Antimicrobial Efficacy of Saline, Chlorhexidine, and Zataria Multiflora and Mentha Piperita Essential Oils in Root Canal Irrigation of Primary Molars
,
Abstract
Objectives: This study aimed to compare the antimicrobial efficacy of saline, 0.5% and 2% Zataria multiflora (Z. multiflora) essential oil, 0.5% and 2% Mentha piperita (M. piperita) essential oil, and 0.2% chlorhexidine (CHX) as root canal irrigants for primary molar teeth.
Materials and Methods: A total of 64 primary molars were used in this in vitro study. The teeth were randomly assigned to six groups (N=10). The root canals were prepared up to file #35, and all teeth were sterilized before contamination with Enterococcus faecalis (E. faecalis; ATCC 29212) suspension. After 48 hours of incubation, the root canals in each group were irrigated with the respective irrigants. Sterile paper points were then used to collect microbial samples from the root canals. A colony counter was used to count the number of colony-forming units (CFUs). Data were analyzed by SPSS version 20 (alpha=0.05).
Results: The colony count was significantly different among the groups (P<0.001), and 2% M. piperita (P=0.009), 0.5% Z. multiflora (P=0.021), and 0.2% CHX (P=0.002) were significantly more effective than saline in elimination of E. faecalis. The ascending order of microbial count after irrigation was as follows: saline > 0.5% M. piperita > 0.2% CHX > 2% M. piperita > 0.5% Z. multiflora.
Conclusion: The current study showed the optimal antibacterial activity of 0.5% Z. multiflora essential oil and 2% M. piperita essential oil against E. faecalis, and indicated their possible efficacy for use as an irrigant for root canal irrigation of primary molars.
1. Siqueira JF, Jr., Rôças IN. Bacterial pathogenesis and mediators in apical periodontitis. Braz Dent J. 2007;18(4):267-80.
2. Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent. 2010;13(4):233-9.
3. Ansari GH, Tabari M, Kazemi B. Assessment of pathogens microorganisms of periapical abscess in primary teeth. J Dent Sch. 2005;22(4):567-73.
4. Javidi M, Behravan J, Goudarzi M, Bagherpour Z. An in vitro evaluation of antimicrobial activity of NaClO and chlorhexidine as intracanal irrigants on streptococcus faecalis. J Mashhad Dent Sch. 2007;31(3):177-82.
5. Dean J, Avery D, McDonald R. Dentistry for the child and adolescent 11th ed. Maryland Heights, Missouri: Mosbey Elsevier Co., 2022.chapter 4, p 95.
6. Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological aspects of root canal infections and disinfection strategies: An update review on the current knowledge and challenges. Front Oral Health. 2021 Jun;2:672887.
7. Rahimi S, Janani M, Lotfi M, Shahi S, Aghbali A, Vahid Pakdel M, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014;9(3):161-8.
8. Behnen MJ, West LA, Liewehr FR, Buxton TB, McPherson JC. Antimicrobial activity of several calcium hydroxide preparations in root canal dentin. J Endod. 2001 Dec;27(12):765-7.
9. Lindfors J. A comparison of an antimicrobial wound cleanser to normal saline in reduction of bioburden and its effect on wound healing. Ostomy Wound Manag. 2004 Aug;50(8):28-41.
10. Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L, Rodiles A, et al. Effects of chlorhexidine mouthwash on the oral microbiome. Sci Rep. 2020 Mar;10(1):5254.
11. Ferraz CCR, de Almeida Gomes BPF, Zaia AA, Teixeira FB, de Souza-Filho FJ. In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant. J Endod. 2001 Jul;27(7):452-5.
12. Ringel AM, Patterson SS, Newton CW, Miller CH, Mulhern JM. In vivo evaluation of chlorhexidine gluconate solution and sodium hypochlorite solution as root canal irrigants. J Endod. 1982 May;8(5):200-4.
13. Gonçalves LS, Rodrigues RCV, Andrade Junior CV, Soares RG, Vettore MV. The effect of sodium hypochlorite and chlorhexidine as irrigant solutions for root canal disinfection: A systematic review of clinical trials. J Endod. 2016 Apr;42(4):527-32.
14. Okino LA, Siqueira EL, Santos M, Bombana AC, Figueiredo JAP. Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel. Int Endod J. 2004 Jan;37(1):38-41.
