Comparative evaluation of antimicrobial efficacy of different combinations of calcium hydroxide against Enterococcus faecalis

Abstract

Background The study aims to compare the synergistic antibacterial efficacy of different combinations of calcium hydroxide as an intracanal medicament against E. faecalis. Material and methods The current study included four hundred extracted human permanent mandibular premolar teeth. After complete chemo-mechanical preparation, the middle third of the root was sectioned using a rotary diamond disc and a total of 400 samples were obtained. The specimens were inoculated with E. faecalis for 21 days. After that, specimens were divided into five groups (n = 80) based on materials used for the disinfection of samples: Group I, calcium hydroxide alone; Group II, calcium hydroxide + 2% chlorhexidine gel; Group III, calcium hydroxide + 2% chitosan gel; Group IV, calcium hydroxide + 0.02% silver nanoparticle gel; Group V, calcium hydroxide + Bioactive glass S53P4. Dentin shavings from the apical third were obtained from the inner third of dentin were obtained using gates glidden no.1 to the apical depth, followed by no.2, 3, 4 and 5 analyzed for E. faecalis using the culture method. One-way analysis of variance (ANOVA) was used for data analysis, followed by post-hoc Tukey's test for multiple comparisons of means to check the difference in bacterial inhibition between the groups. Results ANOVA results revealed a significant reduction of bacterial counts in all the groups compared (p < 0.001). Intergroup comparison showed maximum bacterial reduction (p < 0.001) with calcium hydroxide + bioactive glass S53P4 compared with other groups. Conclusion Synergistic effect of calcium hydroxide showed better bacterial reduction compared to calcium hydroxide alone. Among the combinations evaluated, calcium hydroxide with bioactive glass, found to be most effective compared to other groups.

Comparative evaluation of the antibacterial efficacy of two experimental calcium silicate-based intracanal medicaments: An in-vitro study

“…Relying solely on chemical disinfection may be insufficient, underscoring the critical importance of selecting an appropriate intracanal medicament to comprehensively eradicate microorganisms in such cases. [ 3 ]…”

“…[ 2 ] Studies have shown that a significant proportion, ranging from 40% to 60%, of cultivable bacteria remains present in the root canals, even after undergoing irrigation with sodium hypochlorite. [ 3 ]…”

“…It has demonstrated heightened tenacity to chemo-mechanical disinfection and additional therapies administered during root canal treatment. [ 3 ] In conjunction with root canal disinfection, intracanal medicaments are crucial in enhancing the disinfection protocol. [ 5 ] Achieving optimal disinfection of the root canal complex is essential to prevent tissue destruction caused by the release of bacteria or their by-products into the periapical region.…”

“…[ 5 ] Achieving optimal disinfection of the root canal complex is essential to prevent tissue destruction caused by the release of bacteria or their by-products into the periapical region. [ 3 ] In endodontics, a range of intracanal medicaments, such as antibiotics, calcium hydroxide (CH), iodoform-containing pastes, steroids, and chlorhexidine (CHX), are employed for this purpose. [ 2 ] CH has conventionally been favored as an intracanal therapeutic agent for its antibacterial properties and ability to stimulate mineralized tissue deposition, attributed to hydroxyl and calcium ions.…”

Nanoarchitectonics-Based Materials as a Promising Strategy in the Treatment of Endodontic Infections

“…This finding suggests that incorporating CSNPs into a Ca(OH) 2 -based paste has the potential to increase its antibacterial activity and inhibit bacterial recolonization on root canal dentin; meanwhile, the Ca(OH) 2 /EPE paste was not able to maintain its antibacterial efficacy over time [ 175 ]. Teja et al explored the additive effects of various nanoparticles combined with Ca(OH) 2 on E. faecalis biofilms, concluding that AgNP incorporation into Ca(OH) 2 showcased superior efficacy [ 176 ]. Accumulating studies have also demonstrated that AgNPs mixed with Ca(OH) 2 present more pronounced antibiofilm effects against E. faecalis , C. albicans , F. nucleatum , and even multispecies biofilms compared to Ca(OH) 2 [ 177 , 178 , 179 , 180 ].…”