Synergistic Effect of Plant Extracts on Endodontic Pathogens Isolated from Teeth with Root Canal Treatment Failure: An In Vitro Study

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2021 Jun 2

PMID 34065139

Citations 7

Authors

Suraj Arora

Shahabe Abullais Saquib

Youssef A Algarni

Mohammed Abdul Kader

Irfan Ahmad

Mohammad Y Alshahrani

Priyanka Saluja

Suheel Manzoor Baba

Anshad M Abdulla

Shashit Shetty Bavabeedu

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: This study aimed to evaluate the synergistic antimicrobial activity of extracts obtained from (Miswak), (myrrh) and (neem) in combination with commercially available antimicrobial agents: penicillin, tetracycline, ofloxacin and fluconazole on endodontic pathogens such as and .

Materials And Methods: Microbiological samples from the root canals of the teeth undergoing retreatment were taken using sterile paper points kept at full length in the canal for 30 s. The disc diffusion method was used to check the susceptibility of microbes to the plant extracts and antimicrobials by measuring the diameter of the inhibition zones. Against the microbes, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)/minimum fungicidal concentration (MFC) of the plant extracts were assessed. The fractional inhibitory concentration index (FICI) was used to estimate the synergistic effect of plant extracts combined with antimicrobials against the resistant endodontic microbes.

Results: The findings clearly indicate the effectiveness of all the three plant extracts, against all the experimental pathogenic microorganisms except for the ineffectiveness of against Maximum antimicrobial activity was displayed by against (MIC = 0.09 ± 1.2 mg/mL, MBC = 0.78 ± 1.25 mg/mL) and the minimum antimicrobial activity was displayed by against (MIC = 12.5 ± 3.25 mg/mL, MBC = 100 ± 3.75 mg/mL). The best synergy was displayed by with fluconazole against (FICI = 0.45).

Conclusions: The current study delineates the variable antimicrobial activity of plant extracts against the experimental endodontic pathogenic microorganisms. Plant extracts in conjunction with various antimicrobials can be valuable aids in combating relatively resistant endodontic microorganisms that have been the cause of worry in recent years, leading to failure even in treatment procedures following all required protocols.

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References

Ghonmode W, Balsaraf O, Tambe V, Saujanya K, Patil A, Kakde D . Comparison of the antibacterial efficiency of neem leaf extracts, grape seed extracts and 3% sodium hypochlorite against E. feacalis - An in vitro study. J Int Oral Health. 2014; 5(6):61-6. PMC: 3895719. View

Ahmad I, Wahab S, Nisar N, Dera A, Alshahrani M, Abullias S . Evaluation of antibacterial properties of on clinical isolates of periodontitis patients with special reference to red complex bacteria. Saudi Pharm J. 2020; 28(10):1203-1209. PMC: 7584800. DOI: 10.1016/j.jsps.2020.08.010. View

Chavez de Paz L, Svensater G, Dahlen G, Bergenholtz G . Streptococci from root canals in teeth with apical periodontitis receiving endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(2):232-41. DOI: 10.1016/j.tripleo.2004.10.008. View

Souto R, Colombo A . Prevalence of Enterococcus faecalis in subgingival biofilm and saliva of subjects with chronic periodontal infection. Arch Oral Biol. 2007; 53(2):155-60. DOI: 10.1016/j.archoralbio.2007.08.004. View

Flahaut S, Hartke A, Giard J, Auffray Y . Alkaline stress response in Enterococcus faecalis: adaptation, cross-protection, and changes in protein synthesis. Appl Environ Microbiol. 1997; 63(2):812-4. PMC: 168376. DOI: 10.1128/aem.63.2.812-814.1997. View

Baumgartner J, Watts C, Xia T . Occurrence of Candida albicans in infections of endodontic origin. J Endod. 2001; 26(12):695-8. DOI: 10.1097/00004770-200012000-00003. View

Khazaei S, Keshavarz G, Bozorgi A, Nazari H, Khazaei M . Correction to: Adipose tissue-derived stem cells: a comparative review on isolation, culture, and differentiation methods. Cell Tissue Bank. 2021; 22(4):737. DOI: 10.1007/s10561-021-09928-6. View

Siqueira Jr J, Rocas I . Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97(1):85-94. DOI: 10.1016/s1079-2104(03)00353-6. View

Pinheiro E, Gomes B, Ferraz C, Teixeira F, Zaia A, Filho F . Evaluation of root canal microorganisms isolated from teeth with endodontic failure and their antimicrobial susceptibility. Oral Microbiol Immunol. 2003; 18(2):100-3. DOI: 10.1034/j.1399-302x.2003.00058.x. View

10.

Cappare P, Tete G, Sberna M, Panina-Bordignon P . The Emerging Role of Stem Cells in Regenerative Dentistry. Curr Gene Ther. 2020; 20(4):259-268. DOI: 10.2174/1566523220999200818115803. View

11.

Tyagi S, Sinha D, Garg P, Singh U, Mishra C, Nagpal R . Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica (Neem) and 5% sodium hypochlorite on Candida albicans biofilm formed on tooth substrate: An in-vitro study. J Conserv Dent. 2013; 16(6):532-5. PMC: 3842722. DOI: 10.4103/0972-0707.120973. View

12.

Dugas N, Lawrence H, Teplitsky P, Pharoah M, Friedman S . Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J. 2003; 36(3):181-92. DOI: 10.1046/j.1365-2591.2003.00640.x. View

13.

Abullais Saquib S, Abdullah Alqahtani N, Ahmad I, Kader M, Al Shahrani S, Asiri E . Evaluation and Comparison of Antibacterial Efficacy of Herbal Extracts in Combination with Antibiotics on Periodontal pathobionts: An in vitro Microbiological Study. Antibiotics (Basel). 2019; 8(3). PMC: 6783985. DOI: 10.3390/antibiotics8030089. View

14.

Kayaoglu G, Orstavik D . Virulence factors of Enterococcus faecalis: relationship to endodontic disease. Crit Rev Oral Biol Med. 2004; 15(5):308-20. DOI: 10.1177/154411130401500506. View

15.

Halawany H . A review on miswak (Salvadora persica) and its effect on various aspects of oral health. Saudi Dent J. 2013; 24(2):63-9. PMC: 3723367. DOI: 10.1016/j.sdentj.2011.12.004. View

16.

Ahmed H, Ibrahim N, Mohamad N, Nambiar P, Muhammad R, Yusoff M . Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration. Int Endod J. 2021; 54(7):1056-1082. DOI: 10.1111/iej.13486. View

17.

Bueno M, Estrela C, Granjeiro J, Estrela M, Azevedo B, Diogenes A . Cone-beam computed tomography cinematic rendering: clinical, teaching and research applications. Braz Oral Res. 2021; 35:e024. DOI: 10.1590/1807-3107bor-2021.vol35.0024. View

18.

Jungermann G, Burns K, Nandakumar R, Tolba M, Venezia R, Fouad A . Antibiotic resistance in primary and persistent endodontic infections. J Endod. 2011; 37(10):1337-44. PMC: 3176416. DOI: 10.1016/j.joen.2011.06.028. View

19.

Haque M, Alsareii S . A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health. Saudi Med J. 2015; 36(5):530-43. PMC: 4436748. DOI: 10.15537/smj.2015.5.10785. View

20.

MacNeill S, Rindler E, Walker A, Brown A, Cobb C . Effects of tetracycline hydrochloride and chlorhexidine gluconate on Candida albicans. An in vitro study. J Clin Periodontol. 1997; 24(10):753-60. DOI: 10.1111/j.1600-051x.1997.tb00193.x. View