Root Canal Irrigation: Chemical Agents and Plant Extracts Against Enterococcus faecalis

Abstract

Background:There are various microorganisms related to intra and extra-radicular infections and many of these are involved in persistent infections. Bacterial elimination from the root canal is achieved by means of the mechanical action of instruments and irrigation as well as the antibacterial effects of the irrigating solutions. Enterococcus faecalis can frequently be isolated from root canals in cases of failed root canal treatments. Antimicrobial agents have often been developed and optimized for their activity against endodontic bacteria. An ideal root canal irrigant should be biocompatible, because of its close contact with the periodontal tissues during endodontic treatment. Sodium hypoclorite (NaOCl) is one of the most widely recommended and used endodontic irrigants but it is highly toxic to periapical tissues.Objectives:To analyze the literature on the chemotherapeutic agent and plant extracts studied as root canal irrigants. In particularly, the study is focused on their effect on Enterococcus faecalis.Method:Literature search was performed electronically in PubMed (PubMed Central, MEDLINE) for articles published in English from 1982 to April 2015. The searched keywords were “endodontic irrigants” and “Enterococcus faecalis” and “essential oil” and “plant extracts”.Results:Many of the studied chemotherapeutic agents and plant extracts have shown promising results in vitro.Conclusion:Some of the considered phytotherapic substances, could be a potential alternative to NaOCl for the biomechanical treatment of the endodontic space.

In vitro Antibacterial Activity of Zingiber officinale and Orthosiphon stamineus on Enterococcus faecalis

“…However, E. faecalis biofilm has been reported to resist these common intracanal medicaments (Stuart et al, 2006;Liu, 2010;Sathorn et al, 2007;Haapasalo & Shen, 2012), thus contributing to the failure of root canal treatment and persistent root canal infection. The current irrigant solution, sodium hypochlorite used in cleaning the root canal system is toxic to the surrounding soft tissue (Borzini et al, 2016). Thus, there is a need to find safer, gentler irrigant.…”

Potential Effect of Propolis as an Intracanal Medicament on Root Canal Disinfection and Dentin Microhardness: (An in Vitro Study).

“…Intracanal medicaments are regarded as an integral part of canal disinfection. Most commonly used medicament are calcium hydroxide and Chlorohexidine (1,2,3,5,7,14,15,16,17,18,19,20,21,22,23).…”

“…The combination of chemo-mechanical preparation ensures the eradication of bacteria inside root canal and ensures the success of the endodontic treatment. (2,3) For many years the use of intracanal medicaments has been advocated to enhance the success rates of root canal treatment. Phenolic compounds are used for their potent antibacterial activity; however, they are found to be very 164 toxic and irritant to soft tissues (4).…”

The Comparative Evaluation of the Post-Antimicrobial Effect of MTAD® and 2% Chlorhexidine against Enterococcus faecalis of Permanent Teeth with Necrotic Pulp

“…This can be achieved with both mechanical debridement and using of the suitable irrigating solution with strong bactericidal properties especially against the most resistant type of bacteria in the necrotic teeth which is the Enterococcus faecalis which humper the success of endodontic treatment [1]. E. faecalis is considered a pathogen responsible for persistent apical periodontitis as it can tolerate extreme conditions and survive in the root canals and periapical tissues without the support of other bacteria [2].…”