Intracanal Irrigants Research Articles

Antibacterial effect and smear layer removal ability of herbal intra-canal irrigants in primary teeth

Natural irrigants, specifically when used with children are important as they have fewer adverse effects. Objectives: To evaluate the antibacterial effect and smear layer removal ability of sage versus turmeric irrigants. Methods: 60 roots of primary teeth were inoculated with E. faecalis and randomly allocated to the following subgroups (12 roots each): Subgroup (I): 0.2% sage solution, Subgroup (II): 12.5% turmeric solution, Subgroup (III): 2% chlorhexidine solution, Subgroup (IV): contaminated only, Subgroup (V): negative controls. Microbiological culturing was performed. Assessment of the smear layer removal ability, 40 roots (10 roots in each group) were randomly divided; Subgroup 1: 0.2% Sage solution. Subgroup 2: 12.5% turmeric solution. Subgroup 3: 2% chlorohexidine. Subgroup 4: saline. The evaluation of smear layer removal was performed by SEM. Results: Chlorohexidine showed the highest percentage reduction in bacterial count followed by turmeric, then the sage group. A comparison of the smear layer removal, scores showed significant differences in the middle section of the different groups, with the turmeric group having a significantly higher median score than the sage group. Conclusion: chlorohexidine showed the highest antibacterial properties and smear layer removal ability followed by turmeric then sage.

A Systematic Review of the Comparative Efficacy of Lactobacillus Probiotics and Sodium Hypochlorite as Intracanal Irrigants Against Enterococcus faecalis.

Irrigation plays a pivotal role in the success of root canal treatments. The development of innovative, less hazardous irrigating solutions is necessary because of the inherent limitations of the gold standard, sodium hypochlorite. Since probiotics have proven to be effective in treating common oral diseases such as periodontitis and dental caries, they have gained attention in the field of endodontics as well. The present systematic review aims to assess the efficacy of Lactobacillus probiotics against Enterococcus faecalis compared to that of sodium hypochlorite. A thorough search of five databases, PubMed, Scopus, EBSCOhost, ScienceDirect, and BVS (Biblioteca Virtual en Salud, or Virtual Health Library), from January 2000 to January 2024 yielded 135 articles after a preliminary search. Three research publications that satisfied the strict inclusion and exclusion criteria were charted after the removal of duplicates and careful examination of the full-text articles. The Quality Assessment Tool for In Vitro Studies (QUIN Tool) was used to assess the quality of the study, aiming to identify any risk of bias. All three publications hada low risk of bias and demonstrated that Lactobacillus species were effective against E. faecalis and proved to be a safer alternative to sodium hypochlorite as an intracanal irrigant. However, more clinical trials are required to determine the best probiotic combinations, appropriate probiotic carriers, andideal dosage and frequency of administration before using probiotics as intracanal irrigants in clinical trials.

Evaluation and comparison of the efficiency of ultrasonically activated intracanal irrigants grapeseed and pineapple extract in removing smear layer from the apical third of the root canal: An in vitro SEM analysis

ABSTRACT Aim: This study aims to evaluate and compare the efficiency of grapeseed and pineapple extract in removing smear layer from the apical third of root canal, with and without ultrasonic activation. Methods: Eighty single-rooted permanent teeth were divided into two main groups: Group I: conventional syringe irrigation and Group II: ultrasonic activation. Each group was subdivided into two experimental groups, i.e. grapeseed and pineapple extract and one control group, i.e., 17% ethylenediaminetetraacetic acid (EDTA). For each subgroup, instrumentation was done using ProTaper Gold up to size F3 and irrigated with 5 mL of the respective irrigant, followed by a final rinse of 2.5 mL of 5.25% NaOCl. For Group II, the respective irrigant was ultrasonically activated for 1 min, followed by a final rinse of 2.5 mL of 5.25% NaOCl. Smear layer evaluation was done with scanning electron microscope, and data were statistically analyzed. Results: In Group I, both pineapple and grapeseed extracts were more effective than 17% EDTA in removing smear layer from the apical root canal. However, in Group II, 17% EDTA showed highest efficacy in smear layer removal, followed by pineapple and grapeseed extracts (P < 0.05). Conclusion: Natural extracts such as pineapple and grapeseed seeds extracts exhibit potential for smear layer removal in the apical third, without the disadvantage of dentinal erosion from synthetic smear layer removing agents.

