Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes
Triveni Mohan Nalawade, Kishore G Bhat
Agar well diffusion, Medicaments, Minimum inhibitory concentration, Vehicles
Citation Information :
Nalawade TM, Bhat KG. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016; 9 (4):335-341.
Aims: The aim of this study was to determine the relative antimicrobial effectiveness of these endodontic medicaments and various vehicles using an agar well diffusion assay.
Materials and methods: Double Antibiotic Paste(DAP), modified DAP, 2% Chlorhexidine gluconate and their combination with four vehicles namely Polyethylene glycol 400 (PEG), Propylene glycol (PG), combinations of PG with PEG and lastly Glycerine were tested using agar well diffusion assay. The minimum bactericidal concentration was noted against four standard strains of organisms ie Streptococcus mutans ATCC(American Type Culture Collection) 25175, Staphylococcus aureus ATCC 12598, Enterococcus faecalis ATCC 35550 and Eschericia coli ATCC 25922. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Issues of resistance, limited spectrum of activity and lack of antifungal properties, the hunt for the ideal intracanal medicament continues. In this regard, the vehicles used to form the pastes play a supportive role by forming the appropriate consistency for placement and may dramatically influence their chemical characteristics like their solubility and diffusion. Thus, inorder to use safer and equally effective intracanal medicaments, Chlorhexidine gluconate is being unveiled in this study.
Results: The difference between the four vehicles when combined with the same endodontic medicament studied above is nonsignificant (NS) except against Porphyromonas gingivalis. Propylene glycol is significantly effective than Glycerine when used with DAP ie C+M medicament combination. (p = 0.029)
Conclusion: 2% chlorhexidine gluconate and modified DAP can definitely replace DAP and triple antibiotic paste as end-odontic medicaments with chlorhexidine having an added advantage of bactericidal action, substantivity, biocompatibility, low toxicity, and lesser chances of developing resistance.
How to cite this article: Nalawade TM, Bhat KG, Sogi S. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016;9(4):335-341.
Sheiham A. Oral health, general health and quality of life. Bull World Health Organ 2005 Sep;83(9):644-645.
Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars. Int J Paediatr Dent 2010 May;20(3):214-221.
Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J 2001 Sep;34(6):424-428.
Agarwal M, Das UM, Vishwanath D. A comparative evaluation of noninstrumentation endodontic techniques with conventional ZOE pulpectomy in deciduous molars: an in vivo study. World J Dent 2011 Jul-Sep;2(3):187-192.
Takushige T, Cruz EV, Asgor Moral A, Hoshino E. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J 2004 Feb;37(2):132-138.
Prabhakar AR, Sridevi E, Raju OS, Satish V. Endodontic treatment of primary teeth using combination of antibacterial drugs: An in vivo study. J Indian Soc Pedod Prev Dent 2008 Jan;26 (Suppl 1):S5-S10.
Kalsi R, Vandana KL, Prakash S. Effect of local drug delivery in chronic periodontitis patients: a meta-analysis. J Indian Soc Periodontol 2011 Oct;15(4):304-309.
Cruz EV, Kota K, Huque J, Iwaku M, Hoshino E. Penetration of propylene glycol into dentin. Int Endod J 2002 Apr;35(4): 330-336.
Carreira Cde M, dos Santos SS, Jorge AO, Lage-Marques JL. Antimicrobial effect of intracanal substances. J Appl Oral Sci 2007 Oct;15(5):453-458.
Seol JH, Cho BH, Chung CP, Bae KS. Multiplex polymerase chain reaction detection of black-pigmented bacteria in infections of endodontic origin. J Endod 2006 Feb;32(2):110-114.
Parekh J, Chanda S. In vitro antibacterial activity of the crude methanol extract of Woodfordia fruticosa Kurz. Flower (lythraceae). Braz J Microbiol 2007;38:204-207.
Garcia LFR, de Almeida GL, Pires-de-Souza FCP, Consani S. Antimicrobial activity of a calcium hydroxide and Ricinus communis oil paste against microorganisms commonly found in endodontic infections. Rev Odonto Ciênc 2009 Oct;24(4): 406-409.
Bolla N, Kavuri SR, Tanniru HI, Vemuri S, Shenoy A. Comparative evaluation of antimicrobial efficacy of odontopaste, chlorhexidine and propolis as root canal medicaments against E. faecalis and Candida albicans. J Int Dent Med Res 2012 Apr;5(1):14-25.
Hegde MN, Shetty S, Yelapure M, Patil A. Evaluation of antimicrobial activity of aqueous and hydro-alcoholic Curcuma longa extracts against endodontic pathogens. IOSR J Pharm 2012 Mar-Apr;2(2):192-198.
