International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 3 ( March, 2024 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study

Mayuri M Tawde, Laxmi Lakade, Amol Kamble, Alok Patel, Shweta S Jajoo

Keywords : Aloe vera, Camphorated monochlorophenol, Cucurmin oil, Enterococcus faecalis, Herbal combination, Intracanal medicaments, Intracanal medicaments in deciduous molars, Ocimum sanctum oil, Triple antibiotic paste, Tulsi oil, Turmeric oil

Citation Information : Tawde MM, Lakade L, Kamble A, Patel A, Jajoo SS. Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024; 17 (3):243-254.

DOI: 10.5005/jp-journals-10005-2768

License: CC BY-NC 4.0

Published Online: 01-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: Compare the efficacy of triple antibiotic paste (TAP), herbal extracts, and camphorated monochlorophenol (CMCP) as intracanal medicaments against Enterococcus faecalis (E. faecalis) in deciduous molars. Materials and methods: A total of 60 samples were collected from canals of first and second molars of 4–10-year-old children, with more than two-thirds root length, and fitting the inclusion criteria. Samples were collected at three intervals—S1 was collected just after access opening, S2 was collected after biomechanical preparation (BMP) and irrigation, and just before placement of medicament. Randomization was done to place the medicaments into three groups: group I—CMCP, group II—TAP, and group III—herbal combination. Sample S3 was taken 48 hours after removal of medicament from the canals. The collected samples were transported via Amies media to the laboratory, where they were anaerobically incubated for 24 hours. Growth of E. Faecalis was observed, and manual counting of the colony-forming unit (CFU) was done. The change in CFU in all samples was calculated, and the results were statistically analyzed. Results: The results show that there is a change from S1 (TAP = 118.67 ± 122.48, herbal = 109.07 ± 106.43; CMCP = 110.73 ± 120.53) to S2 (TAP = 34.13 ± 63.47; herbal = 27.67 ± 39.39; CMCP = 16.40 ± 26.32) and S3 (TAP = 12.33 ± 24.82; herbal = 4.73 ± 12.78; CMCP = 3.40 ± 7.12). It is seen that there is a significant difference seen from S1 to S2 in all three groups (p ≤ 0.05) using repeated measure analysis of variance (ANOVA) test. This shows that all three medicaments were effective in reducing bacterial counts of E. Faecalis from sample S1 (pre) to S3 (post) significantly after exposure to root canal bacterial flora for 48 hours (2 days). The pairwise comparison of the change in CFU within each group, S1–S3, also shows significant changes. There is a significant decrease in CFU seen from S1 to S2 and S1 to S3 but not from S2 to S3 for all three groups, which was evaluated using the post hoc Bonferroni test. It was also observed that in between the canals, although there was a change from S1 to S3 in terms of the CFU, there was no significant difference in the decrease in the bacterial count when intercanal comparison was made. There was, however, a change that was seen to be significant when values from each canal were compared from S1 to S3. Conclusion: All three medicaments have successfully shown a decrease in the numbers of E. faecalis, which the study aimed at checking. Although the effect varied intergroups, it was mild, so herbal alternatives could be used instead of antibiotics and CMCP. Also, because the local application is effective in controlling interappointment flare-ups, the medicaments can be successfully given without having to prescribe systemic antibiotics.


