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Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 5-7

Evaluation and comparison of the antimicrobial activity of herbal extracts with the standard irrigant against Enterococcus faecalis

1 Assistant Professor, Department of Conservative Dentistry and Endodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
2 Assistant Professor, Department of Conservative Dentistry and Endodontics, Dental College, JNIMS, Imphal, Manipur, India
3 Assistant Professor, Department of Periodontology, Dental College, JNIMS, Imphal, Manipur, India
4 Professor, Department of Conservative Dentistry and Endodontics, Dental College, JNIMS, Imphal, Manipur, India

Date of Submission27-Feb-2022
Date of Acceptance07-Mar-2022
Date of Web Publication24-Mar-2022

Correspondence Address:
Dr. Jenny Atom
Department of Conservative Dentistry and Endodontics, Dental College, Regional Institute of Medical Sciences, Lamphelpat, Imphal West - 795 004, Manipur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpcdr.ijpcdr_5_22

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Background: Numerous actions to diminish the number of microorganisms in the root canal system comprise the usage of a variety of functional techniques, irrigation methods, and intracanal medications. Irrigation goes hand in hand with resources to help remove pulp tissue and/or microorganisms.
Purpose: The intent of this trial was to assess as well as compare the antimicrobial activity of herbal irrigant with normal irrigant (2.5% sodium hypochlorite [NaOCl]) against Enterococcus faecalis to test its effectiveness as root irrigation water.
Materials and Methods: The culture was elevated overnight at 37°C in brain heart infusion (BHI) broth followed by testing microbial growth for changes in turbidity for 24 h. BHI broth comprising E. faecalis is vaccinated on a BHI agar plate using a grass planting method utilizing a sterile glass dispenser. Five test herbal discs (Curcuma longa [CT]-turmeric, Azadirachta indica [AI], MI, Propolis [P], and Triphala [T]); in addition to two control discs (ethanol as well as NaOCl) positioned on a custom plate.
Results: The average blocking area with a drop-down program for each drug was observed to be: NaOCl (24.0 ± 1.74) >P (14.6 ± 1.84) > AI (09.5 ± 1.72) > T (06.4 ± 0.83) > CT (04.3 ± 04.1± ±0.83).) > Morinda citrifolia (03.2 ± 0.30) > ethanol (00.1 ± 0.01).
Conclusions: P and AI have shown assuring outcomes in the completion of E. faecalis. Nevertheless, their work has been observed to be under NaOCl.

Keywords: Antimicrobial activity, Enterococcus faecalis, herbal extracts

How to cite this article:
Atom J, Devi NR, Kangabam N, Thoudam BD, Lairenlakpam R, Singh N S. Evaluation and comparison of the antimicrobial activity of herbal extracts with the standard irrigant against Enterococcus faecalis. Int J Prev Clin Dent Res 2022;9:5-7

How to cite this URL:
Atom J, Devi NR, Kangabam N, Thoudam BD, Lairenlakpam R, Singh N S. Evaluation and comparison of the antimicrobial activity of herbal extracts with the standard irrigant against Enterococcus faecalis. Int J Prev Clin Dent Res [serial online] 2022 [cited 2023 Jun 10];9:5-7. Available from: https://www.ijpcdr.org/text.asp?2022/9/1/5/340844

