Infected Root Canals Research Articles

The Influence of Minimally Invasive Access Cavities on the Cleaning Ability of Primary Infected Root Canals: An in-Vitro Study

The Influence of Minimally Invasive Access Cavities on the Cleaning Ability of Primary Infected Root Canals: An in-Vitro Study

Comparative evaluation of antimicrobial efficacy of 3C antibiotic paste with triple antibiotic paste as root canal filling material for primary teeth: An in-vitro study

Root canal infection in primary teeth is polymicrobial in nature. Most resistant micro-organisms, such as E.faecalis survive in chronic infection of the root canal at the periapical area and are difficult to remove by various root canal irrigants. C.albicans has been found in chronic infections of root canals of primary teeth due to its ability to invade dentinal tubules. The multiple bacteria strains which cause endodontic infections, make it difficult to clean root canals with a single effective antibiotic. Hence Triple Antibiotic Paste (TAP) has been previously introduced, consisting of ciprofloxacin, metronidazole, and minocycline. Although this mixture aids in pulp regeneration and has been used to disinfect root canal systems, it is linked to tooth discolouration. The aim of this study is to evaluate and compare the antimicrobial efficacy of a newly formulated 3C antibiotic paste (consisting of Ciprofloxacin, Clindamycin, and Cefaclor) with conventional TAP against E. faecalis and C. albicans. In this in-vitro laboratory study, pure culture of C. albicans and E. faecalis will be grown on Sabouraud’s dextrose agar (SD) agar and Brain heart infusion agar (BHI) agar respectively and will be suspended for 24 hours at 37°C. For comparison of antimicrobial efficacy, the zone of inhibition will be for the 3C antibiotic paste against conventional TAP (control) for E. faecalis and C. albicans, and will be determined using digital calliper in millimetre after every 24 and 72 hours. We hypothesise that the newly formulated 3C paste will have better antimicrobial efficacy when compared with conventional TAP. It is expected that a newly formulated 3C paste will prove to be the successful as root canal filling material for primary teeth.

Comparative molecular study of Enterococcus faecalis in endodontic treatment pre and postdiode laser application

Abstract Background: Endodontic infections are polymicrobial, with the majority of bacteria being anaerobic and others being facultative. Objective: To detect and measure the level of Enterococcus faecalis in infected root canals during traditional cleaning techniques and after diode laser application by using real-time polymerase chain reaction (RT-PCR). Materials and Methods: Ninety samples were collected from 30 participant patients complaining of acute or chronic pulpitis with an age range of 18–50 years old; the teeth indicated endodontic treatment, including both anterior and posterior teeth. Thirty swabs were taken preinstrumentation, and then 30 swabs were taken after instrumentation and canal irrigation using sodium hypochlorite 5.25%, and then 30 swabs were taken in the same manner after the root canal sterilization with the diode laser. Results: This study included 30 patients with root canal infection presented with a mean age of 31.7 ± 8.6 years and a range of 18–50 years; Female patients were more than males (34.3% vs. 36.7%). The mean E. faecalis copy number was significantly reduced from precleaning status to postcleaning with sodium hypochlorite (5.25%) and postlaser therapy (P = 0.05). Conclusions: RT-PCR assay is a highly effective, dependable, and rapid technique for accurate detection and copy number counting of E. faecalis in the infected root canal; this molecular and clinical study supports the diode laser application of 940-nm WL as an adjuvant tool combined with sodium hypochlorite (5.25%) in canal disinfection during root canal treatment to reduce E. faecalis copy numbers.

Highly Effective DPA-SCP Sonosensitizer for Biofilm Removal in Infected Root Canals via Sonodynamic Therapy

Chemical debridement constitutes a pivotal phase in eradicating microbial entities during endodontic therapy. The antimicrobial efficacy of endodontic irrigants in clinical use is contingent upon their concentration; however, elevated concentrations...

