobial activity of miswak, propolis, sodium hypochlorite and saline as root canal irrigants by microbial culturing and quantification in chronically exposed primary teeth

Abstract

One of the essential factors for successful root canal therapy is elimination of bacterial contaminants using an effective root canal chemical irrigant such as sodium hypochlorite which inherently possesses certain disadvantages like irritation to periapical tissues, staining of the instruments, burning of surrounding tissues etc. The aim of the study was to explore newer irrigant agents which would probably be as effective or more and at the same time less irritating to the tissues than sodium hypochlorite. Our search included two such agents, propolis and miswak. The study was performed on 40 infected primary teeth (20 male and 20 female patients). The subjects were divided into 4 groups of 10 children. Group 1 received 3% sodium hypochlorite as irrigating solution, group 2 received 12.5% alcoholic extract of miswak, group 3 received 11% alcoholic extract of propolis and group 4, 0.9% saline. We used the antimicrobial activity of sodium hypochlorite as gold standard for comparing the activities of both propolis and miswak. We collected pre- and post-irrigation samples using sterile paper points. Samples were cultured on tryptose soya agar at a temperature of 37(o)C for 24-48 hours. The colonies were counted with a digital colony counter. For the statistical analysis, we used the unpaired t test at level of significance 0.05 and the ANOVA test for analysis of variance. The differences in pre- and post- irrigation values were calculated for each group, the greatest difference being seen in group 1 (95.549%) followed by group 2 (89.794%), group 3 (34.735%) and group 4 (28.087%). When comparing the results between groups, there was no statistically significant difference between groups 3 and 4. The statistically analyzed results suggested that miswak could be a good natural substitute to sodium hypochlorite, while propolis showed results comparable to those of the negative control.