The antibacterial effect of herbal alternatives, Triphala and Turmeric, on Enterococcus faecalis - an in vitro study

Abstract

Disinfection and shaping of the canal with a combination of chemical agents and endodontic instruments play important roles in the success of endodontic therapy. Root canal irrigants aid in achieving disinfection in canal systems inaccessible to biomechanical preparation. A wide variety of synthetic irrigants are available today but some may be ineffective, and there may be safety concerns and side effects. Herbal alternatives may be advantageous. To evaluate the antibacterial properties of herbal extracts, namely turmeric and triphala as irrigants during endodontic treatment in comparison with the conventional irrigating solutions. Agar well diffusion assay and MIC methods were used to determine the efficacy of the experimental irrigant in removing E. faecalis. The difference between groups was statistically analysed. 2% chlorhexidine showed the highest zone of inhibition against E. faecalis followed by triphala. There was no significant difference between triphala and turmeric but triphala showed more inhibition effect against E. faecalis because of chelating properties. Chlorhexidine has significant antimicrobial efficacy against E. faecalis. Considerable reduction in growth of E. faecalis was seen in the herbal extract groups and considering their non-toxic nature and other physiological benefits, further studies are warranted. Herbal irrigants, E. faecalis, chlorhexidine. The goal of endodontic therapy is the removal of all vital or necrotic tissue, microorganisms, and microbial by-products from the root canal system. This may be achieved through chemo-mechanical debridement of the root canal. 1 The complex nature of the root canal complex and the presence of many inaccessible areas requires a combination of mechanical instrumentation and irrigation to decrease the amount of bacteria/microorganisms in the system. 2 E. faecalis is an enteric facultative gram positive bacterium which can grow independently in the root canal. 2 It is the most commonly isolated species from the root canals of the teeth, especially those with failed endodontic treatment. 3,4

Triphala in Endodontics-A Review

“…Triphala showed increased effectiveness in microbial decrease in the root canal, according to Divya S et al [38] Karan Bhargava et al [39] Triphala was found to be more effective against endodontic bacteria. This is owing to its formulation, which contains equal amounts of three different ayurvedic botanicals.…”

Potensi Antibakteri Triphala Sebagai Bahan Irigasi Saluran Akar Terhadap Bakteri Enterococcus faecalis

“…10 Choudhary et al pada tahun 2018 menggunakan 84 gigi permanen manusia dengan akar tunggal yang telah didekoronasi sehingga didapatkan panjang akar 11 mm. 18 Thomas et al pada tahun 2017 menggunakan 49 gigi manusia berakar tunggal yang telah didekoronasi sampai ke cemento enamel junction, kemudian dilakukan preparasi akses. 15 Srikumar et al pada tahun 2020 menggunakan 140 gigi premolar mandibula manusia dengan akar tunggal yang telah didekoronasi hingga cemento enamel junction sehingga didapatkan panjang akar yang seragam sekitar 12 mm.…”

“…Mayoritas peneliti menggunakan media Blood agar medium. 10,17,18,19 Namun, beberapa peneliti lain ada yang menggunakan metode…”

“…17 Hasil menunjukan bahwa CHX 2% memiliki zona inhibitor yang paling besar terhadap bakteri E. faecalis dibandingkan triphala dan turmenic dengan rata-rata zona inhibitor CHX 2% (32.77 mm), triphala (24.08 mm) dan turmenic (12.95 mm), maka dari itu hasil penelitian ini adalah triphala menunjukan aktivitas yang kurang lebih setara dengan CHX terhadap bakteri E. faecalis. 18…”

“…Bubuk kemudian dicampur dengan air suling dan didiamkan selama tujuh hari dalam glass chamber sambil sesekali diaduk. 18 Selain menggunakan buah triphala segar yang sudah matang peneliti juga ada yang menggunakan bubuk triphala yang sudah jadi. Terdapat beberapa penelitian yang menggunakan bubuk triphala.…”