Evaluation of the antibacterial efficacy of nanomodified triple antibiotic paste with nano anti-inflammatory drug and nano calcium hydroxide as intracanal medicament using confocal laser scanning microscope

Aim: To evaluate and compare the antibacterial efficacy of Nano amoxicillin modified Triple antibiotic paste (mTAP) with nano Ibuprofen and nano calcium hydroxide (Ca(OH)2) as a root canal medicament on Enterococcus faecalis infected root canal dentin.. Methods: Sixty eight semi-cylindrical root samples were infected for 3 weeks with E. faecalis ATCC 29212 and randomly assigned into 4 Groups based on the medication used, Ca(OH)2; Nano Ca(OH)2; Amoxicillin mTAP +I (Ibuprofen); Nano Amoxicillin mTAP + Nano Ibuprofen and was incubated for 7 days. The proportions of dead and live bacteria was quantitatively analyzed by Confocal laser scanning microscopy. One-way ANOVA was used to compare the four groups and intergroup comparison with Tukey’s post hoc tests. Results: Nano Amoxicillin mTAP with Nano Ibuprofen was shown to have a higher antibacterial effect against E. faecalis compared to the unmodified medicaments. Conclusion: Nanomodified ICMs of APIs showed better antimicrobial activity due to their increased stability and deeper penetration into dentinal tubules when compared to conventional forms of ICMs.

Poly(Lysine)-Derived Carbon Quantum Dots Conquer Enterococcus faecalis Biofilm-Induced Persistent Endodontic Infections.

Persistent endodontic infections (PEIs) mediated by bacterial biofilm mainly cause persistent periapical inflammation, resulting in recurrent periapical abscesses and progressive bone destruction. However, conventional root canal disinfectants are highly damaging to the tooth and periodontal tissue and ineffective in treating persistent root canal infections. Antimicrobial materials that are biocompatible with apical tissues and can eliminate PEIs-associated bacteria are urgently needed. Here, ε-poly (L-lysine) derived carbon quantum dots (PL-CQDs) are fabricated using pyrolysis to remove PEIs-associated bacterial biofilms. Due to their ultra-small size, high positive charge, and active reactive oxygen species (ROS) generation capacity, PL-CQDs exhibit highly effective antibacterial activity against Enterococcus faecalis (E. faecalis), which is greatly dependent on PL-CQDs concentrations. 100 µg/mL PL-CQDs could kill E. faecalis in 5 min. Importantly, PL-CQDs effectively achieved a reduction of biofilms in the isolated teeth model, disrupting the dense structure of biofilms. PL-CQDs have acceptable cytocompatibility and hemocompatibility in vitro and good biosafety in vivo. Thus, PL-CQDs provide a new strategy for treating E. faecalis-associated PEIs.

Comparison of antimicrobial efficacy of green tea extract and Triphala as root canal irrigants against Fusobacterium nucleatum using real-time polymerase chain reaction – An in vitro study

Aim: Fusobacterium nucleatum has gained attention in the endodontic literature as it is a predominant microorganism in primary, secondary, and persistent root canal infections. Current irrigants have lot of drawbacks and are unlikely to predictably achieve a bacteria-free root canal system, which can lead to these failures. Herbal alternatives are now gaining popularity in the field of endodontics, paving a new way in the disinfection of root canals. The aim of this study is to evaluate the antimicrobial efficacy of green tea extract and Triphala as root canal irrigants against F. nucleatum using real-time Polymerase chain reaction (PCR). Methods: Extracted teeth were taken and inoculated with F. nucleatum, which was grown in a Mueller–Hinton agar plate under anaerobic conditions. The samples were cleaned and shaped and irrigated with green tea extract, Triphala extract, and dimethyl sulfoxide, which were compared to the widely used irrigant, sodium hypochlorite. Cycle threshold value was used to calculate the efficacy of the irrigant against F. nucleatum after which the samples were subjected to reverse transcriptase PCR. The data were analyzed and the data between the group were compared using the one-way ANOVA followed by a post hoc Tukey’s test. Results: Triphala extract demonstrated high antimicrobial activity against F. nucleatum1. It revealed statistically significant differences between Triphala extract and sodium hypochlorite (NaOCL) (P = 0.001). Green tea extract also displayed antimicrobial activity. Both the Triphala and green tea extracts showed a significant difference (P < 0.001). Conclusion: Triphala extract showed better antibacterial efficacy when compared to 3% NaOCl and green tea extract against F. nucleatum.

Photodynamic therapy empowered by nanotechnology for oral and dental science: Progress and perspectives

Abstract Photodynamic therapy (PDT), as a noninvasive therapeutic modality, has significantly revolutionized the contemporary management of oral and dental health. Recently, PDT has witnessed significant technological advancements, especially with the introduction of biomaterials and nanotechnologies, thus highlighting its potential as a multi-functional tool in therapeutics. In this review, our objective was to provide a comprehensive overview of the advancements in nanotechnology-enhanced PDT for the treatment of oral diseases, encompassing dental caries, root canal infection, periodontal disease, peri-implant inflammation, tooth staining, and whitening, as well as precancerous lesions and tumors. Furthermore, we extensively deliberated upon the persisting challenges and prospective avenues of nanotechnology-enhanced PDT in the realm of oral diseases, which will open up new possibilities for the application of nanotechnology-enhanced PDT in clinical implementation.

