Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection

Sandeep Dubey; Suparna Ganguly Saha; Balakrishnan Rajkumar; Tapan Kumar Dhole

doi:10.4103/ejd.ejd_141_16

European Journal of Dentistry, Table of Contents

CC BY-NC-ND 4.0 · Eur J Dent 2017; 11(01): 012-016
DOI: 10.4103/ejd.ejd_141_16

Original Article

Dental Investigation Society

Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection

Sandeep Dubey

¹Department of Conservative Dentistry and Endodontics, College of Dental Sciences and Hospital, Indore, Madhya Pradesh, India

,

Suparna Ganguly Saha

¹Department of Conservative Dentistry and Endodontics, College of Dental Sciences and Hospital, Indore, Madhya Pradesh, India

,

Balakrishnan Rajkumar

²Department of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India

,

Tapan Kumar Dhole

³Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

› Author Affiliations

Abstract

ABSTRACT

Objective: This study aims to evaluate and compare the antimicrobial efficacy of three selected root canal irrigants (BioPure MTAD, metronidazole, aztreonam) against microbes commonly isolated from polymicrobial microbiota of root canal infection. Materials and Methods: This study was designed with four experimental groups (Group I - Bacteroides fragilis, Group II - Propionibacterium acnes, Group III - Enterococcus faecalis, Group IV - Candida albicans) based on the microbes selected for the study. Group I and Group II bacteria were used to compare and evaluate antimicrobial effect of BioPure MTAD, metronidazole, aztreonam, and normal saline. Group III and Group IV bacteria were used to compare and evaluate antimicrobial efficacy of BioPure MTAD, aztreonam, and normal saline. Normal saline was used as a control irrigant in this study. Agar disc diffusion method was applied to assess and compare the antimicrobial action of selected irrigants. Results: Metronidazole was found to be the most effective root canal irrigant against B. fragilis and P. acnes among the tested irrigants. Mean zone of inhibition against E. faecalis has been shown to be maximum by BioPure MTAD, followed by aztreonam. Antifungal effect against C. albicans was only shown by BioPure MTAD. Conclusions: Overall, BioPure MTAD is the most effective root canal irrigant as it has shown an antibacterial effect against all the tested microorganisms. However, metronidazole showed maximum antibacterial effect against obligate anaerobes. Aztreonam also showed an antibacterial effect in the present study, raising its possibility to be used as a root canal irrigant in the future.

Key words:

Agar disc diffusion method - BioPure MTAD - Candida albicans - Enterococcus faecalis