  Introduction Top

Microorganisms have long been suspected of enacting a character in the genesis and progression of endodontic disorders. To remove microorganisms from the pulp region, an integrated chemo-mechanical approach is used. Machine tools alone are unable to cover all regions of the trench wall, according to microcomputed tomography scans of the trench walls. To achieve disinfection and healing, irrigation solutions along with intracanal medicament must be used in combination with machine instrumentation.[1],[2],[3] In light of the microbiological origins of pulpal together with periapical illnesses, a suitable irrigation solution should contain antibacterial properties. The most extensively used irrigation solution, according to the current research, is sodium hypochlorite (NaOCl). It's antibacterial as well as tissue dissolving. If it manifests beyond the boundaries of pulp space, it may cause significant inflammation of the soft tissues, as well as extreme discomfort and/or inflammation. Furthermore, it is unable to entirely removing the smear layer from the steel canal walls. We are currently considering alternate therapy because of the possible side effects, safety issues, and ineffectiveness of standardized endodontic irrigation. For thousands of years, plant extracts have been discovered to have therapeutic effects. According to the WHO estimate, traditional medicine is used by 80% of the world's population.[4],[5],[6] Herbs as antimicrobials have numerous advantages: They have fewer adverse effects, are less costly, have a higher tolerance, and are naturally renewed. Antimicrobial activities have been observed in phytochemical components, for instance, Curcuma longa (CT)-turmeric, Azadirachta indica (AI)-neem, Morinda citrifolia (MC)-noni, Propolis (P), in addition to Triphala (T), which increase their efficacy when employed as endodontic irrigants.[7] Nevertheless, there is little documentation to demonstrate the antibacterial action of these endodontic extracts. The goal of this research was to compare the antibacterial activity of these extracts to that of regular irrigation (2.5% NaOCl) against Enterococcus faecalis to see whether they could be used as root irrigation water.

  Materials and Methods Top

CT, AI, T, and MC quotes obtained from the powder were utilized in the trial. 20 g of each powder is integrated with 25 ml of ethanol subsequently stored in airtight containers for 48 h. 20 g of P, obtained in the form of raw cake was integrated with 25 ml of ethanol and stored for 48 h in an airtight container. 48 h later, the extracts were filtered utilizing Whatman filters and filters were accumulated in Petri containers. In each Petri container, 20 mg of extract was taken, after that integrated with 2 ml of ethanol, which was then stored in test tubes. From each test tube, a 10 μL solution was loaded onto the empty discs until the filtrate was completely absorbed by the discs. The discs are then dried. NaOCl as well as ethanol discs are also equipped in a similar way, acting as a control. Culture grown overnight at 37°C in brain heart infusion (BHI) broth and microbial growth was tested for changes in turbidity for 24 h. BHI broth containing E. faecalis is vaccinated on a BHI agar plate using a grass planting method utilizing a sterile glass dispenser. Five test herbal discs (CT, AI, MI, P, and T); and two control discs (ethanol along with NaOCl) positioned on a custom plate. The plate was placed aerobically 24 h at 37°C. After 24 h, the microbial barrier area is measured in millimeters.

  Results Top

Results were documented on a per-site basis. The central blocking area with a drop-down program for each drug was observed: NaOCl (24.0 ± 1.74) > P (14.6 ± 1.84) > AI (09.5 ± 1.72) > T (06.4 ± 0.83) > CT (04.32) >04.32 ± 04.32 MC (03.2 ± 0.30) > ethanol (00.1 ± 0.01) as shown in [Table 1]. The statistical analysis was performed utilizing a single variance analysis, which exhibited significant differences in the NaOCl and P inhibition (P < 0.001) with no significant differences scrutinized between T, CT, and MC.
Table 1: Mean zone of inhibition for each drug