Assessment of Periapical Status in Posterior Root Canal-Treated Teeth Using Cone Beam Computed Tomography in the Iranian Population

Background: Periapical radiolucency occurs due to root canal infections. In this respect, effective root canal treatment and appropriate coronal restoration can aid in preventing these lesions. Thus, the present study aimed to assess the periapical status in posterior root canal-treated teeth by cone-beam computed tomography (CBCT) in the Iranian population. Methods: The CBCT images of 210 patients (475 endodontically treated molars and premolars) referred to the Hamadan Dental School (from 2020 to 2022) were evaluated in this observational study. The images were obtained by a NewTom 3G CBCT device (NewTom, Verona, Italy) with an FOV of 6×6 inches at 110 kVp and varying milliampers and exposure times according to the patient’s age and body size. They were observed by two maxillofacial radiologists who recorded the periapical status, coronal seal, and endodontic treatment quality of root canal-treated teeth. The Chi-square test was used for data analysis (P≤0.05). Finally, the periapical lesion was determined, along with its association with gender, type of tooth, endodontic treatment quality, and appropriate restoration. Results: The results revealed no significant association between periapical radiolucency and gender. The prevalence of periapical lesions was higher in males aged 25–50 years, but no significant correlation was found in this regard. There was no significant relationship between tooth type and the presence of periapical lesions, while it had the highest prevalence in maxillary molars. Endodontic treatment quality and coronal restoration showed significant correlations with the presence of periapical radiolucency. Conclusion: There was no significant association between the presence of periapical radiolucency and gender and age. The prevalence of periapical lesions was higher in males. Cases with poor endodontic treatment and poor restoration demonstrated the highest prevalence of periapical lesions.

Profiling Antibiotic Susceptibility among Distinct Enterococcus faecalis Isolates from Dental Root Canals.

Enterococcus faecalis, a leading multi-resistant nosocomial pathogen, is also the most frequently retrieved species from persistently infected dental root canals, suggesting that the oral cavity is a possible reservoir for resistant strains. However, antimicrobial susceptibility testing (AST) for oral enterococci remains scarce. Here, we examined the AST profiles of 37 E. faecalis strains, including thirty-four endodontic isolates, two vanA-type vancomycin-resistant isolates, and the reference strain ATCC-29212. Using Etest gradient strips and established EUCAST standards, we determined minimum inhibitory concentrations (MICs) for amoxicillin, vancomycin, clindamycin, tigecycline, linezolid, and daptomycin. Results revealed that most endodontic isolates were susceptible to amoxicillin and vancomycin, with varying levels of intrinsic resistance to clindamycin. Isolates exceeding the clindamycin MIC of the ATCC-29212 strain were further tested against last-resort antibiotics, with 7/27 exhibiting MICs matching the susceptibility breakpoint for tigecycline, and 1/27 reaching that of linezolid. Both vanA isolates confirmed vancomycin resistance and demonstrated resistance to tigecycline. In conclusion, while most endodontic isolates remained susceptible to first-line antibiotics, several displayed marked intrinsic clindamycin resistance, and MICs matched tigecycline's breakpoint. The discovery of tigecycline resistance in vanA isolates highlights the propensity of clinical clone clusters to acquire multidrug resistance. Our results emphasize the importance of implementing AST strategies in dental practices for continued resistance surveillance.

Polymeric nanoparticles delivery circumvents bacterial resistance to ciprofloxacin

Polymeric nanoparticles delivery circumvents bacterial resistance to ciprofloxacin

Clinical efficacy of endodontic protocols on reducing cultivable bacteria and endotoxin in infected root canal in patients submitted to head and neck radiotherapy: a randomised clinical trial.