Comparative Evaluation of 1% Sodium Hypochlorite vs Other Intracanal Irrigants during Pulpectomy of Primary Teeth: A Systematic Review

Comparative Evaluation of 1% Sodium Hypochlorite vs Other Intracanal Irrigants during Pulpectomy of Primary Teeth: A Systematic Review

The ability of working length determination of the electronic apex locator Propex Pixi in the presence of various irrigants - an in vitro study

Background: To achive success in endodontic treatment, the clinicians have to completely control the depth of penetration of instruments inside the root canal called the working length. Determining the working length by using electronic apex loactors have been increasingly popular and gradually become an indispensable tool in endodontics. The purposes of this study was to compare the working length determined by Propex Pixi with the actual canal length as well as evaluate the effect of various intracanal irrigants on the accuracy of Propex Pixi. Materials and method: 45 human incisors extracted for periodontal reasons were selected for this in vitro study. Standard access preprations were prepared, then digital Caliper was used to meassure the actual root canal length. Teeth were imbedded in alginate model. The working length was determined by using the Propex Pixi in the presence of different irrigant solutions: distilled water, 2.5% NaOCl and 2% Chlorhexidine. The working length meassurements obtained with Propex Pixi were compaired with the actual root canal length and then evaluating the effect of irrigation solutions on the accuracy of Propex Pixi. Results: There was no significant differences between the actual canal length and the WL determined by Propex Pixi (p > 0.05). Root canal irrigants has no effect on the accuracy of Propex Pixi. Conclusion: There was no significant differences between actual root canal length with the measurements obtained by Propex Pixi. The accuracy of Propex Pixi was not affected by the irrigants used. Key words: working length, electronic apex locator, Propex Pixi.

Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study.

It is difficult to completely eradicate microorganisms from the infected root canal system. Intracanal irrigants seem necessary for eradication of infected tissues and microorganisms in addition to mechanical debridement. Continuous use of chemical antimicrobial agents leads to serious side effects. Therefore, the need arises for alternative agents to overcome the disadvantages of their chemical counterparts. To evaluate and compare the antimicrobial efficacy of three endodontic irrigants against clinically isolated bacteria found in root canals containing necrotic pulp. Preirrigation sample were collected using sterile paper points and sent for microbial count. Chemomechanical preparation was performed, and the root canals were irrigated with 5 mL of test samples. After 3 days, the patient was recalled, and a postirrigation sample was collected and sent for microbial count. Both 3.8% silver diamine fluoride (SDF) and 3% sodium hypochlorite (NaOCl) showed a superior capacity to sterilize the root canals compared to the neem group. The use of SDF as an endodontic irrigant is feasible as it effectively removes the microbes present in the canal. Silver diamine fluoride has not been shown to be cytotoxic or carcinogenic, unlike NaOCl, suggesting it could be used as a potential endodontic irrigant. However, few studies have evaluated the antimicrobial efficacy of SDF as an endodontic irrigant. Raj S, Sharma A, Dhinsa K, et al. Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(6):625-629.

The effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth.

This experimental study investigated the effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth. The crowns of 90 anterior primary teeth were sectioned horizontally, 1 mm above the cementoenamel junction (CEJ). Following canal preparation with K-files, all groups except the negative control received normal saline irrigation. Canals were then irrigated with either 3% or 5.25% sodium hypochlorite (NaOCl), 2% or 0.2% chlorhexidine (CHX) solution (except negative and positive controls). The roots were filled with Metapex material and covered with a calcium hydroxide liner. In root canals, the bond was applied by self-etching and then light-cured for 20 seconds before canals were restored incrementally with composite. Stereomicroscopes were used to assess failure patterns. Push-out bond strengths (MPa ± SD) were: 3% NaOCl (16.92 ± 5.78), 5.25% NaOCl (8.96 ± 3.55), 2% CHX (14.76 ± 5.56), and 0.2% CHX (7.76 ± 2.93). Significant differences were seen across the irrigants regarding the push-out bond strength of dentin sections (P <0.001). The most frequent failures were adhesive and cohesive. NaOCl and CHX irrigants increased the push-out bond strength compared to controls. Compared to controls, both 3% NaOCl and 2% CHX irrigants significantly increased the push-out bond strength of dentin in non-vital anterior primary teeth.

