The Effectiveness of Salavadora Persica (Siwak) Petroleum Ether Extract As An Intracanal Medicament Used in Endodontic Therapy: An In Vitro Study

Abstract

Background: Salvadora persica L. (Siwak) of the family Salvadoraceae has been used for many centuries as oral hygiene tools, particularly in Saudi Arabia. The current study aimed at developing a new root canal medicament based on the extract of Salvadora persica (SP). The antibacterial activity against Enterococcus faecalis was determined compared with the gold standard intracanal medicament, Ca (OH)2. Materials and Methods: Freeze-dried Siwak sticks were extracted with Petroleum ether to yield an oily extract (SPE). GC-MS analysis was carried out to identify SPE components, whereas 32 compounds were identified (89.09%), with main components of benzyl isothiocyanate (BITC) (33.32%) and steroids (34%). Firstly, the consistency of the experimental medicament was accomplished according to ANSI/ADA Specification no 57. SPE assessment as intracanal medicament was conducted through an in vitro assay on 45 single-rooted mandibular premolars inoculated of 5 μL of E. faecalis. Colony-forming units (CFU) were counted before the application of experimental intracanal medicament (CFU-1) and then after seven days of its application (CFU-2). Group I: Siwak extract-based intracanal medicament, Group II positive control group received Ca(OH)2 paste, and Group III: negative control group received no medication. Results: CFU before and after using Siwak based medicament recorded statistically significant reduction (P=0.006) as well as those of Group II when Ca(OH)2 was applied (P=0.01). On comparing both medicaments with Group III, there were significant differences; (P=0.00) and (P=0.007), respectively. Siwak oil extract-based medication proved complete eradication of E. faecalis.Conclusion: SPE has a good potential as an intracanal medicament, besides the cleaning and shaping during endodontic therapy. This finding could be referred to as the high content of BITC bactericidal against pulpal and periodontal pathogens, in synergism with other antimicrobial components, representing 70.71% of SP oil extract.

Clinical Effects, Uses and Applications of Miswak (Salvadora Persica) on Oral Health Over the Last Three Decades: A Scoping Review of Literature

“…Extracts of S. persica as intracanal irrigant have demonstrated considerable antimicrobial activity on the oral pathogens, both in vitro and in vivo Ayoub N, et al, (2021) assessed the effectiveness of S. persica petroleum ether extract (SPE) as an intracanal bactericidal medicament for endodontic treatment against Enterococcus faecalis (E. faecalis). According to the study, SPE may effectively remove E. faecalis from the root canal, making it a viable substitute for calcium hydroxide in endodontic therapy (42). In examining three different plant extracts, S. persica, Commiphora molmol (C. molmol), and Azadirachta indica (A. indica), combined with commercially available antimicrobial agents, penicillin, tetracycline, ofloxacin, and fluconazole, on endodontic pathogens including E. faecalis, Streptococcus mitis (S. mitis), Actinomyces naeslundii (A. naeslundii), and C. albicans, The findings demonstrate the efficiency of C. molmol, A. indica, and S. persica against all endodontic experimental pathogenic bacteria (43).…”