Assess the efficacy of biomechanical preparation using a reciprocating system followed by final irrigation protocols, then intracanal medication, on reducing endotoxins and cultivable bacteria of infected teeth in irradiated patients. Twenty-two infected single-rooted canals in patients submitted to head and neck radiotherapy were prepared by reciprocating motion and 2.5% NaOCl. Patients were randomly divided into two groups of 11 patients before the final irrigation protocol: apical positive pressure (APP) or passive ultrasonic activation (PUA). Both groups were treated in two sessions, using Ca(OH)2 as intracanal medication for 14 days. Root canal content sampling was performed after canal access (S1), after biomechanical preparation plus the irrigation protocol (S2), and after intracanal medication (S3). Chromogenic limulus amoebocyte lysate assay measured endotoxin levels (EU/mL), and bacterial load was determined by culture techniques (CFU/mL). Treatment protocols reduced bacterial counts after S2 in both groups (p = 0.01). S3 differed from S1 (p = 0.01), but not from S2 (p = 0.4). Endotoxin levels were reduced in both groups after S2 (P = 0.03) and were lower in S3 than in S2, with significant differences in the APP group (p = 0.03). Biomechanical preparation using a reciprocating system and 2.5% NaOCl in irradiated teeth, followed by the irrigation protocol (APP or PUA), demonstrated efficacy in reducing endodontic contaminants. Ca(OH)2 as intracanal medication should be performed in irradiated patients with infected root canals. This clinical study demonstrated that endodontic treatment in irradiated patients is efficacious at reducing bacterial load and endotoxin levels.

Molecular Identification of Candida albicans in Endodontic Retreatment Cases by SYBR Green I Real-time Polymerase Chain Reaction and its Association with Endodontic Symptoms.

Recent microbiological studies have expressed ever-increasing concerns about Candida albicans as a causal factor in the failure of endodontic treatments. Real-time quantitative polymerase chain reaction (qPCR), including the SYBR Green I system, is a technique in which a fluorescent dye is incorporated into the double-stranded DNA that is produced during DNA polymerase activity. This study aimed to determine the relative prevalence of Candida albicans in root canals of retreatment cases and its association with endodontic symptoms. In the present cross-sectional/analytical study fifty subjects were selected. Clinical features and radiographic status of the teeth were also evaluated. After access cavity preparation, the retrieved material and dentinal chips removed from the root canal were transferred into 1.5-mL microtubes, followed by storage at -20ºC until used for DNA extraction. A DNeasy Tissue Kit was used to extract DNA using the DNeasy protocol for animal tissues. Master Plus SYBR Green I (Jena Bioscience, Germany) was used in a Rotor-gene Real-time PCR System for real-time PCR. The relationship between the presence of Candida albicans and the clinical and radiographic features were analyzed using McNemar's test. There was a significant relationship between the radiographic findings in endodontically treated teeth and the presence of Candida albicans. However, there was no significant relationship between the presence of Candida albicans and any of the clinical symptoms. In spite of the limitations of this study, we concluded that Candida albicans was associated with root canal infections in endodontic retreatment cases, but there was no relationship between root canal infections and the clinical symptoms.

Bacterial diversity in primary infected root canals of a Chinese cohort: analysis of 16 S rDNA sequencing

PurposeTo characterize the bacterial community in the primarily infected root canals.MethodsA total of 13 samples were collected from the primarily infected root canals. 16 S rDNA sequencing was performed to define bacterial community. Taxonomic annotation, bacterial hierarchical structures, community richness and diversity, and inter-subject variability of the bacterial community in the root canal samples were analyzed. Gender, age, and duration of the toothache-specific bacterial community associated with the patient groups were analyzed.ResultsA total of 359 Species were annotated and identified in the whole study cohort. The Alpha diversity analysis showed that the species diversity and detection rate of the 13 samples were high, which reflected the authenticity of sequencing results. The Beta diversity analysis was used to compare the degree of difference between different root canal samples. The 13 samples were divided into two groups according to the results, group A was samples I1-I12, and group B was samples I13. The bacterial species of group A samples were analyzed with the clinical characteristics of patients, and it was found that gender, and duration specific differences in bacterial species, and there was no significant difference in species types among different ages of patients.ConclusionThere were a wide diversity and inter-subject variability in the bacterial community in the primary infected root canals. While Porphyromonas gingivalis was the most abundant species, Fusobacterium nucleatum was the most variable species in the bacterial community of the root canal. The bacterial community at different taxonomic levels varied from sample to sample, despite consistent disease diagnoses. There was gender, duration-specific differences in the bacterial species in the primary infected root canals.

Exploring the impact of oral bacteria remnants on stem cells from the Apical papilla: mineralization potential and inflammatory response.

