Comparative Evaluation of the Antimicrobial Efficacy of Chemical and Phytomedicinal Agents When Used As Intracanal Irrigants: An In Vitro Study.

AIM: This study aimed to compare and evaluate the antimicrobial efficacy of chemical and phytomedicinal agents when used as intracanal irrigants against Candida albican (C. albican) and Enterococcus faecalis (E. faecalis). Materials and methods: This study was conducted at Kothiwal Dental College and Research Centre, Moradabad, India. One-hundred human tooth roots with a standardized length of 12±0.5 mm were divided into two groups (A and B, 50 each) inoculated with C. albican and E. faecalis,  respectively. The groups were further divided according to the irrigants: A1 (11% ethanolic extract of propolis), A2 (2% chlorhexidine gluconate (CHX)), A3 (0.5% metronidazole), A4 (10% babool), and A5 (sterile saline (control) for the  C. albican group and E. faecalis group (B1 to B5, respectively). The samples of different specimens were taken at subsequent intervals. The first collection was taken two days and 21 days after inoculation in group A and group B, respectively. The second collection was taken post irrigation, and the third  collection seven days after different irrigants were used in both the groups. Microbiological samples were grown in a culture medium and incubated at 37°C for 24 hours for C. albican and 48 hours for E. faecalis (Sabouraud dextrose agar for C. albican and brain heart fusion for E. faecalis ). The results were submitted for analysis of variance (ANOVA) and post-hoc test for statistical analysis.

RESULTS: In group A, 2% chlorhexidine gluconate showed a highly significant percentage reduction of colony-forming unit (CFU) count (p≤0.001) with respect to the time interval against C. albican, followed by metronidazole, babool, propolis, and saline, whereas in group B, propolis showed a significant percentage reduction of CFU count (p<0.001) with respect to time interval against E. faecalis,  followed by 2% CHX, metronidazole, babool, and saline.

CONCLUSION: Two percent chlorhexidine gluconate showed the highest antimicrobial efficacy against C. albican, whereas propolis showed the highest antimicrobial efficacy against E. faecalis . Chemical irrigants proved effective over herbal irrigants against C. albican, whereas herbal irrigants showed better antimicrobial efficacy over chemical irrigants against E. faecalis .