Assessment of Antimicrobial Activity of Different Intracanal Medicaments against Enterococcus faecalis and Candida albicans: An In Vitro Study
Asha Reddy, Vineesh Krishnan, CV Renjith Raj, Harikaran Jayakkodi, Sona Joseph
Keywords : Candida albicans, Enterococcus faecalis, Intracanal medicaments, Zone of inhibition
Citation Information :
Reddy A, Krishnan V, Raj CR, Jayakkodi H, Joseph S. Assessment of Antimicrobial Activity of Different Intracanal Medicaments against Enterococcus faecalis and Candida albicans: An In Vitro Study. J Contemp Dent Pract 2019; 20 (2):179-183.
Aim: The aim of the present study was to compare the antimicrobial efficacy of various intracanal medicaments against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans).
Materials and methods: Sixty single rooted, non-carious, permanent mandibular premolars with no developmental defects that were previously extracted for the orthodontic purpose were included in this study. E. faecalis and C. albicans strains were cultured on brain heart infusion (BHI) and sabouraud dextrose (SD) agar plates respectively. Sixty specimens were divided into two main groups and three subgroups with 10 teeth receiving a medicament; group I: E. faecalis (Subgroup Ia: BioPure MTAD, Subgroup Ib: propolis, Subgroup Ic: Triple antibiotic paste), group II: C. albicans (Subgroup IIa: BioPure MTAD, Subgroup IIb: propolis, Subgroup IIc: Triple antibiotic paste). The antimicrobial activity of the intracanal medicaments against E. faecalis and C. albicans were assessed at the end of 2nd and 7th day. The mean zones of inhibition were analyzed with a one-way ANOVA test.
Results: After 2 days, the mean zone of inhibition of E. faecalis and C. albicans was maximum for triple antibiotic paste (24.74 ± 0.622 mm, 28.22 ± 0.489 mm), followed by BioPure MTAD (19.58 ± 1.734 mm, 24.75 ± 0.954 mm) and propolis (13.10 ± 0.278 mm, 17.96 ± 0.163 mm). Similarly, the mean zone of inhibition of E. faecalis and C. albicans was maximum for triple antibiotic paste (26.86 ± 0.112 mm, 32.10 ± 0.908 mm), followed by BioPure MTAD (20.13 ± 1.842 mm, 27.22 ± 1.977) and propolis (14.11 ± 0.101 mm, 19.90 ± 0.742 mm) after 7 days. Statistically significant differences (p <0.0001) were found between the groups.
Conclusion: Present study concluded that the antimicrobial effectiveness of triple antibiotic paste was significantly more than BioPure MTAD and propolis against E. faecalis and C. albicans at the end of 2nd and 7th day.
Clinical significance: An endodontic treatment is considered successful only when the root canals are completely eradicated of microorganisms. As the morphology of the root canals is complex, mechanical instrumentation alone cannot completely debride them. Thus, the role of intracanal medicaments in complementing the mechanical instrumentation becomes important.
Chua et al. Antifungal effectiveness of various intracanal medicaments against Candida albicans: an ex-vivo study. BMC Oral Health 2014;14:53.
Turk BT, Sen BH, Ozturk T. In vitro antimicrobial activity of calcium hydroxide mixed with different vehicles against Enterococcus faecalis and Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:297-301.
Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999;32:361-369.
Shaik J, Garlapati R, Nagesh B, Sujana V, Jayaprakash T, Naidu S. Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and calcium hydroxide using chitosan as carrier against Candida albicans and Enterococcus faecalis: An in vitro study. J Conserv Dent 2014;17:335-339.
Hagihara Y, Kaminishi H, Cho T, Tanaka M, Kaita H. Degradation of human dentin collagen by an enzyme produced by the yeast Candida albicans. Arch Oral Biol 1988;33:617-619.
Blome B, Braun A, Sobarzo V, Jepsen S. Molecular identification and quantification of bacteria from endodontic infections using real-time polymerase chain reaction. Oral Microbiol Immunol 2008 Oct;23(5):384-390.
Manzur A, González AM, Pozos A, Silva-Herzog D, Friedman S. Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial. J Endod 2007 Feb;33(2): 114-118.
Krithikadatta J, Indira R, Dorothykalyani AL. Disinfection of dentinal tubules with 2% chlorhexidine, 2% metronidazole, bioactive glass when compared with calcium hydroxide as intracanal medicaments. J Endod 2007;33:1473-1476.
Krittika Ravi. Antimicrobial Efficacy of Various Intracanal Medicaments against Enterococcus faecalis. J. Pharm. Sci. & Res 2017;9(10):1861-1863.
Waltimo TMT, Siren EK, Torkko HLK, Olsen I, Happasalo MPP. Fungi in therapy-resistant apical periodontitis. Int Endod J 1997;30:96-101.
Somanath G, Samant PS, Gautam V, Singh Birring OJ. To comparatively evaluate the antimicrobial efficacy of chlorhexidine, nisin and linezolid as an intracanal medicament on Enterococcus faecalis: An in vitro study. Indian J Dent Res 2015;26: 613-618.
Siqueira JF Jr., Rocas IN, Paiva SS, Guimaraes. Pinto T, Magalhaes KM, Lima KC. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:122.130.
Bhandari S, Ashwini T S, Patil R C. An in Vitro Evaluation of Antimicrobial Efficacy of 2% Chlorhexidine Gel, Propolis and Calcium Hydroxide Against Enterococcus faecalis in Human Root Dentin. Journal of Clinical and Diagnostic Research. 2014;8(11):ZC60-ZC63.
Madhubala MM, Srinivasan N, Ahamed S. Comparative evaluation of propolis and triantibiotic mixture as an intracanal medicament against Enterococcus faecalis. J Endod. 2011;37:376-381.
Mehta S, Verma P, Tikku AP, Chandra A, Bains R, Banerjee G. Comparative evaluation of antimicrobial efficacy of triple antibiotic paste, calcium hydroxide, and a proton pump inhibitor against resistant root canal pathogens. Eur J Dent 2017;11:53-57.
Hoshino E, Kurihara. Ando N, Sato I, Uematsu H, Sato M, Kota K, et al. In.vitro antibacterial susceptibility of bacteria taken from infected rootdentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 1996;29:125.130.
Sato I, Ando. Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J 1996;29:118-124.
Davis M J, Maki J, and Bahcall J K. An In Vitro Comparison of the Antimicrobial Effects of Various Endodontic Medicaments on Enterococcus faecalis. J Endod 2007;33(5):567-569.
Torabinejad M, Shabahang S. Effect of MTAD on Enterococcus faecalis-contaminated root canals of extracted human teeth. J Endod 2003;29:576-579.
Gomes BP, Pinheiro ET, Gade-Neto CR, Sousa EL, Ferraz CC, Zaia AA, Teixeira FB, Souza-Filho FJ. Microbiological examination of infected dental root canals. Oral Microbiol Immunol. 2004 Apr;19(2):71-76.