Bacterial persistence is considered one of the main causal factors for regenerative endodontic treatment (RET) failure in immature permanent teeth. This interference is claimed to be caused by the interaction of bacteria that reside in the root canal with the stem cells that are one of the essentials for RET. The aim of the study was to investigate whether prolonged exposure of stem cells from the apical papilla (SCAP) to bacterial remnants of Fusobacterium nucleatum, Actinomyces gerensceriae, Slackia exigua, Enterococcus faecalis, Peptostreptococcaceae yurii, commonly found in infected traumatized root canals, and the probiotic bacteria Lactobacillus gasseri and Limosilactobacillus reuteri, can alter SCAP's inflammatory response and mineralization potential. To assess the effect of bacterial remnants on SCAP, we used UV-C-inactivated bacteria (as cell wall-associated virulence factors) and bacterial DNA. Histochemical staining using Osteoimage Mineralization Assay and Alizarin Red analysis was performed to study SCAP mineralization, while inflammatory and osteo/odontogenic-related responses of SCAPs were assessed with Multiplex ELISA. We showed that mineralization promotion was greater with UV C-inactivated bacteria compared to bacterial DNA. Immunofluorescence analysis detected that the early mineralization marker alkaline phosphatase (ALP) was increased by the level of E. coli lipopolysaccharide (LPS) positive control in the case of UV-C-inactivated bacteria; meanwhile, DNA treatment decreased the level of ALP compared to the positive control. SCAP's secretome assessed with Multiplex ELISA showed the upregulation of pro-inflammatory factors IL-6, IL-8, GM-CSF, IL-1b, neurotrophic factor BDNF, and angiogenic factor VEGF, induced by UV-C-killed bacteria. The results suggest that long term stimulation (for 21 days) of SCAP with UV-C-inactivated bacteria stimulate their mineralization and inflammatory response, while DNA influence has no such effect, which opens up new ideas about the nature of RET failure.

Comparative oral metagenome insight into acute and chronic root canal infections

Background: In the dynamic progression of root canal infections, the resultant change in environmental conditions directs the adaptation of the microbiome in terms of richness, evenness, and diversity. Objective: The goal of this study is to contrast the interradicular bacterial community structures of teeth in acute and chronic stages and investigate potential microorganisms associated with persistent apical periapical infections. Methods: Interradicular samples were collected from 10 teeth in the apical periodontitis group and 10 teeth in the chronic apical periodontitis group. High-throughput next-generation sequencing (NGS)–based microbial identification through the Illumina platform was used to characterize the complex intraradicular microbial communities in acute and chronic root canal infections. Results: Bacteria were the major domain, with a prevalence of >97% (acute cases: 98.11% and chronic cases: 97.6%) compared to eukaryotes and archaea. Bacterial diversity was relatively higher in acute compared to chronic conditions under 10 and 9 phyla, 79 and 64 genera, and 172 and 135 species, respectively. These endodontically infecting bacteria belonged to Firmicutes (47.21%), Bacteroidetes (20.07%), and Proteobacteria (10.72%) in acute conditions, while in the chronic stage, Firmicutes (40.85%), Proteobacteria (27.80%), and Actinobacteria (14.79%) were abundant. The phylum Candidatus Saccharibacteria was exclusively found in acute samples. Spirochaetes and Synergistetes were found predominantly in acute infections compared to chronic infections. Bacillus and Lactobacillus were found in equal and highest abundance under the phylum Firmicutes in both conditions. Conclusion: This study provides information on the differential microbial community present in the apical root canal system of teeth with acute and chronic apical periodontitis and contributes to new approaches or channels for future research on preventive measures and therapeutic protocols during disease progression and treatment. However, functional characterization and detection of antimicrobial resistance in these two clinical conditions can supplement these findings for deciding routine drug treatment for periodontal infections.

Photodynamic Suppression of Enterococcus Faecalis in Infected Root Canals with Indocyanine Green, TroloxTM and Near-Infrared Light.

Recently, our group showed that additional supplementation of Trolox™ (vitamin E analogue) can significantly enhance the antimicrobial photodynamic effect of the photosensitizer Indocyanine green (ICG). Up to now, the combined effect has not yet been investigated on Enterococcus faecalis in dental root canals. In the present in vitro study, eighty human root canals were inoculated with E. faecalis and subsequently subjected to antimicrobial Photodynamic Therapy (aPDT) using ICG (250, 500, 1000 µg/mL) and near-infrared laser light (NIR, 808 nm, 100 Jcm-2). Trolox™ at concentrations of 6 mM was additionally applied. As a positive control, irrigation with 3% NaOCl was used. After aPDT, root canals were manually enlarged and the collected dentin debris was subjected to microbial culture analysis. Bacterial invasion into the dentinal tubules was verified for a distance of 300 µm. aPDT caused significant suppression of E. faecalis up to a maximum of 2.9 log counts (ICG 250 µg/mL). Additional application of TroloxTM resulted in increased antibacterial activity for aPDT with ICG 500 µg/mL. The efficiency of aPDT was comparable to NaOCl-irrigation inside the dentinal tubules. In conclusion, ICG significantly suppressed E. faecalis. Additional application of TroloxTM showed only minor enhancement. Future studies should also address the effects of TroloxTM on other photodynamic systems.