15. Sandasi M, Leonard CM, Van Vuuren SF, Viljoen AM. Peppermint (Mentha piperita) inhibits microbial biofilms in vitro. S. Afr J Bot. 2011 Jan;77(1):80-5.
16. Ashrafi B, Rashidipour M, Marzban A, Soroush S, Azadpour M, Delfani S, et al. Mentha piperita essential oils loaded in a chitosan nanogel with inhibitory effect on biofilm formation against S. mutans on the dental surface. Carbohydr Polym. 2019 May;212:142-9.
17. Beyki M, Zhaveh S, Khalili ST, Rahmani-Cherati T, Abollahi A, Bayat M, et al. Encapsulation of Mentha piperita essential oils in chitosan–cinnamic acid nanogel with enhanced antimicrobial activity against Aspergillus flavus. Ind Crops Prod. 2014 Mar;54:310-9.
18. Ravanshad S, Basiri E, Mohammadzadeh M. In vitro evaluation of the antimicrobial effectiveness of Zataria multiflora as an irrigant in infected root canals with Enterococcus faecalis. J Dent. 2009 Jun;10(2):92-8.
19. Kranz S, Guellmar A, Braeutigam F, Tonndorf-Martini S, Heyder M, Reise M, et al. Antibacterial effect of endodontic disinfections on Enter-ococcus faecalis in dental root canals-An in-vitro model study. Materials. 2021 May;14(9):2427.
20. Heidari AR. Comparative evaluation of antiseptic effects of sodium hypochlorite, thyme essence and normal saline in root canal irrigation of primary teeth. J Dent Med. 2014;27(3):161-7.
21. Hasheminiya SM, Havaee SA, Rajabi M. Antibacterial and substantivity evaluation of 2.5% sodium hypochlorite, 0.2% cholorhexidine and distilled water as root canal irrigants (In - vitro). J Islam Dent Assoc Iran. 2005 Aug;17(5):38-45.
22. Almyroudi A, Mackenzie D, McHugh S, Saunders WP. The effectiveness of various disinfectants used as endodontic intracanal medications: An in vitro study. J Endod. 2002 Mar;28(3):163-7.
23. Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TB, McPherson JC. In vitro antimicrobial activity of various medication preparations on E. faecalis in root canal dentin. J Endod. 2003 Mar;29(3):187-90.
24. Shabahang S, Torabinejad M. Effect of MTAD on Enterococcus faecalis–contaminated root canals of extracted human teeth. J Endod. 2003 Sep;29(9):576-9.
25. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, et al. A new solution for the removal of the smear layer. J Endod. 2003 Mar;29(3):170-5.
26. Önçağ Ö, Hoşgör M, Hilmioğlu S, Zekioğlu O, Eronat C, Burhanoğlu D. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J. 2003 Jun;36(6):423-32.
27. Faria G, Nelson-Filho P, Freitas AC, Assed S, Ito IY. Antibacterial effect of root canal preparation and calcium hydroxide paste (Calen) intracanal dressing in primary teeth with apical periodontitis. J Appl Oral Sci. 2005;13(4):351-5.
28. Khosravi Eghbal R, Akhavan Sepahy A, Khanafari A. Comparison of antimicrobial effects of silver and cooper nanoparticles and chlorinated chemicals on Bacillus subtilis and Bacillus cereus spores and vegetative cells. J Microbiol Biotechnol. 2011;2(7):37-44.
29. Javidi M, Behravan J, Goodarzi M, Bagherpoor Z. An In Vitro Evaluation of Antimicrobial Activity of NaClO and Chlorhexidine as Intracanal Irrigants on Streptococcus Faecalis. J Mashhad Dent Sch. 2007;31(3):177-82.
30. Khayat A, Sahebi S, Moazami F. Antimicrobial effect of naocl, hydrated Ca (OH2), thyme oil and normal saline as irrigating solutions on black pigmented and strep viridance. J Dent (Shiraz). 2019 Jan;4(3):19-28.
31. Mallya L, Shenoy R, Mala K, Shenoy S. Evaluation of the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis: An in-vitro study. J Conserv Dent. 2019 Jul;22(4):367-70.
32. Nourzadeh M, Amini A, Fakoor F, Raoof M, Sharififar F. Comparative Antimicrobial Efficacy of Eucalyptus Galbie and Myrtus Communis L. Extracts, Chlorhexidine and Sodium Hypochlorite against Enterococcus Faecalis. Iran Endod J. 2017;12(2):205-10.
