Comparative efficacy of endodontic medicaments & sodium hypochlorite against Enterococcus faecalis biofilms

Abstract

Background

Many studies have investigated the effectiveness of root canal irrigants and medicaments against Enterococcus faecalis. The aim was to compare the efficacy of commonly used medicaments against Enterococcus faecalis cultured as a biofilm on dentine substrate.

Method

An E. faecalis biofilm was established on human dentine slices using a continuous flow cell. Each test medicament (Ledermix, Ca(OH)₂, Odontoposte, 0.2% chlorohexidine and 50:50 combinations of Ledermix/Ca(OH)₂ and Odontopaste/ Ca(OH)₂) was introduced into the flow cell and biofilms were harvested and quantitated by determining cellular protein. Cellular viability was determined using serial plating and the number of colony forming units was normalised against cellular protein to allow treatment protocols to be compared. Qualitative SEM analyses of the biofilm were done after a 48-hour exposure to each test agent.

Results

Sodium hypochlorite achieved total bacterial elimination. Ledermix and Odontopaste had no significant effect on the E. faecalis biofilm. Ca(OH)₂ and 50:50 combinations of Ca(OH)₂ /Ledermix or Ca(OH)₂/Odontopaste reduced the viability by > 99% while 0.2% chlorhexidine reduced bacterial numbers by 97%.

Conclusion

Sodium hypochlorite remains the gold standard for bacterial elimination in root canal therapy. However, Ca(OH)₂ in isolation and combined with Ledermix, and Odontopaste was highly effective in reducing bacterial viability.

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