Gomes BP, Ferraz CC, Vianna ME, Rosalen PL, Zaia AA, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of calcium hydroxide pastes and their vehicles against selected microorganisms. Braz Dent J 2002;13(3):155-161.
Fabris A, Nakano V, Avila-Campos M. Bacteriological analysis of necrotic pulp and fistulae in primary teeth. J Appl Oral Sci 2014 Apr;22(2):118-124.
Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol 1993 Jun;8(3):172-176.
Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against E. faecalis. Iran Endod J 2012 Summer;7(3): 149-155.
Gomes BP, Vianna ME, Sena TN, Zaia AA, Ferraz CC, Filho FJS. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006 Oct;102(4):544-550.
Filho FJS, Soares Ade J, Vianna ME, Zaia AA, Ferraz CC, Gomes BP. Antimicrobial effect and pH of chlorhexidine gel and calcium hydroxide alone and associated with other materials. Braz Dent J 2008;19(1):28-33.
Câmara AC, Albuquerque MM, Aguiar CM, Correia ACRB. Antimicrobial activity of chlorhexidine in root canals instrumented with the ProTaper Universal™ System. Braz J Oral Sci 2010 Jul-Sep;9(3):402-409.
Siqueira JF Jr, Batista MM, Fraga RC, de Uzeda M. Antibacterial effects of endodontic irrigants on black-pigmented gram-negative anaerobes and facultative bacteria. J Endod 1998 Jun;24(6):414-416.
Radeva E, Indjov B, Vacheva R. Antibacterial activity of intracanal medicaments against bacterial isolates in cases of acute periapical periodontitis (nonexudative form). J IMAB 2005;11(2):35-38.
Martina LP, Ebenezar AVR, Ghani MF, Narayanan A, Sundaram M, Mohan AG. An in vitro comparative antibacterial study of different concentrations of green tea extracts and 2% chlorhexidine on E. faecalis. Saudi Endod J 2013 Sep-Dec;3(3): 120-124.
Machnick TK, Torabinejad M, Munoz CA, Shabahang S. Effect of MTAD on flexural strength and modulus of elasticity of dentin. J Endod 2003 Nov;29(11):747-750.
Mistry KS, Sanghvi Z, Parmar G, Shah S. The antimicrobial activity of Azadirachta indica, Mimusops elengi, Tinospora cardifolia, Ocimum sanctum and 2% chlorhexidine gluconate on common endodontic pathogens: an in vitro study. Eur J Dent 2014 Apr;8(2):172-177.
Davis JM, Maki J, Bahcall JK. An in vitro comparison of the antimicrobial effects of various endodontic medicaments on E. faecalis. J Endod 2007 May;33(5):567-569.
Oboh IE, Akerele JO, Obasuyi O. Antimicrobial activity of the ethanol extract of aerial parts of sida acuta burm.f. (malvaceae). Trop J Pharm Res 2007 Dec;6(4):809-813.
Jain P, Pundir RK. Antibiotic sensitivity pattern of Streptococcus mutans against commercially available drugs. J Pharm Res 2009;2(7):1250-1252.
Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of E. faecalis and Porphyromonas gingivalis. J Endod 2013 Nov;39(11): 1385-1389.
Choudhary S, Singh V, Chauhan PK, Tyagi A, Kumar M. In vitro antibacterial activity of Eugenia jambolana against S. mutans causing dental plaque formation. Int J Institut Pharm Life Sci 2011 Jul-Aug;1(1):91-99.
Detection of antimicrobial resistance in common gram negative and gram positive bacteria encountered in infectious diseases – an update. ICMR Bull 2009 Jan-Mar;39(1-3):1-20.
Baumgartner JC, Xia T. Antibiotic susceptibility of bacteria associated with endodontic abscesses. J Endod 2003 Jan;29(1):44-47.
Kaplowitz GJ, Cortell M. Chlorhexidine: a multi-functional antimicrobial drug [accessed 13 Nov 24]. Available from: www.ineeedce.com/courses/1423/PDF/Chlorhexidine.pdf.
Nalawade TM, Bhat K, Sogi SH. Bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400 and polyethylene glycol 1000 against selected microorganisms. J Int Soc Prevent Community Dent 2015 Mar-Apr;5(2):114-119.
Athanassiadis B, Abbott PV, George N, Walsh LJ. An in vitro study of the antimicrobial activity of some endodontic medicaments and their bases using an agar well diffusion assay. Aust Dent J 2009 Jun;54(2):141-146.
Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A. Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod 2012 Oct;38(10):1372-1375.
Guerreiro-Tanomaru JM, Pereira KF, Nascimento CA, Bernadi MI, Tanomaru-Filho M. Use of nanoparticulate zinc oxide as intracanal medication in endodontics: pH and antimicrobial activity. Acta Odontol Latinoam 2013;26(3):144-148.