Efficacy of Salvadora persica root extract as an endodontic irrigant – An in-vitro evaluation

Abstract

IntroductionThe main reason for endodontic failure is bacteria and chemical irrigation using chemicals in the form of irrigation has been deemed effective. The objectives of this study were to evaluate the in vitro antimicrobial effects of Salvadora persica extract as an endodontic irrigant and to compare it with sodium hypochlorite (NaOCl). MethodsIn this study, stock solutions of 10 mg/ml of ethanolic Salvadora persica extract and 1% of sodium hypochlorite were serially diluted three times and then exposed to alamarBlue® cell viability testing on human gingival fibroblast cells. Antimicrobial investigations used Crystal violet assay and live/dead® Baclight™ assay on Pseudomonas aeruginosa and E. faecalis biofilms followed by confocal laser scanning microscopy (CLSM) imaging. The results were further analyzed using appropriate statistical tests. Values of p ≤ 0.05 were considered statistically significant. ResultsThe Salvadora persica root extract was cytotoxic to gingival fibroblasts but significantly weaker than NaOCl at its highest concentration. Antimicrobial activity was observed for both irrigation solutions, but NaOCl has significantly stronger antimicrobial effects in the live/dead® assay. NaOCl could reduce the bacterial viability for both species more than Salvadora persica extract in the Crystal violet assay. There were limited effects of Salvadora persica extract on Pseudomonas aeruginosa; these effects were confirmed on CLSM images. ConclusionEthanolic Salvadora persica root extract demonstrated cytotoxic and antimicrobial effects that were significantly weaker than NaOCl exposure. These variations in effects might introduce the herbal extract as an alternative irrigant especially for regenerative endodontic treatments that require great care for cellular components.