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  Discussion Top

Herbal products have been utilized in traditional medicine for thousands of years, in both oriental and western medical traditions. Phytomedicine is used in the dental clinic as an anti-inflammatory, antibiotic, analgesic, sedative, and together with endodontic irrigant. Plants have advantageous therapeutic properties due to the presence of secondary metabolites that also have an antimicrobial effect. Plant-derived antimicrobials have a lot of therapeutic potentials.[8],[9] They have been studied for their antimicrobial properties as well as how they can help with the side effects and side effects allied with synthetic antimicrobials. There has been a surge in research into the usage of natural plant extract as an antibacterial agent against endogenous microorganisms in recent years. Against a variety of endodontic pathogens, all of these herbal extracts have shown antimicrobial efficacy. Since it has flexible nature and high diffusibility in the agar plate, sodium hypochlorite showed a greater degree of inhibition in this trial.[10] Nevertheless, the size of the inhibitory sites does not imply that the material has complete antimicrobial activity. Melting and distribution in agar, load loading on an agar plate, vegetative extraction method, and the dynamic nature of the drug are all important factors.[11] P exhibited the highest level of inhibition among all herbal extracts tested in this trial. In past investigations, it has demonstrated to have strong antibacterial action.[12],[13] Flavonoids, phenolics, and aromatics are pharmacologically significant substances observed in P. Flavonoids are thought to have a vital biological function in P. Antimicrobial, anti-inflammatory, antioxidant, anesthetic effect, and cytotoxicity are only a few of P' biological properties.[14] P ethanol extract has good antibacterial characteristics for endodontic usage. In pulpotomies or pulp capping, it stimulates bone repair and induces the creation of solid tissues. P has shown potential as an irrigation and intracanal medication due to its antibacterial and anti-inflammatory properties. When utilized as an intracanal irrigation, a comparison of the microbiological effectiveness of P, NaOCl, and saline revealed that P exhibits antibacterial activity when compared to NaOCl.[9] AI's antibacterial action is ascribed to a number of active compounds, including nimbidin, nimbin, nimbolide, gedunin, azadirachtin, mahmoodin, margolone, and cyclic trisulphide. It has been shown to be effectual in the fight against E. faecalis. Its antioxidant and antibacterial qualities make it an effective treatment for replacing NaOCl in root canals.[15] It has the second greatest degree of inhibition, which might be attributed to its antibacterial active ingredients. The dried fruits of three medicinal plants, Terminalia bellirica, Terminalia chebula, as well as Emblica officinalis, are combined in T, an Indian Ayurvedic herb. It contains citric acid, which acts as a chelating agent and may be used in conjunction with NaOCl for canal root irrigation to assist in eliminating the smear layer.[11],[16] Curcumin is a yellow bioactive pigment that has a yellow color. CT has a variety of biological activities, including anti-inflammatory, antioxidant, antifungal, and antibacterial properties. The presence of L-asperuloside and azirine in MC gives it antibacterial characteristics.[17] Trials have looked into MC juice in combination with ethylenediaminetetraacetic acid as a viable NaOCl substitute.[18] T, turmeric, and Morinda, on the other hand, exhibited just minor antibacterial activity in this investigation.[13] which may be attributable to (1) a modest load capacity, i.e., 10 L was employed to make discs, as compared to previous experiments. (2) Unlike prior research that employed aqueous extracts,[9] this trial used alcohol withdrawal as a control.

  Conclusions Top

Within the limitations of the present study, P and AI showed promising results in the elimination of E. faecalis. However, their activity was found to be inferior to NaOCl. Further, in vitro and clinical studies are required to evaluate their efficacy, biocompatibility, and safety factors before they can conclusively be recommended as root canal irrigants.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Gajan EB, Aghazadeh M, Abashov R, Salem Milani A, Moosavi Z. Microbial flora of root canals of pulpally-infected teeth: Enterococcus faecalis a prevalent species. J Dent Res Dent Clin Dent Prospects 2009;3:24-7.  Back to cited text no. 1
Singamaneni V, Guna Shekhar M, Himagiri S. In vitro effectiveness of different endodontic irrigants on the reduction of Enterococcus faecalis in root canals. J Clin Exp Dent 2010;2:169-72.  Back to cited text no. 2
Nayak A, Ranganathan N, Sowmya GB, Kishore B, Kudalkar M. Evaluation of antibacterial and anticandidial efficacy of aqueous and alcoholic effect of neem (Azadirachta indica): An in vitro study. Int J Res Ayurveda Pharm 2011;2:230-5.  Back to cited text no. 3
Bohora A, Hegde V, Kokate S. Comparison of the antibacterial efficiency of neem leaf extract and 2% sodium hypochlorite against E. faecalis, C. albicans and integrated culture – An in vitro study. Endodontology 2010;22:8-12.  Back to cited text no. 4
Ghonmode WN, Balsaraf OD, Tambe VH, Saujanya KP, Patil AK, Kakde DD. Comparison of the antibacterial efficiency of neem leaf extracts, grape seed extracts and 3% sodium hypochlorite against E. feacalis – An in vitro study. J Int Oral Health 2013;5:61-6.  Back to cited text no. 5
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Rosaline H, Kandaswamy D, Gogulnath D, Rubin M. Influence of various herbal irrigants as a final rinse on the adherence of Enterococcus faecalis by fluorescence confocal laser scanning microscope. J Conserv Dent 2013;16:352-5.  Back to cited text no. 7
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