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      Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study

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          ABSTRACT

          Aim: To evaluate and compare the antibacterial efficacy of turmeric extract as an intracanal medicament against E. faecalis and its effect on the microhardness of root dentin in comparison with calcium hydroxide and 2% chlorhexidine gel.

          Materials and methods: One hundred and fourty dentin blocks were prepared from 70 extracted human single-rooted teeth and standardized. For antibacterial assessment, 120 blocks were infected for 21 days with E. faecalis (n = 24/group). Dentin blocks were treated with group I (Ca(OH) 2), group II (2% chlorhexidine gel), group III (turmeric extract), group IV (saline) and group V (negative control). Dentin shavings were obtained in TSB at depth of 400 μm and plated to count CFUs at 24 hours, 3 and 7 days (n = 8/day). For microhardness assessment, eight samples of 2 mm thickness were prepared form four dentin blocks (n = 8/group) . Following treatment with medicaments, microhardness test was performed at 24 hours, 3 and 7 days using Vickers hardness indentation machine at 400 μm from canal lumen.

          Results: Complete inhibition of E. faecalis was observed with group II, followed by 64% with group I and 54% with group III which was statistically highly significant (p < 0.001). Highest effect on microhardness of root dentin was shown by group I, followed by group II and no effect was seen with group III which was statistically highly significant (p < 0.001).

          Conclusion: Turmeric extract has substantial antibacterial activity with no effect on microhardness of root dentine and hence has a potential to be used as intracanal medicament if its antibacterial activity could be enhanced.

          How to cite this article: Prabhakar AR, Swapnil T, Savita H, Sugandhan S. Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study. Int J Clin Pediatr Dent 2013;6(2):171-177.

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          Most cited references12

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          Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis.

          To determine to what extent does calcium hydroxide intracanal medication eliminate bacteria from human root canals, compared with the same canals before medication, as measured by the number of positive cultures, in patients undergoing root canal treatment for apical periodontitis (teeth with an infected root canal system). CENTRAL, MEDLINE and EMBASE databases were searched. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through the Science Citation Index to identify potentially relevant subsequent primary research. The included studies were pre-/post-test clinical trials comparing the number of positive bacterial cultures from treated canals. Data in those studies were independently extracted. Risk differences of included studies were combined using the generic inverse variance and random effect method. Eight studies were identified and included in the review, covering 257 cases. Sample size varied from 18 to 60 cases; six studies demonstrated a statistically significant difference between pre- and post-medicated canals, whilst two did not. There was considerable heterogeneity among studies. Pooled risk difference was -21%; 95% CI: -47% to 6%. The difference between pre- and post-medication was not statistically significant (P = 0.12). Calcium hydroxide has limited effectiveness in eliminating bacteria from human root canal when assessed by culture techniques.
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            Disinfection of dentinal tubules with 2% chlorhexidine, 2% metronidazole, bioactive glass when compared with calcium hydroxide as intracanal medicaments.

            Thorough disinfection of the root canal system is essential for the success of root canal therapy. This requires the use of an intra-canal medicament. Enterococcus faecalis is the most frequently found species in persistent/secondary intracanal infection associated endodontic treatment failure. This study evaluates the disinfection of dentinal tubules using 2% chlorhexidine gel, 2% metronidazole gel, bioactive glass (S53P4) in comparison with calcium hydroxide. The antibacterial efficacy of the four medicaments against Enterococcus faecalis was assessed in vitro using extracted premolar teeth at the depths of 200 microm and 400 microm. The overall percentage inhibition of bacterial growth (at 200 microm and 400 microm depth) was 100% with 2% chlorhexidine gel. The inhibition of growth was moderate with 2% metronidazole gel (86.5%), followed by bioactive glass (62.8%) and calcium hydroxide (58.5%). It can be concluded from the present study that 2% chlorhexidine gel alone was most effective against E. faecalis when compared to other medicaments tested.
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              In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant.

              The objective of this study was to assess the chlorhexidine gluconate gel as an endodontic irrigant. First the ability of chlorhexidine gel to disinfect root canals contaminated in vitro with Enterococcus faecalis was investigated. A scanning electron microscope was also used to evaluate its cleansing ability compared with endodontic irrigants commonly used, such as sodium hypochlorite and chlorhexidine gluconate liquid. The results indicated that the chlorhexidine gel produced a cleaner root canal surface and had an antimicrobial ability comparable with that obtained with the other solutions tested. It was concluded that chlorhexidine gluconate in gel form has potential for use as an endodontic irrigant.
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                Author and article information

                Contributors
                Journal
                Int J Clin Pediatr Dent
                Int J Clin Pediatr Dent
                IJCPD
                International Journal of Clinical Pediatric Dentistry
                Jaypee Brothers Medical Publishers
                0974-7052
                0975-1904
                Sep-Dec 2013
                14 October 2013
                : 6
                : 3
                : 171-177
                Affiliations
                Professor and Head, Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere-577004 Karnataka, India, e-mail: attiguppeprabhakar@gmail.com
                Assistant Professor, Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
                Assistant Professor, Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
                Professor, Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
                Author notes
                Correspondence Author: Professor and Head, Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere-577004 Karnataka, India, e-mail: attiguppeprabhakar@gmail.com
                Article
                10.5005/jp-journals-10005-1213
                4086604
                25206217
                da279129-1569-4364-a661-bb737a04bda4
                Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.

                This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/

                History
                : 08 May 2013
                : 01 August 2013
                Categories
                Research Article

                intracanal medicaments,ca(oh)2,2% chlorhexidine gel,turmeric extract,microhardness

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