Eugenol-Based Polymeric Materials-Antibacterial Activity and Applications.

Eugenol (4-Allyl-2-methoxy phenol) (EUG) is a plant-derived allyl chain-substituted guaiacol, widely known for its antimicrobial and anesthetic properties, as well as the ability to scavenge reactive oxygen species. It is typically used as a mixture with zinc oxide (ZOE) for the preparation of restorative tooth fillings and treatment of root canal infections. However, the high volatility of this insoluble-in-water component of natural essential oils can be an obstacle to its wider application. Moreover, molecular eugenol can be allergenic and even toxic if taken orally in high doses for long periods of time. Therefore, a growing interest in eugenol loading in polymeric materials (including the encapsulation of molecular eugenol and polymerization of EUG-derived monomers) has been noted recently. Such active macromolecular systems enhance the stability of eugenol action and potentially provide prolonged contact with pathogens without the undesired side effects of free EUG. In this review, we present an overview of methods leading to the formation of macromolecular derivatives of eugenol as well as the latest developments and further perspectives in their pharmacological and antimicrobial applications.

Multispecies oral biofilm and identification of components as treatment target

Endodontic infections involve a multispecies biofilm, making it difficult to choose an antimicrobial treatment. Characteristics such as the pathogens involved and number of microorganisms, nutrients, material surface to develop the biofilm, flow and oxygenation conditions are important for biofilm development using in vitro models. ObjectiveTo develop a standardized biofilm model, which replicates the main features (chemical, microbiological, and topographical) of an infected root canal tooth to detect components as treatment target. DesignClinical strains of Enterococcus faecalis, Candida albicans, and Actinomyces israelii were isolated, and a multispecies biofilm was developed using continuous laminar flow reactors under anaerobic conditions in human dental roots. The microbiological composition was determined by counting colony-forming units and scanning electron microscope micrographs. In addition, the chemical composition of the exopolymeric matrix was determined by vibrational Raman spectroscopy and liquid chromatography of biofilm supernatant treated with enzyme. ResultsE. faecalis turned out to be the main microorganism in mature biofilm, this was related to the presence of β-galactosidase detected by vibrational Raman spectroscopy. After the enzymatic treatment of the extracellular polymeric substance, the presence of mannose and glucose was established. ConclusionsThe present work contributes to better understanding of standard conditions to develop a multispecies biofilm in human dental roots, which could have an impact on the generation of new root canal disinfection techniques in endodontic pathologies.

Comparative Evaluation of Antimicrobial Activity of Herbal and Nonherbal Root Canal Irrigants on Enterococcus faecalis: An in vitro Study

Introduction: Enterococcus faecalis is one of the most prevalent pathogens in infected root canals. Even though the role of irrigants in controlling pathogens is well established, there is a chance for drug resistance and cytotoxicity in using chemical irrigants, Therefore newer researches have forced the man to look the herbal way. Aim of the Study: This study aims to evaluate and compare the anti-bacterial effects of nonherbal and herbal root canal irrigants on E. faecalis. Methodology: The study was conducted on 110 permanent extracted human teeth each root canal was inoculated with a culture suspension of E. faecalis and then randomly assigned into groups, (i) Herbal group (QMix™ 2 in 1, Endoseptone, Biopure MTAD) and (ii) Nonherbal group (Morinda citrifolia juice, Triphala juice, Coconut milk), and control group (Sodium hypochlorite and Distilled water). Colony forming units (CFUs) were evaluated and counted at baseline (S0), immediatedly after irrigation (S1) and after 3 days (S2). The Friedman two-way ANOVA was used to compare the obtained mean of log CFU. Results: Both the herbal and nonherbal groups had a significant reduction in the number of CFUs. The greatest anti-microbial effects were observed in nonherbal group against E. faecalis. Conclusion: While the herbal group also demonstrated significant reductions, the nonherbal group experienced the greatest overall anti-microbial effects of the various irrigants. Research into the herbal irrigants is necessary since they have the potential to be effective irrigants.