Investigating the Effects of Herbal Nanoparticle Endodontic Irrigants on Candida albicans and Enterococcus faecalis: An In Vitro Study

Abstract

The concentrations of sodium hypochlorite play a major role in removing E. faecalis in both biofilm and planktonic form. Higher concentrations result in better outcomes. 8 Unfortunately, NaOCl irrigant has some drawbacks, such as hypersensitivity reactions, tissue sepsis, damage to the instruments, irritation to periodontium tissue, failure to remove the smear layer, and an unfavorable taste and smell. 9 NaOCl has a substantial impact on the mechanical characteristics of dentin, including flexural strength, microhardness, roughness, elastic modulus, inorganic content, and organic-inorganic ratio. 10 Furthermore, NaOCl cannot penetrate narrow areas of the root wall. 11 Herbal medicine has gained popularity as a therapeutic agent due to its biocompatibility, safety, and cost-effectiveness. Therefore, there is a need to investigate their possible use in dentistry. 12 The main benefits of using herbal irrigants are their low microbiological resistance, safety, availability, and extended shelf-life. 13 Its greater patient acceptance compared to other irrigants such as NaOCl, along with its sustainable nature, renders it an efficient antibacterial irrigant for the eradication of E. faecalis. 14 Many herbal irrigants are available, including Morinda citrifolia, Curcuma longa, Tea tree oil, and Azadirachta indica (Neem). These herbal plants possess therapeutic properties and powerful effects on different microbes. When used as endodontic irrigants, they are antibacterial, antioxidant, as well as biocompatible. 9,15 These advantages make herbal irrigants a possible alternative to NaOCl. Curcuma longa (C.longa) is an herbal plant that belongs to the Zingiberaceae family commonly called turmeric. It is characterized by its anti-inflammatory, antioxidant, antibacterial, antifungal, antiprotozoal, and antiviral properties. 16 However it is less soluble in water with subsequent poor absorption, and fast metabolism. 17 Curcumin is only soluble in organic solvents, which are toxic making it of limited biological use. 18 Neem is another botanical extract with antibacterial, anti-inflammatory, and anti-cariogenic activities. 19 Because neem contains a variety of