Comparative evaluation of effect of modified triple antibiotic paste and calcium hydroxide as intracanal medicament on microhardness of root dentin: An in vitro study

ABSTRACT Aim: To assess and compare the impact of modified triple antibiotic paste (MTAP) and calcium hydroxide (CH) as intracanal medicament on microhardness (MH) of root dentin. Materials and Methods: Twenty single-rooted, noncarious, single-canaled permanent teeth were selected. They were decoronated and vertically sectioned into two equal parts to acquire 40 samples. These samples were submerged in acrylic blocks with their pulpal surfaces exposed. These samples were enclosed within acrylic blocks, with their pulp surfaces visible. They were then randomly allocated into four groups (n = 10). MH was measured at three steps: initial measurement of MH before irrigation with 3% sodium hypochlorite (NaOCl); after irrigation with 3% NaOCl; and after interaction with medications (MTAP or CH pastes at an interval of 7 days or 30 days). The degree of reduction in MH percentage was computed. The collected data underwent statistical examination at a significance threshold of P &lt; 0.05. Results: All procedures led to a noteworthy decline in MH values when compared to both prior and initial measurement. The highest reduction in MH was seen after irrigation with 3% NaOCl (P &lt; 0.05). CH showed a greater reduction in MH as compared to MTAP (P &lt; 0.05). More reduction in MH was seen after 30 days as compared to that after 7 days for both CH and MTAP (P &lt; 0.05). Conclusion: Use of intracanal irrigants and medicaments reduces the MH of root dentin. Lesser reduction in MH was observed when utilization of MTAP as compared to CH.

The ability of different diffusing enhancers to deliver chlorhexidine into dentinal tubules: An in vitro evaluation

Background/purposeRoot canal irrigants are difficult to diffuse deep into the dentinal tubules for root canal disinfection. The purpose of this study was to assess the ability of different diffusing enhancers to deliver chlorhexidine (CHX) into dentinal tubules. Materials and methodsThe diffusing property of five diffusing enhancers (acetone, DMSO, Triton X-100, JFC-E and azone) into dentinal tubules was firstly assessed using the Rhodamine B. The ability of the diffusing enhancers to deliver CHX into dentinal tubules was then evaluated both qualitatively and quantitatively. A deep dentinal tubule Enterococcus faecalis infection model was further established to test the bactericidal effect of CHX delivered by different diffusing enhancers. Finally, the in vitro cytotoxicity of these diffusing enhancers was tested using the CCK-8 method. ResultsAzone, Triton X-100 and JFC-E exhibited the largest maximum diffusing depths at all root canal parts (P < 0.05). Azone group also showed the highest percentage of diffusing depths for all root canal parts, followed by Triton X-100 (P < 0.05). The percentage of dead bacteria in dentinal tubules close to cementum layer was significantly higher in the CHX + azone group than in the other groups (P < 0.05), followed by CHX + Triton X-100 and CHX + JFC-E groups. The concentration of CHX diffusing onto the exterior surface of root was significantly higher in CHX + azone group than in the other groups (P < 0.05). All the diffusing enhancers showed relatively low cytotoxicity. ConclusionAzone showed the highest diffusing ability with low cytotoxicity and might be employed as a carrier agent for either intracanal irrigants or medications to achieve more thorough root canal disinfection.

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.

Ozone: An Adjunct in Dental Treatment.

Ozone is utilized in dentistry as ozonated oils, ozonated water, and gaseous ozone. The application of ozone in all specialties of dentistry has been demonstrated to be biocompatible. It has been demonstrated to encourage the remineralization of recently carious teeth, and it is utilized in dental caries and intracanal irrigants in endodontic treatment. Herpes virus infection, avascular osteonecrosis of the jaw, and alveolitis have all been treated with it. It can be applied as a supplement in the surgical and ongoing stages of periodontal disease and also hinders plaque formation. The purpose of the present review article is to discuss the numerous application of ozone in dentistry.

