Antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis in endodontics: A systematic review

Aim: The aim of this systematic review was to investigate the in vitro antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis during root canal treatment. Methods: An electronic databases (PubMed, ScienceDirect, Google Scholar, CENTRAL, Health Advance) was performed (last updated was 1st April 2019). The reference lists of the included studies were hand-searched. Randomized in vitro studies that compared sodium hypochlorite gel to solution as a root canal irrigant were included. No limitation on publication date. Results: Out of 20741 articles, only two studies with 116 human teeth were included in this review. The studies showed 50% high risk of bias, and 50% medium risk of bias for the included studies. Both sodium hypochlorite gel and solution had some bacterial growth inhibition over E. faecalis. The heterogeneity in methodology of the included studies and the lack of high evidence led to contradictory results. However, sodium hypochlorite solution was better in enhancing the antibacterial effect according to the robust study. Conclusion: There is insufficient reliable evidence about the antibacterial effect of sodium hypochlorite gel on enterococcus faecalis. Although the robust study included in this review revealed that sodium hypochlorite gel is less efficient than the solution as a root canal irrigant, further studies are needed to consider the most effective type, concentration, duration and treatment protocols in enhancing the antibacterial effect of sodium hypochlorite. How to cite this article: Al Nesser S, Bshara N, Adıgüzel Ö. Antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis in endodontics: A systematic review. Int Dent Res 2020;10(1):22-29. https://doi.org/10.5577/intdentres.2020.vol10.no1.3 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Antimicrobial Efficacy of a Novel Root Canal Irrigant Made from Coconut and Bromelain Extract against Biofilm Forming Pathogens– An In vitro Evaluation

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.00909 ◽

2021 ◽

pp. 5222-5226

Author(s):

Jerry Jose ◽

Ajitha Palanivelu

Keyword(s):

Candida Albicans ◽

Enterococcus Faecalis ◽

Sodium Hypochlorite ◽

Root Canal ◽

Antimicrobial Efficacy ◽

Diffusion Method ◽

Measured Quantity ◽

Zone Of Inhibition ◽

Root Canal Irrigant

Objective: Sodium hypochlorite is shown to be a gold standard intracanal irrigant which has shown to have adequate antimicrobial properties and tissue dissolving properties. The toxicity of these irrigants are seen to be high towards various cells. Natural irrigants provide an alternative to show adequate antimicrobial activity and lesser cytotoxicity potential. The current study proposes a novel intracanal irrigant made from coconut and bromelain extract. Material and Methods: 10grams of sodium hydroxide was dissolved in deionized water followed by which 60ml of coconut oil was added to the warm water bath (40C). The final product was left to dry and crushed manually to powder. This powder was then taken in measured quantity to make a final product containing 20% of coconut and 4% of bromelain. The obtained irrigant was then evaluated against Enterococcus faecalis using Agar well diffusion method. Results: For the natural irrigant, the maximum zone of inhibition was seen highest at 22mm against Enterococcus faecalis and 25mm against Candida Albicans. For 3% sodium hypochlorite when compared against Enterococcus faecalis and Candida Albicans showed a maximum zone of inhibition at 33mm against Enterococcus faecalis and 35mm against Candida Albicans. Conclusion: The study shows that the novel irrigant derived from coconut and bromelain extract has a good antimicrobial efficacy against Enterococcus faecalis and Candida albicans. It can be concluded that it has a potential application as a root canal irrigant for root canal disinfection.

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Comparison of Herbal Agents with Sodium Hypochlorite as Root Canal Irrigant: A Systematic Review of In Vitro Studies

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8967219 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Kavalipurapu Venkata Teja ◽

Krishnamachari Janani ◽

Kumar Chandan Srivastava ◽

Deepti Shrivastava ◽

Jerry Jose ◽

...

Keyword(s):

Systematic Review ◽

Sodium Hypochlorite ◽

Root Canal ◽

Research Question ◽

In Vitro Studies ◽

Microbial Load ◽

Antimicrobial Efficiency ◽

Significant Difference ◽

Root Canal Irrigant

During endodontic treatment, eliminating microorganisms from the root canals should be considered with utmost importance. Before filling the canal, every effort should be made to ensure optimal shaping and adequate disinfection of the root canal system. This systematic review aimed to compare the efficacy of herbal agents with sodium hypochlorite (NaOCl) in reducing the microbial load while used as a root canal irrigant. The research question in the present study was to assess “Is there a significant difference in reducing microbial load comparing sodium hypochlorite (NaOCl) and herbal agents.” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to November 2020 using strict inclusion and exclusion criteria and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Only in vitro studies comparing herbal agents with NaOCl regarding antimicrobial efficiency were included. Two reviewers independently assessed the included article. 825 articles were obtained from an electronic database. Twenty papers were included for review of the full text. Eleven papers were excluded because they did not meet the inclusion criteria. Finally, nine articles were included in the systematic review. The present systematic review was at the in vitro level; therefore, the result cannot translate the exact clinical conditions. This systematic review concludes that herbal agents cannot be used as a main irrigant for canal disinfection.

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