HTML PDF Share
  1. Chen X, Daliri EB, Kim N, et al. Microbial etiology and prevention of dental caries: Exploiting natural products to inhibit cariogenic biofilms. Pathogens 2020;9(7):569.
  2. Yadav K, Prakash S. Dental caries: A microbiological approach. J Clin Infect Dis Pract 2017;2:1–5.
  3. Bader JD, Rozier RG, Lohr KN, et al. Physicians’ roles in preventing dental caries in preschool children: a summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med 2004;26(4):315–325. DOI: 10.1016/j.amepre.2003.12.001
  4. Pinheiro ET, Gomes BP, Ferraz CC, et al. Evaluation of root canal microorganisms isolated from teeth with endodontic failure and their antimicrobial susceptibility. Oral Microbiol Immunol 2003;18(2):100–103. DOI: 10.1034/j.1399-302x.2003.00058.x
  5. Ravi GR, Subramanyam RV. Calcium hydroxide-induced resorption of deciduous teeth: a possible explanation. Dent Hypothes 2012;3(3):90–94. DOI: 10.4103/2155-8213.103910
  6. Sahebi S, Khosravifar N, Sedighshamsi M, et al. Comparison of the antibacterial effect of sodium hypochlorite and aloe vera solutions as root canal irrigants in human extracted teeth contaminated with enterococcus faecalis. J Dent 2014;15(1):39–43.
  7. Molander A, Lundquist P, Papapanou PN, et al. A protocol for polymerase chain reaction detection of Enterococcus faecalis and Enterococcus faecium from the root canal. Int Endod J 2002;35(1):1–6. DOI: 10.1046/j.1365-2591.2002.00476.x
  8. Chavez de Paz LE. Redefining the persistent infection in root canals: possible role of biofilm communities. J Endod 2007;33(6):652–662. DOI: 10.1016/j.joen.2006.11.004
  9. Love RM. Enterococcus faecalis–a mechanism for its role in endodontic failure. Int Endod J 2001;34(5):399–405. DOI: 10.1046/j.1365-2591.2001.00437.x
  10. da Silva LA, Nelson-Filho P, Faria G, et al. Bacterial profile in primary teeth with necrotic pulp and periapical lesions. Braz Dent J 2006;17(2):144–148. DOI: 10.1590/s0103-64402006000200012
  11. Cancio V, Carvalho Ferreira D, Cavalcante FS, et al. Can the Enterococcus faecalis identified in the root canals of primary teeth be a cause of failure of endodontic treatment? J Acta Odontol Scand 2017;75(6):423–428. DOI: 10.1080/00016357.2017.1328742
  12. Siqueira JF Jr, Rôças IN, Souto R, et al. Actinomyces Species, Streptococci, and Enterococcus faecalis in primary root canal infections. J Endod 2002;28(3):168–172. DOI: 10.1097/00004770-200203000-00006
  13. Ledezma-Rasillo G, Flores-Reyes H, Gonzalez-Amaro AM, et al. Identification of cultivable microorganisms from primary teeth with necrotic pulps. J Clin Pediatr Dent 2010;34(4):329–333. DOI: 10.17796/jcpd.34.4.20124lu111544377
  14. Ruviere DB, Leonardo MR, da Silva LA, et al. Assessment of the microbiota in root canals of human primary teeth by checkerboard DNA-DNA hybridization. J DentChild 2007;74(2):118–123.
  15. Sjögren U, Figdor D, Spångberg L, et al. The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J 1991:(3):119–25.
  16. Bystrom A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol 1985;1(5):170–175. DOI: 10.1111/j.1600-9657.1985.tb00652.x
  17. Onçag O, Cogulu D, Uzel A. Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study. J Clin Pediatr Dent 2006 Spring;30(3):233–237. Erratum in: J Clin Pediatr Dent 2007;32(1):26
  18. Varshini R, Subha A, Prabhakar V, et al. Antimicrobial efficacy of Aloe vera, Lemon, Ricinus communis, and Calcium Hydroxide as Intracanal Medicament Against Enterococcus faecalis: A Confocal Microscopic Study. J Pharm Bioallied Sci 2019;11(2):S256–S259.
