A Comparative Evaluation of Antimicrobial Efficacy of Triphala and Calcium Hydroxide As Intracanal Medicament: An Study

Overview

Journal J Pharm Bioallied Sci

Specialty Pharmacology

Date 2022 Sep 16

PMID 36110780

Authors

Mathi Muthamil Selvi

Arumugam Selvabalaji

Anagha Chonat

Vasanthakumari Ananthan

Ebenezeer Mani

Ananda Devi Chinnaswamy

Affiliations

Soon will be listed here.

Abstract

Background: The goal for placement of intracanal medicament during pulpal therapy procedures is to eradicate the bacteria and the exotoxins from the infected root canal, thereby preventing and controlling pulpal and periradicular infections. Chemo-mechanical preparation is considered an essential step in root canal disinfection; but to accomplish the total elimination of bacteria in highly complex root canal anatomy is difficult. Intracanal medicaments help eliminate bacteria by remaining in the root canal, and calcium hydroxide has been recommended as one of the most effective antimicrobial dressings during endodontic therapy. The herbal agents offer an alternative to synthetic compounds. They have been considered either non-toxic or less toxic. The rapid increase in antibiotic-resistant strains and side effects caused by synthetic drugs have prompted researchers to look for herbal alternatives.

Aim And Objective: The study aims to evaluate and compare the antibacterial activity of triphala and calcium hydroxide against as an intracanal medicament.

Materials And Methods: The antimicrobial efficacy of triphala and calcium hydroxide was evaluated against cultured and incubated for various time frames in 42 intact, caries-free, human, single-rooted teeth with straight roots and mature apices. The comparison of the number of counted colonies after each incubation time and based on the type of drug used inside the canal is evaluated using non-parametric Kruskal-Wallis test and Mann-Whitney test, respectively. Statistical analysis was done using SPSS version 14.0.

Results: Efficacy of calcium hydroxide against was best in the first 72-hr time duration compared with triphala. Triphala showed significant antimicrobial activity against that was closely parallel to the calcium hydroxide group in one week. Calcium hydroxide and triphala had complete eradication of in a given one-month time duration.

References

Kawashima N, Wadachi R, Suda H, Yeng T, Parashos P . Root canal medicaments. Int Dent J. 2009; 59(1):5-11. View

Lima R, Carvalho C, Ribeiro T, Fonteles C . Antimicrobial efficacy of chlorhexidine and calcium hydroxide/camphorated paramonochlorophenol on infected primary molars: a split-mouth randomized clinical trial. Quintessence Int. 2013; 44(2):113-22. DOI: 10.3290/j.qi.a28932. View

Siqueira Jr J, Lopes H . Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J. 1999; 32(5):361-9. DOI: 10.1046/j.1365-2591.1999.00275.x. View

Sjogren U, Figdor D, Spangberg L, Sundqvist G . The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J. 1991; 24(3):119-25. DOI: 10.1111/j.1365-2591.1991.tb00117.x. View

Valera M, de Moraes Rego J, Jorge A . Effect of sodium hypochlorite and five intracanal medications on Candida albicans in root canals. J Endod. 2001; 27(6):401-3. DOI: 10.1097/00004770-200106000-00008. View

Gomes B, Vianna M, Sena N, Zaia A, Ferraz C, de Souza Filho F . In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102(4):544-50. DOI: 10.1016/j.tripleo.2006.04.010. View

Pallotta R, Ribeiro M, de Lima Machado M . Determination of the minimum inhibitory concentration of four medicaments used as intracanal medication. Aust Endod J. 2007; 33(3):107-11. DOI: 10.1111/j.1747-4477.2007.00095.x. View

Srinagesh J, Pushpanjali K . Assessment of antibacterial efficacy of triphala against mutans streptococci: a randomised control trial. Oral Health Prev Dent. 2012; 9(4):387-93. View

Prabhakar J, Senthilkumar M, Priya M, Mahalakshmi K, Sehgal P, Sukumaran V . Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod. 2009; 36(1):83-6. DOI: 10.1016/j.joen.2009.09.040. View

10.

Nair P, Sjogren U, Krey G, Kahnberg K, Sundqvist G . Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study. J Endod. 1990; 16(12):580-8. DOI: 10.1016/S0099-2399(07)80201-9. View

11.

Lynne R, Liewehr F, West L, Patton W, Buxton T, McPherson J . In vitro antimicrobial activity of various medication preparations on E. faecalis in root canal dentin. J Endod. 2003; 29(3):187-90. DOI: 10.1097/00004770-200303000-00006. View

12.

Lin L, Skribner J, Gaengler P . Factors associated with endodontic treatment failures. J Endod. 1992; 18(12):625-7. DOI: 10.1016/S0099-2399(06)81335-X. View

13.

Brandle N, Zehnder M, Weiger R, Waltimo T . Impact of growth conditions on susceptibility of five microbial species to alkaline stress. J Endod. 2008; 34(5):579-82. DOI: 10.1016/j.joen.2008.02.027. View

14.

Iqbal A . The Factors Responsible for Endodontic Treatment Failure in the Permanent Dentitions of the Patients Reported to the College of Dentistry, the University of Aljouf, Kingdom of Saudi Arabia. J Clin Diagn Res. 2016; 10(5):ZC146-8. PMC: 4948527. DOI: 10.7860/JCDR/2016/14272.7884. View

15.

Farhad A, Barekatain B, Allameh M, Narimani T . Evaluation of the antibacterial effect of calcium hydroxide in combination with three different vehicles: An in vitro study. Dent Res J (Isfahan). 2012; 9(2):167-72. PMC: 3353693. DOI: 10.4103/1735-3327.95231. View

16.

Srinagesh J, Krishnappa P, Somanna S . Antibacterial efficacy of triphala against oral streptococci: an in vivo study. Indian J Dent Res. 2013; 23(5):696. DOI: 10.4103/0970-9290.107423. View

17.

Podbielski A, Spahr A, Haller B . Additive antimicrobial activity of calcium hydroxide and chlorhexidine on common endodontic bacterial pathogens. J Endod. 2003; 29(5):340-5. DOI: 10.1097/00004770-200305000-00006. View

18.

El Karim I, Kennedy J, Hussey D . The antimicrobial effects of root canal irrigation and medication. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103(4):560-9. DOI: 10.1016/j.tripleo.2006.10.004. View