In-Vitro Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste with Chitosan Against Enterococcus Faecalis

Abstract

Aim: To evaluate the antimicrobial efficacy of triple antibiotic paste (ciprofloxacin, metronidazole and cefaclor) with chitosan, calcium hydroxide and normal saline against Enterococcus faecalis. Introduction: An infected root canal system is a unique niche for selective yet multiple species of microorganisms. There are broad spectrum species especially Gram-positive facultatives, which possess greater resistance to antimicrobial agents used during endodontic treatment. To prevent reinfection of a treated root canal, it is mandatory to disinfect the pulp space & dentinal tubules thoroughly with an endodontic irrigant or intra canal medicaments. Methodology: E. faecalis grown at a concentration of 1.5 ×108 CFU/ml is inoculated into 21 extracted human teeth with single root canal and incubated. These teeth are divided into 3 groups based on medicament used. Each experimental canal is placed with intracanal dressing TAP + Chitosan , calcium hydroxide and Normal Saline in group 1, 2, 3. Dentinal shavings are collected at 24 hours and 21 days interval following which post colony counts for microbial evaluation are calculated. Results: All groups except normal saline showed negligible microbial counts after 24 hours. At 21 day interval, there was significant increase in microbial count from 24 hours to 21 days. TAP+ chitosan had maximum antimicrobial efficacy while least by Calcium hydroxide. Conclusion: From the findings, it can be concluded Triple antibiotic paste with chitosan can be used as possible alternative for intracanal dressing over longer period of time. Keywords: Intracanal medicaments, Triple antibiotic paste, chitosan, calcium hydroxide, enterococcus faecalis