A Comparative Evaluation of Antimicrobial Efficacy of Novel Surfactant-Based Endodontic Irrigant Regimen's on Enterococcus faecalis

Abstract

Introduction: Irrigants play an important role in the eradication of microorganisms in the complex root canal system. Sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) have certain limitations despite their routine clinical use. Surfactant irrigants with antimicrobial properties can be a milestone in endodontics to overcome the drawbacks of conventional irrigants. The aim of this study was to evaluate the antimicrobial efficacy of surfactants in comparison with routine endodontic irrigants on Enterococcus faecalis. Materials and Methods: Primary irrigants NaOCl, CHX, IKI were prepared at concentrations of 5%, 2.5%, 2%, and 1%; while mixture of tetracycline acid and detergent (MTAD) (100%) served as control group. Surfactants such as cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared at concentrations of 0.5%, 1%, and 2%. The direct contact assay was used to evaluate the antimicrobial efficacy after 5 min. Statistical analysis was performed using one-way ANOVA and Mann–Whitney U-test. Results: In the primary group, only 5% CHX was significant over MTAD (P < 0.05). In the surfactant group, all concentrations of CTR and SDS (except 0.5%) were significant (P < 0.05) in killing E. faecalis over MTAD. Two percent CHX in combination with 0.5% CTR and 1% SDS had an effective kill percentage over 2% CHX and MTAD alone. Conclusion: Surfactant irrigant regimens can be used as adjuncts with CHX to overcome its clinical limitations and potentiate its substantivity, thereby enhancing clinical success in endodontics.

Effect of Addition of Cetylpyridinium Chloride Cationic Surfactant on the Antimicrobial Activity of Chlorhexidine Endodontic Irrigant

“…This method measures the effect of direct and close contact between a fixed volume of the antimicrobial agent and a fixed volume of a microbial suspension for a particular time [ 2 ]. The antimicrobial activities of the used irrigants in this study were assessed after 5 min because MTAD, according to the manufacturer's instructions, requires a contact time of 5 min [ 1 ].…”

“…Isolated colonies of these microorganisms were suspended in a sterile saline (0.9% NaCl) solution after being grown aerobically in BHI broth for 24 hr. The cell suspension was adjusted spectrophotometrically at 600 nm to match the turbidity of 0.5 McFarland scale (1.5 × 10 8 colony-forming units (CFU)/mL) [ 1 , 21 ].…”

“…This in vitro study was carried out at the educational laboratories of the College of Health and Medical Technologies, Baghdad. One milliliter of each microbial suspension was obtained and added to a tube containing 1 mL of the irrigant solutions (2% CHX, 0.2% CPC + 2% CHX, and 100% MTAD) for the experimental time of 5 min [ 1 , 21 ]. After the indicated exposure time, 100 µ L samples were obtained, added to 900 µ L of sterile saline contained in Eppendorf tubes, and serially diluted.…”

“…Finally, droplets of 10 µ L from the diluted and undiluted tubes were cultured on Mueller–Hinton agar plates and incubated at 37°C for 24 hr for colony counting under magnification using a colony-counting device (Suntex, Taiwan). The procedure was performed ten times for each subgroup [ 1 , 21 , 22 ].…”

“…The main goal of the endodontic therapy is to provide a biologically suitable condition inside the root canal system that permits healing and ongoing maintenance of the periradicular tissue's health [ 1 ]. Therefore, complete debridement and effective elimination of microbiological irritants, including microorganisms and their byproducts, followed by obturation of the entire root canal system, are necessary for successful endodontic therapy [ 2 ].…”