Effects of Irrigants on Pulp Stem Cells: A Systematic Review

Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal methods to achieve predictable clinical outcome. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This systematic review summarizes the present knowledge regarding the effect of intracanal irrigants on the dental derived stem cells fate in regenerative endodontic procedures. Keywords: Chlorhexidine; Growth factors; Intracanal irrigants; NaOCl; Regenerative endodontics;

Assessment of the root surface temperature during the use of intracanal agitation systems: In vitro study.

This study aimed to evaluate the temperature changes that the different methods of agitation of irrigants promote on the external dental root surface. Nine extracted human lower premolars were standardized by cone-beam computed tomography and used. The root canal was instrumented with a Reciproc 40.06 file. Temperature measurement was performed using K-type thermocouple sensors attached to the middle, cervical, and apical thirds of the teeth. The teeth had their roots immersed in distilled water at 37ºC, which were distributed into 3 experimental groups according to the mechanical agitation methods to be studied. US Group (n=3), Irrisonic Ultrasonic Tip activated through ultrasound; EC Group (n=3), Easyclean Tip coupled to a contra-angle low-speed handpiece; XP Group (n=3), XP-endo Finisher file coupled to an endodontic electrical motor. Temperature measurements were performed simultaneously with agitation and irrigation of intracanal irrigants. Statistical analysis was performed using SPSS software with a significance level of 5%. For multiple comparisons, the Tukey test was used. The association between mechanical agitation methods and root third was statistically significant. Regarding the temperatures recorded on the external surface of the roots, the ultrasonic tip was significantly higher than the XP-endo Finisher file and the Easyclean tip, which did not differ from each other. Regarding the ultrasonic tip, the external temperature in the middle third (39.46ºC) of the root was significantly lower than in the cervical (40.41ºC) and apical third (40.53ºC). None of the agitation methods of irrigants studied presented heating above 47ºC, and their use is safe for periodontal tissues.

Efficacy of Smear Layer Removal of Human Teeth Root Canals Using Herbal and Chemical Irrigants: An In Vitro Study.

Objectives Over many years, many intracanal irrigants have removed smear layers during routine root canal therapy. The efficacies of conventional endodontic chemical irrigants are documented, but limited research is available on herbal irrigants' role in the endodontic therapy irrigation protocol. This study aimed to evaluate endodontic irrigants' smear layer removal efficacy, namely, 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), green tea extract, and Triphala extract, using scanning electron microscopy (SEM) analysis. Methods Fifty freshly extracted human permanent maxillary and mandibular single-rooted teeth were collected from the Oral Surgery Department of Regional Dental College (RDC), Guwahati, India. The samples were divided into five groups with 10 teeth each: Group A: sterile distilled water (negative control), Group B: 3% NaOCl, Group C: 17% EDTA, Group D: green tea, and Group E: Triphala (citric acid). Each tooth was then longitudinally splitand prepared for SEM inspection under 1000X magnification. The comparison of smear layer removal scores between the groups was done by the Kruskal-Wallis test and Mann-Whitney test, with the significance level set at p<0.01. Results The comparison of the overall mean smear scores and those at different root portions shows that Group C has the lowest mean score, followed by Group E. The pairwise comparison shows that the difference in the mean smear scores between Group C and the other four groups is statistically significant (p-value<0.05). Moreover, the difference in the overall, coronal, middle, and apical mean smear scores between Group A and Group E was highly significant (p-value<0.001). Conclusions The highest smear layer removal efficacy was observed in the samples treated with 17% EDTA. Moreover, the clearing efficacy of Triphala is significantly better than that of distilled water in smear layer removal.

A Comparative Evaluation of Antibacterial Efficacy of Moringa oleifera Leaf Extract, Octenidine Dihydrochloride, and Sodium Hypochlorite as Intracanal Irrigants against Enterococcus faecalis: An In Vitro Study.