Full Text

References

1 Kargül B, Tanboga I, Altinok B. Conventional endodontic treatment of primary molars using metronidazole as an intra-canal medicament: A pilot study. Eur Arch Paediatr Dent 2010; 11: 196-200
2 Jacobus NV, Ferreira MC, Barza M. In vitro activity of azthreonam, a monobactam antibiotic. Antimicrob Agents Chemother 1982; 22: 832-8
3 Antonio-Velmonte MM, Santana RT, Manalastas RM. Efficacy and safety of Aztreonam in the treatment of nosocomial gram negative bacterial infections. Phil J Microbiol Infect Dis 1989; 18: 53-7
4 Demiryurek EO, Onuk EE, Yuksel G, Ciftci A. Evaluation of microbial contamination of resilon and gutta-percha cones and their antimicrobial activities. Afr J Microbiol Res 2012; 6: 6275-80
5 Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov KA. new solution for the removal of the smear layer. J Endod 2003; 29: 170-5
6 Ando N, Hoshino E. Predominant obligate anaerobes invading the deep layers of root canal dentin. Int Endod J 1990; 23: 20-7
7 Sanjiwan R, Chandra S, Jaiswal JN. Mastan The effect of metronidazole on the anaerobic microorganisms of the root canal – A clinical study. Fed Oper Dent 1990; 1: 30-6
8 Newberry BM, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. The antimicrobial effect of biopure MTAD on eight strains of Enterococcus faecalis. J Endod 2007; 33: 1352-4
9 Brauner AW, Conrads G. Studies into the microbial spectrum of apical periodontitis. Int Endod J 1995; 28: 244-8
10 Waltimo TM, Sirén EK, Torkko HL, Olsen I, Haapasalo MP. Fungi in therapy-resistant apical periodontitis. Int Endod J 1997; 30: 96-101
11 Le Goff A, Bunetel L, Mouton C, Bonnaure-Mallet M. Evaluation of root canal bacteria and their antimicrobial susceptibility in teeth with necrotic pulp. Oral Microbiol Immunol 1997; 12: 318-22
12 Abou-Rass M, Bogen G. Microorganisms in closed periapical lesions. Int Endod J 1998; 31: 39-47
13 Tronstad L, Sunde PT. The evolving new understanding of endodontic infections. Endod Topics 2003; 6: 57-77
14 Gajan EB, Aghazadeh M, Abashov R, Salem Milani A, Moosavi Z. Microbial flora of root canals of Pulpally-infected teeth: Enterococcus faecalis a prevalent species. J Dent Res Dent Clin Dent Prospects 2009; 3: 24-7
15 Chavez De Paz L. Gram-positive organisms in endodontic infections. Endod Topics 2004; 9: 79-96
16 Siqueira Jr JF, Sen BH. Fungi in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 632-41
17 Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections & antimicrobial resistance. Indian J Med Res 2008; 128: 111-21
18 Ashraf H, Samiee M, Eslami G, Ghodse Hosseini MR. Presence of Candida albicans in root canal system of teeth requiring endodontic retreatment with and without periapical lesions. Iran Endod J 2007; 2: 24-8
19 Waltimo TM, Sen BH, Meurman JH, Ørstavik D, Haapasalo MP. Yeasts in apical periodontitis. Crit Rev Oral Biol Med 2003; 14: 128-37
20 Vijaykumar S, Gunashekhar M, Himagiri S. In vitro effectiveness of different endodontic irrigants on the reduction of Enterococcus faecalis in root canals. J Clin Exp Dent 2010; 2: 169-72
21 Whelan JPF, Hale JH. Bactericidal activity of metronidazole against Bacteroides fragilis. J Clin Pathol 1973; 26: 393-95
22 Gaetti-Jardim Junior E, Landucci LF, Lins SA, Vieira EM, de Oliveira SR. Susceptibility of strict and facultative anaerobes isolated from endodontic infections to metronidazole and beta-lactams. J Appl Oral Sci 2007; 15: 539-45
23 Khodaeiani E, Fouladi RF, Yousefi N, Amirnia M, Babaeinejad S, Shokri J. Efficacy of 2% Metronidazole gel in moderate Acne Vulgaris. Indian J Dermatol 2012; 57: 279-81
24 Kamberi B, Bajrami D, Stavileci M, Omeragiq S, Dragidella F, Koçani F. The antibacterial efficacy of biopure MTAD in root canal contaminated with Enterococcus faecalis. ISRN Dent 2012 2012; 390526
25 Krishna JN, Raghu R, Bolla N, Muddanna K. An in vitro comparative evaluation of the antimicrobial efficacy of 10% metronidazole gel, 2% chlorhexidine gel, and a combination of calcium hydroxide and 2% chlorhexidine gel against Enterococcus faecalis. J Orofac Sci 2012; 4: 26-31
26 Yujra VQ, Scherma AP, Junqueira JC. The role of metronidazole on the establishment and persistence of oral candidosis. Braz J Oral Sci 2006; 5: 1041-47
27 Arslan S, Ozbilge H, Kaya EG, Er O. In vitro antimicrobial activity of propolis, biopure MTAD, sodium hypochlorite and chlorhexidine on Enterococcus faecalis and Candida albicans. Saudi Med J 2011; 32: 479-83
28 Asna Ashari M, Fayaz F, Moezzi Ghadim N, Alim Marvasti L, Mehrabi Y. Evaluation of the antimicrobial effects of MTAD, NaOCl against selected endodontic pathogens. Iran Endod J 2009; 4: 63-8