  19. Ehsani M, Amin Marashi, Zabihi E, et al. A Comparison between antibacterial activity of Propolis and Aloe vera on Enterococcus faecalis (an in Vitro Study). Int J Mol Cell Med 2013;2(3):110–116.
  20. Abbaszadegan A, Sahebi S, Gholami A, et al. Time-dependent antibacterial effects of Aloe vera and Zataria multiflora plant essential oils compared to calcium hydroxide in teeth infected with Enterococcus faecalis. J Investig Clin Dent 2016;7(1):93–101.
  21. Kusuma CS, Manjunath V, Gehlo PM. Comparative evaluation of Neem, Aloe vera, Chlorhexidine and Calcium Hydroxide as an intracanal medicament against E. faecalis: An in vitro Study. J Clin Diagn Res 2018;12:ZC21–ZC25.
  22. Prasad SD, Goda PC, Reddy KS, et al. Evaluation of antimicrobial efficacy of Neem and Aloe vera leaf extracts in comparison with 3% sodium hypochlorite and 2 % chlorhexidine against E. faecalis and C. Albicans. J NTR Univ Health Sci 2016;5:104–110.
  23. Deshpande AN, Sudani U. Intracanal medicament in pediatric endodontics: a literature review. J Adv Med Dent Sci Res 2015;3(2):63–68.
  24. Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J 2009;42(4):288–302. DOI: 10.1111/j.1365-2591.2008.01540.x
  25. Gilad JZ, Teles R, Goodson M, et al. Development of a clindamycin-impregnated fiber as an intracanal medication in endodontic therapy. J Endod 1999;25(11):722–727. DOI: 10.1016/S0099-2399(99)80117-4
  26. Abbott PV. Selective and intelligent use of antibiotics in endodontics. Aust Endod J 2000;26(1):30–39. DOI: 10.1111/j.1747-4477.2000.tb00149.x
  27. Saivin S, Houin G. Clinical pharmacokinetics of doxycycline and minocycline. Clin Pharmacokinet 1988;15(6):355–366. DOI: 10.2165/00003088-198815060-00001
  28. Greenstein G. The role of metronidazole in the treatment of periodontal diseases. J Periodontol 1993;64(1):1–15. DOI: 10.1902/jop.1993.64.1.1
  29. Roche Y, Yoshimori RN. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother 1997;40(3):353–357. DOI: 10.1093/jac/40.3.353
  30. Lima KC, Fava LR, Siqueira JF Jr. Susceptibilities of Enterococcus faecalis biofilms to some antimicrobial medications. J Endod 2001;27(10):616–619. DOI: 10.1097/00004770-200110000-00004
  31. Grover G, Rao S. Investigations of antimicrobial efficiency from essential oil from O. Sanctum & O. gratissimum. Perfuma, Kosmat 1977;58:326–329.
  32. Kumar A, Agarwal K, Maurya AK, et al. Pharmacological and phytochemical evaluation of Ocimum sanctum root extracts for its antiinflammatory, analgesic and antipyretic activities. Pharmacogn Mag 2015;11(1):S217–S224.
  33. Menezes MM, Valera MC, Jorge AOC, et al. In vitro evaluation of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 2004;37(5):311–319. DOI: 10.1111/j.0143-2885.2004.00799.x
  34. Ahirwar P, Shashikiran ND, Sundarraj RK, et al. A clinical trial comparing antimicrobial efficacy of “essential oil of Ocimum sanctum” with triple antibiotic paste as an intracanal medicament in primary molars. J Indian Soc Pedod Prev Dent 2018;36(2):191–197. DOI: 10.4103/JISPPD.JISPPD_237_17
  35. Lele GS, Subba Reddy VV. Comparison of antibacterial efficacy of intracanal medicaments in multiple visit pulpectomies in primary molars-an in vivo study. J Indian Soc Pedod Prev Dent 2010;28(1):18–24. DOI: 10.4103/0970-4388.60482
  36. Reddy GA, Sridevi E, Sai Sankar AJ, et al. Endodontic treatment of chronically infected primary teeth using triple antibiotic paste: an in vivo study. J Conserv Dent 2018;20(6):405–410. DOI: 10.4103/JCD.JCD_161_17
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.