The aim of this study is to investigate and compare the microbial efficacy of Moringa oleifera leaf extract, octenidine dihydrochloride (OCT), NaOCl, and their combinations as intracanal irrigants against Enterococcus faecalis. Sixty single-rooted mandibular premolars were decoronated followed by root canal preparation. Each root specimen was autoclaved, inoculated with E. faecalis, and incubated at 37°C for 48 hr. Then, the specimens were divided into six groups based on the irrigation solution used: 2.5% NaOCl (Group 1), 0.1% OCT (Group 2), M. oleifera leaves extract (Group 3), a combination of M. oleifera extract and 1.25% NaOCl (Group 4), a combination of M. oleifera extract and OCT (Group 5) and normal saline (Group 6). Microbial samples were taken from each root canal before (S1) and after (S2) irrigation and the bacterial viability was assessed using colony-forming units (CFU) on bile esculin agar plates. Comparing the number of CFU/ml before and after irrigation showed a significant reduction (P < 0.001) in all studied groups. Comparison between the CFU/ml after irrigation by NaOCl and each of the combination groups showed a significant difference. M. oleifera leaves extract and 0.1% OCT solutions have antibacterial effect against E. faecalis comparable to 2.5% NaOCl and might be used as root canal irrigants. The combination groups showed better antimicrobial activities than individual irrigants. However, further studies are required to investigate the biocompatibility and possible toxic effects of the tested irrigants.

Antibacterial Efficacy of Irrigants with Varying Osmolarity on E. faecalis Biofilm: An In Vitro Study.

To evaluate the role of the addition of different concentrations of sodium chloride salt to conventional intracanal irrigants to vary their osmotic values and thereby compare their antibacterial efficacy. In an active attachment biofilm model, Enterococcus faecalis (ATCC 29212) biofilms were grown. Sodium chloride salts were added to 100 mL of distilled water to make 6M (hyperosmotic), 0.5M, and 0.25M (hypoosmotic) sodium chloride solutions, respectively. The experimental groups were divided into three groups: Group I: 5.25% sodium hypochlorite, group II: 2% chlorhexidine, and group III: 2% povidone iodine, and four subgroups within these three groups, such as subgroup A (without salt solution), subgroup B (with 6M of hyperosmotic salt solution), subgroup C (with 0.5M of hypoosmotic salt solution), and subgroup D (with 0.25M of hypoosmotic salt solution), respectively. Biofilms were treated with all the subgroups for a contact time of 15 min. A crystal violet assay was done to estimate the bacterial cell biomass. The results revealed that subgroups IIIB, IB, and IID, ID had a statistical reduction in bacterial biomass at p < 0.05. There were no significant differences between subgroups IC, IIC, and IIIC and subgroups IA, IIA, and IIIA. The antibacterial efficacy of all three irrigants was significantly affected by varying the osmolarities. The results prove that the hyperosmotic and hypoosmotic salt solutions, along with irrigants, have enhanced antibacterial efficacy on E. faecalis biofilm due to its ability to vary the turgor pressure of cell wall, as well as the inherent properties of the irrigants such as hypochlorous acid formation, ionic interaction, and free radical interactions.

Comparative antibacterial effects of ginger and marjoram extract versus conventional irrigants on mature Enterococcus faecalis biofilms: An in vitro study.

This study evaluated antibacterial effects of Ginger and Marjoram extract compared with Routine Intracanal Irrigants on Mature Enterococcus faecalis Biofilms. Sixty-six extracted human teeth, were randomly assigned to four groups 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), chloroform extract of marjoram (Origanum majorana), and oil extract of ginger (Zingiber officinale), and two positive and negative control groups (n=11). Samples were contaminated with E. faecalis, except the negative control group. Then the root canals were irrigated with solutions above, after which dental debris was collected from each tooth separately, followed by culturing on plates containing BHI agar. The bacterial counts were finally determined with a colony counting machine. No bacterial growth was detected in the NaOCl, CHX, and negative control groups. However, some bacterial growth was observed in the ginger and marjoram groups. All four solutions successfully eliminated E. faecalis biofilms compared to the positive control group. Significant difference in the median bacterial growth between the ginger and marjoram groups and the positive control group (P<0.001) has been shown. There was no significant difference in median bacterial growth between the ginger and marjoram groups (P=0.94). Chloroform extract of marjoram and oil extract of ginger were effective in eliminating 6-week-old biofilms of E. faecalis in vitro; however, their effect was not as favorable as CHX and NaOCl. These herbal extracts yielded promising results in the present study; therefore, they can be used as intracanal irrigants instead of chemical agents. Key words:Biofilm, Chlorhexidine, E. faecalis, Ginger, Marjoram, Sodium hypochlorite.

