Abstract
Introduction Salvadora persica L. (S. persica, Siwak) has been used for many centuries as oral hygiene tools, particularly in Saudi Arabia. This study aimed to assess the effectiveness of S. persica petroleum ether extract (SPE) as an intracanal bactericidal for endodontic treatment against Enterococcus faecalis. Calcium hydroxide Ca(OH)2 gold standard intracanal medicament was used for comparison. Methods The gas chromatography mass spectrometry (GC/MS) analysis was carried out to identify the components of SPE. First, the consistency of SPE was accomplished according to ANSI/ADA specification no 57. Forty-five single-rooted mandibular premolars were infected with that of E. faecalis suspension. Colony-forming units (CFU) were counted before the medicaments' application (CFU-1) and after seven days of their applications (CFU-2). Group I: SPE, Group II: positive control Ca(OH)2, and Group III: saline solution negative control. The microdilution method was applied to determine minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of SPE. Results Thirty-two compounds were identified (89.09%), with main components of benzyl isothiocyanate (BITC) (33.32%) and steroids (34%). CFU before and after using SPE and Ca(OH)2 recorded a statistically significant reduction in bacterial count (P=0.006) and (P=0.01), respectively. There was an insignificant difference between CFU after using SPE and Ca(OH)2 (P=0.210). On the contrary, comparing both medicaments with the negative control saline group resulted in significant differences, (P=0.001) and (P=0.007), respectively. Moreover, the equality of minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) of SPE is recorded. Conclusion This finding could be referred to the high content of bactericidal BITC in synergism with other antimicrobial components, representing 70.71% of SPE. Thus, SPE is a good candidate as an intracanal medicament, which warrants further investigation.
Highlights
Salvadora persica L. (S. persica, Siwak) has been used for many centuries as oral hygiene tools, in Saudi Arabia. is study aimed to assess the effectiveness of S. persica petroleum ether extract (SPE) as an intracanal bactericidal for endodontic treatment against Enterococcus faecalis
Teeth with previous endodontic therapy, fracture, crack, resorption, and root caries were excluded from the study. e present study followed the ethical guidelines for clinical investigation: ethical policy of the American Dental Association (ADA) regarding the use of human subjects in clinical research and approved by the Institutional Review Board (IRB), 21 January 2019, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia (IRB # 122-19)
Analysis of SPE by GC and gas chromatography mass spectrometry (GC/mass spectral data (MS)) revealed that SPE contained 32 compounds, of which benzyl isothiocyanate (33.32%), c-sitosterol (25.76%), stigmasterol (5.92%), β-sitosterol acetate (2.28%), n-hexadecanoic acid (4.27%), and (Z)-11-octadecenoic acid (3.16%) were found to be the major constituents
Summary
E foremost commonly utilized irrigants in endodontics are sodium hypochlorite (NaOCl), ethylenediamine-tetra-acetic acid (EDTA), and chlorhexidine (CHX), which can cause destructive side effects. Intracanal medicament such as Ca(OH) causes collagen breakdown and leads to weakening of radicular dentin. Plants and their extracts can be utilized as irrigant and intracanal medicament to avoid the potential side effects caused by routine chemical agents [9]. E present in vitro study was designed to assess the effect of an experimental intracanal medicament based on SPE against the most causative bacteria for endodontic pulpitis/periodontitis; E. faecalis. E gold standard intracanal medicament Ca(OH) was employed as positive control. e null hypothesis: there would be no difference between Ca(OH), the gold standard endodontic medicament, and SPE as an experimental intracanal medicament in bactericidal activity against E. faecalis for 7 days
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