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      Evaluation of the Anti-microbial Efficacy of a Novel Endodontic Irrigant Against Enterococcus faecalis: An In Vitro Study

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      1 , , 2 , 1 , 1 , 1 , 1
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      Cureus
      Cureus
      chlorhexidine, anti-microbial, simvastatin, e. faecalis, irrigant

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          Abstract

          Introduction: Enterococcus faecalis is a constant microbiome that plays an inevitable role in the etiology of peri radicular lesions after endodontic treatment, chronic and, apical periodontitis and, recently, in periimplantitis. The effective biomechanical preparation and the use of potent irrigating solutions will permit bacterial neutralization and toxin inactivation, leading to the success of endodontic treatment. This study aimed to evaluate the "anti-microbial" efficacy of simvastatin (SMV) against E. faecalis as an endodontic irrigant.

          Materials and methods: In this invitro experimental study, the antimicrobial efficacy of SMV was evaluated against E. faecalis using the agar diffusion method. The samples were divided randomly into the following groups. GROUP 1: SMV solution 1 μM/L concentration, GROUP 2: SMV solution 5 μM/L concentration, GROUP 3: SMV solution 10 μM/L concentration, GROUP 4: 2% chlorhexidine gluconate (CHX) solution (positive control), and GROUP 5: normal saline (negative control). Linear measurement was done by measuring the zones of inhibition around the medicaments in the cavities in millimeters. Results were tabulated.

          Results: The results of the study have shown the zone of inhibition of Group 4 (2% CHX solution) is 19 mm, which demonstrated the best outcome. When comparing the test samples, Group 3 (SMV solution 10 M/L concentration) has the best zone of inhibition, measuring 14 mm, followed by Group 2 (SMV solution 5 M/L concentration), which is 9 mm.

          Conclusion: The results of this in vitro study have proven that SMV's anti-microbial activity, albeit less potent than CHX in this in vitro investigation, has demonstrated that it can be utilized as an efficient endodontic irrigant.

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          Most cited references30

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          Microbiological status of root-filled teeth with apical periodontitis

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            Irrigation in endodontics.

            Irrigation is a key part of successful root canal treatment. It has several important functions, which may vary according to the irrigant used: it reduces friction between the instrument and dentine, improves the cutting effectiveness of the files, dissolves tissue, cools the file and tooth, and furthermore, it has a washing effect and an antimicrobial/antibiofilm effect. Irrigation is also the only way to impact those areas of the root canal wall not touched by mechanical instrumentation. Sodium hypochlorite is the main irrigating solution used to dissolve organic matter and kill microbes effectively. High concentration sodium hypochlorite (NaOCl) has a better effect than 1 and 2% solutions. Ethylenediaminetetraacetic acid (EDTA) is needed as a final rinse to remove the smear layer. Sterile water or saline may be used between these two main irrigants, however, they must not be the only solutions used. The apical root canal imposes a special challenge to irrigation as the balance between safety and effectiveness is particularly important in this area. Different means of delivery are used for root canal irrigation, from traditional syringe-needle delivery to various machine-driven systems, including automatic pumps and sonic or ultrasonic energy.
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              The Influence of Enterococcus faecalis as a Dental Root Canal Pathogen on Endodontic Treatment: A Systematic Review

              Endodontic treatment failure may occur due to different causes such as persistence of bacteria, root canals that are poorly cleaned and obturated, improper coronal seal (leakage), and untreated canals (missed canals). The main reason for endodontic failure is the presence of some species of bacteria inside the root canal system such as Enterococcus (E.) faecalis. Those bacteria are more resistant to disinfection agents, causing a persistent intra-radicular or extra-radicular infection. The current review aims to compile all the current studies concerning Enterococcus faecalis as a dental root canal pathogen that causes endodontic failure. In this systemic review, two databases, PubMed and Google Scholar, were searched using specific inclusion and exclusion criteria. Among 2943 studies, only 11 met the inclusion criteria and were included in the review for further analysis. The 11 studies give prominence to the high distribution of Enterococcus faecalis within the root canal system. These studies investigated different aspects of Enterococcus faecalis, including its prevalence, resistance mechanisms, characteristics, express survival genes, and treatment. The compiled data observed that most of the studies highlight Enterococcus faecalis as the primary pathogen associated with endodontic treatment. It has characteristic proprieties that make it capable of escaping disinfection means. Furthermore, clinical trials are required to examine E. faecalis and may provide valuable information about novel microbial detection methods to decrease the number of E. faecalis within the root canal system.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                3 October 2023
                October 2023
                : 15
                : 10
                : e46410
                Affiliations
                [1 ] Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, IND
                [2 ] Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, IND
                Author notes
                Article
                10.7759/cureus.46410
                10620624
                316e76b3-306b-47b6-b93b-593584652f97
                Copyright © 2023, Selvakumar et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 October 2023
                Categories
                Dentistry

                chlorhexidine,anti-microbial,simvastatin,e. faecalis,irrigant

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