The aim of this article was (i) to define the chemical constituents of Cinnamomum zeylanicum essential oil (CEO), (ii) to compare the antimicrobial activity of CEO with triple antibiotic paste (TAP) and calcium hydroxide [Ca(OH)2] on planktonic and biofilm Enterococcus faecalis; and (iii) to compare the cytotoxicity of these medicaments on L929 fibroblasts.
Materials and methods
Gas chromatography-mass spectrometry was used to define the constituents of CEO. Zone of inhibition, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill tests were performed. Further, 108 human teeth were infected with E. faecalis and treated with the medicaments for 1, 7, and 14 days. Cytotoxicity was assessed by exposing L929 fibroblasts to the medicaments.
Cinnamaldehyde was the main component of CEO. Triple antibiotic paste had the greatest zone of inhibition and the smallest MIC and MBC. Triple antibiotic paste and CEO eradicated planktonic E. faecalis after 4 and 24 hours, while Ca(OH)2 failed to achieve 100% killing after 24 hours. Cinnamomum zeylanicum essential oil and TAP eradicated biofilm E. faecalis after 7 and 14 days, but Ca(OH)2 could not eliminate E. faecalis after 14 days. Cinnamomum zeylanicum essential oil was the most biocompatible medicament.
Cinnamomum zeylanicum essential oil is an efficient antibacterial agent against planktonic and biofilm E. faecalis and it was cytocompatible to L929 fibroblasts. Therefore, CEO has the potential to be used as an antimicrobial agent in root canal treatment.
How to cite this article
Abbaszadegan A, Dadolahi S, Gholami A, Moein MR, Hamedani S, Ghasemi Y, Abbott PV. Antimicrobial and Cytotoxic Activity of Cinnamomum zeylanicum, Calcium Hydroxide, and Triple Antibiotic Paste as Root Canal Dressing Materials. J Contemp Dent Pract 2016;17(2):105-113.
Medicinal plants and antimicrobial activity. J Ethnopharmacol 2005 Aug22;100(1–2):80-84.
In vitro evaluation of the antibacterial activity of Arctium lappa as a phytotherapeutic agent used in intracanal dressings. Phytother Res 2006 Mar;20(3):184-186.
Evaluation of Morinda citrifolia as an endodontic irrigant. J Endod 2008 Jan;34(1):66-70.
Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod 2010 Jan;36(1):83-86.
A laboratory evaluation of the antibacterial and cytotoxic effect of Liquorice when used as root canal medicament. Int Endod J 2011 Jan;44(1):51-58.
Comparative evaluation of antimicrobial efficacy of Syzygium aromaticum, Ocimum sanctum and Cinnamomum zeylanicum plant extracts against Enterococcus faecalis: a preliminary study. Int Endod J 2013 Aug;46(8):775-783.
Time-dependent antibacterial effects of Aloe vera and Zataria multiflora plant essential oils compared to calcium hydroxide in teeth infected with Enterococcus faecalis. J Investig Clin Dent 2016 Feb;7(1):93-101.
Chemical constituent and antimicrobial effect of essential oil from Myrtus communis leaves on microorganisms involved in persistent endodontic infection compared to two common endodontic irrigants: an in vitro study. J Conserv Dent 2014 Sep;17(5):449-453.
Antimicrobial and cytotoxic activity of Ferula gummosa plant essential oil compared to NaOCl and CHX: a preliminary in vitro study. Restor Dent Endod 2015 Feb;40(1):50-57.
Antimicrobial and cytotoxic activity of Cuminum cyminum as an intracanal medicament compared to chlorhexidine gel. Iran Endod J 2016 Winter;11(1):44-50.
Cortex Cinnamomi. WHO monographs on selected medicinal plants, Geneva. Vol 11999. p. 95-104.
Chemistry, biogenesis, and biological activities of Cinnamomum zeylanicum. Crit Rev Food Sci Nutr 2011 Jul;51(6):547-562.
Role of cinnamon as beneficial antidiabetic food adjunct: a review. Adv App Sci Res 2011;2(4):440-450.
Volatile constituents of leaf, stem and root oils of cinnamon (Cinnamomum zeylanicum). J Sci Food Agric 1974 Oct;25(10):1211-1220.
Plant products as antimicrobial agents. Clin Microbiol Rev 1999 Oct;12(4):564-582.
Controlled trial of the effect of cinnamon extract on Helicobacter pylori. Helicobacter 2000 Jun;5(2):94-97.
Solid- and vapor-phase antimicrobial activities of six essential oils: susceptibility of selected foodborne bacterial and fungal strains. J Agric Food Chem 2005 Aug 24;53(17):6939-6946.
Antimicrobial activity of five herbal extracts against multi drug resistant (MDR) strains of bacteria and fungus of clinical origin. Molecules 2009 Feb 4;14(2):586-597.
Chemistry of polyethylene glycol conjugates with biologically active molecules. Adv Drug Deliv Rev 1995 Sep;16(2–3):157-182.
Performance standards for antimicrobial disk susceptibility tests; approved standard. 11th ed. CLSI document M02-A11. Wayne, PA: National Committee for Clinical Laboratory Standards; 2008.
Efficacy of a combined nanoparticulate/calcium hydroxide root canal medication on elimination of Enterococcus faecalis. Aust Endod J 2014 Aug;40(2):61-65.
Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans. Int J Oral Sci 2013 Mar;5(1):32-36.
The chemical composition of some Lauraceae essential oils and their antifungal activities. Phytother Res 2004 Sep;18(9):713-717.