In vitro study to compare antibacterial efficacy of cinnamon extract, neem extract and sodium hypochlorite as root canal irrigants

Background: E. faecalis is the predominant micro-organism recovered from root canal of the teeth where previous endodontic treatment has failed. Thorough debridement and complete elimination of micro-organisms are objectives of an effective endodontic treatment. For many years, intracanal irrigants have been used as an adjunct to enhance antimicrobial effect of cleaning and shaping in endodontics. Aim: The aim of the study is to compare the antibacterial effectiveness between cinnamon extract as irrigant with neem extract irrigant and sodium hypochlorite against E. fecalis. Methodology: The present study is a randomized controlled in vitro study conducted on 90 extracted permanent single rooted teeth. The teeth were divided into three groups- Group 1 was irrigated with cinnamon extract, Group 2 was irrigated with neem extract irrigant and Group 3 with 3% sodium hypochlorite. The colonies in the reduction of E. feacalis was noted as CFU values per ml. Wilcoxon signed ranked test was used to compare in between the three groups. Mann- Whitney's test was used for inter group comparison between the three groups.

Exploiting the antibacterial effects of nine formulations of intracanal medication and irrigants against several bacterial strains

Elimination of intraradicular infection is essential for the success of endodontic treatment. This study evaluated the antibacterial effects of nine different formulations of intracanal medication and irrigating solutions, based on calcium hydroxide (Ca(OH)2), calcium sulfate (CaSO4), and a chlorhexidine (CHX), against nine bacterial strains. Aerobic or facultative anaerobic bacteria were grown in trypticase-soy broth and the anaerobic strain was grown in pre-reduced anaerobically sterilized brain heart infusion. The evaluation was performed by using the agar diffusion test in aerobic and anaerobic conditions using plates containing mitis-salivarius agar or trypticase-soy agar. The results showed that practically all substances tested had some antibacterial activity, except for calcium hydroxide and calcium sulfate when associated only with glycerin, which did not show any bacterial growth inhibition. On average, the drugs that showed the greatest antibacterial effects were 2% chlorhexidine and calcium hydroxide paste in camphorated paramonochlorophenol (CPMC) /glycerin and 0.12% chlorhexidine. It was concluded that 0.12% CHX as intracanal medication based on 2% CHX gel showed better antimicrobial action of the substances tested on bacterial species of endodontic infection.

Antimicrobial Efficacy of Morinda citrifolia, Nisin, and 2% Chlorhexidine Against Enterococcus faecalis: An In-Vitro Study.

AimThe aim of this study was to evaluate and compare the antimicrobial activity of 2% chlorhexidine gluconate (2% CHX), Morinda citrifolia (M. citrifolia), and nisin (NI) all in gel forms against Enterococcus faecalis (E. faecalis)-infected root canals.MethodologyForty single-rooted mandibular premolars extracted for orthodontic reasons were decoronated and chemomechanical preparation of the root canal was performed. After sterilization, the samples were inoculated with E. faecalis for one week and grouped according to the medicament used namely, saline as the control group (Group-A), 2% CHX (Group-B), M. citrifolia (Group-C), and NI (Group-D). After 7days of incubation, in order to evaluate the effectiveness of the intracanal medicaments on the canal wall and its radicular dentin, the specimens dentin chips were retrieved and inoculated on brain heart infusion (BHI) blood agar plates from each tube and incubated at 37°C for 24 hours to obtain bacterial colony forming unit (CFU) count. The data was statistically analyzed using one-way ANOVA test and multiple comparisons among different groups were complemented by post hoc Tukey test.ResultsThe CFU count indicating the number of viable bacterial colonies was found to be highest in Group-A (saline). Group-B (CHX 2%) showed the least CFUs followed by Group-D (NI) and Group-C (M. citrifolia).ConclusionIn an attempt to overcome the disadvantages and toxic effects of a few commercially available intracanal medicaments and irrigants, the present study was aimed at using herbal extracts to evaluate and compare their antimicrobial efficacy with the commercially available medicaments against E. faecalis. Nisin was an effective antimicrobial agent and its action was found to be comparable with CHX.