Anti-microbial Efficacy of Calcium-hydroxide, 0.02% Chlorhexidine, 1% Metronidazole and Chitosan as Intracanal Medicament – a Double-Blind Invitro Study

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Anti-microbial Efficacy of Calcium-hydroxide, 0.02% Chlorhexidine, 1% Metronidazole and Chitosan as Intracanal Medicament – a Double-Blind Invitro Study

Muhammad Muslim Khahro1, Yusra Shafquat2, Riyasat Ahmed Memon2, Hira Shafquat Memon3, Erum Khan4 and Anny Memon5

1,5 Department  Science of Dental Materials, Liaquat University of Medical and Health Sciences (LUMHS), 2Department of Pathology, Bilawal Medical College for Boys (LUMHS), 3Women Medical Officer, (LUMHS) 4Department of Oral Pathology, (LUMHS)

ABSTRACT

Introduction: Enterococcus faecalis (E.faecalis) and Candida albicans (C.albicans) are mostly found microbes in root canal failure cases. Calcium-hydroxide is most commonly used as intra-canal medicament to control infections. Recent studies show emerging resistance of Enterococcus faecalis and Candida albicans against Calcium-hydroxide, 0.02% chlorhexidine gel, 1% metronidazole gel and a bio polymer chitosan are being used as medicament for different oral infections like gingivitis, ulcers and in intra-canal irrigations. Their role as intra-canal medicament is not established. In this study, we have determined the anti-microbial efficacy of Calcium-hydroxide, chlorhexidine, metronidazole and chitosan against Enterococcus-faecalis and candida-albicans by agar diffusion test, thereby confirming their role as intra-canal medicament.

Objective: In this study, we wanted to determine antimicrobial activity of 0.02% chlorhexidine gel, 1% metronidazole gel and a bio polymer chitosan and their role as intracanal medicament against E.faecalis and C.albicans using Agar diffusion method.

Materials and Methods: Enterococcus faecalis and Candida albicans isolated on culture were subjected to agar diffusion on Muellar-Hinton Agar (MHA) against 1% metronidazole gel, calcium-hydroxide, chitosan and 0.02 % chlorhexidine gel. Zones of inhibition were measured after 24 hours of incubation, presence of which was interpreted as their activity against the organisms. Data was analyzed using SPSS. 

Results: 0.02 % chlorhexidine gel had a zone of inhibition of 10 mm and 12 mm against E.faecalis and C.albicans, suggesting that it can be used as intracanal medicament, whereas 1% metronidazole and calcium hydroxide showed minimal antimicrobial efficacy with 1 mm zone of inhibition for both isolates. Chitosan showed no zone of inhibition.

Conclusion: Our study shows 0.02 % chlorohexidine gel has higher antimicrobial efficacy against E.faecalis and Candida albicans than 1% metronidazole gel, calcium hydroxide and chitosan, suggesting its use as intracanal medicament. However further studies with larger sample size; clinical samples and molecular intervention are needed to establish their role as a definite intracanal medicament.Key words: Intracanal medicament, Enterococcus faecalis, Candida albicans, Antimicrobial efficacy



         

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