33. Sedigh-Shams M, Badiee P, Adl A, Sarab MD, Abbaszadegan A, Nabavizadeh M. In vitro comparison of antimicrobial effect of sodium hypochlorite solution and Zataria multiflora essential oil as irrigants in root canals contaminated with Candida albicans. J Conserv Dent. 2016 Jan;19(1):101-5.
34. Mathew J, Pathrose S, Kottoor J, Karaththodiyil R, Alani M, Mathew J. Evaluation of an Indigenously Prepared Herbal Extract (EndoPam) as an Antimicrobial Endodontic Irrigant: An Ex Vivo Study. J Int Oral Health. 2015 Jun;7(6):88-91.
35. Sharififar F, Moshafi MH, Mansouri SH, Khodashenas M, Khoshnoodi M. In vitro evaluation of antibacterial and antioxidant activities of the essential oil and methanol extract of endemic Zataria multiflora Boiss. Food Control. 2007 Jul;18(7):800-5.
36. Haindongo N, Anyogu A, Ekwebelem O, Anumudu C, Onyeaka H. Antibacterial and antibiofilm effects of garlic (Allium sativum), ginger (Zingiber officinale) and mint (Mentha piperta) on Escherichia coli biofilms. Food Sci Appl Biotechnol. 2021 Oct;4(2):166-76.
37. Sivropoulou A, Kokkini S, Lanaras T, Arsenakis M. Antimicrobial activity of mint essential oils. J Agric Food Chem. 1995 Sep;43(9):2384-8.
38. Joy Sinha D, K DSN, Jaiswal N, Vasudeva A, Prabha Tyagi S, Pratap Singh U. Antibacterial Effect of Azadirachta indica (Neem) or Curcuma longa (Turmeric) against Enterococcus faecalis Compared with That of 5% Sodium Hypochlorite or 2% Chlorhexidine in vitro. Bull Tokyo Dent Coll. 2017;58(2):103-9.
39. da Silva TM, Alves FR, Lutterbach MT, Paiva MM, Ferreira DdC. Comparison of antibacterial activity of alexidine alone or as a final irrigant with sodium hypochlorite and chlorhexidine. BDJ Open. 2018 Jun 1:4:18003.
40. Zehnder M. Root Canal Irrigants. J Endod. 2006 May;32(5):389-98.
2. Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent. 2010;13(4):233-9.
3. Ansari GH, Tabari M, Kazemi B. Assessment of pathogens microorganisms of periapical abscess in primary teeth. J Dent Sch. 2005;22(4):567-73.
4. Javidi M, Behravan J, Goudarzi M, Bagherpour Z. An in vitro evaluation of antimicrobial activity of NaClO and chlorhexidine as intracanal irrigants on streptococcus faecalis. J Mashhad Dent Sch. 2007;31(3):177-82.
5. Dean J, Avery D, McDonald R. Dentistry for the child and adolescent 11th ed. Maryland Heights, Missouri: Mosbey Elsevier Co., 2022.chapter 4, p 95.
6. Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological aspects of root canal infections and disinfection strategies: An update review on the current knowledge and challenges. Front Oral Health. 2021 Jun;2:672887.
7. Rahimi S, Janani M, Lotfi M, Shahi S, Aghbali A, Vahid Pakdel M, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014;9(3):161-8.
8. Behnen MJ, West LA, Liewehr FR, Buxton TB, McPherson JC. Antimicrobial activity of several calcium hydroxide preparations in root canal dentin. J Endod. 2001 Dec;27(12):765-7.
9. Lindfors J. A comparison of an antimicrobial wound cleanser to normal saline in reduction of bioburden and its effect on wound healing. Ostomy Wound Manag. 2004 Aug;50(8):28-41.
10. Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L, Rodiles A, et al. Effects of chlorhexidine mouthwash on the oral microbiome. Sci Rep. 2020 Mar;10(1):5254.
11. Ferraz CCR, de Almeida Gomes BPF, Zaia AA, Teixeira FB, de Souza-Filho FJ. In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant. J Endod. 2001 Jul;27(7):452-5.
12. Ringel AM, Patterson SS, Newton CW, Miller CH, Mulhern JM. In vivo evaluation of chlorhexidine gluconate solution and sodium hypochlorite solution as root canal irrigants. J Endod. 1982 May;8(5):200-4.
13. Gonçalves LS, Rodrigues RCV, Andrade Junior CV, Soares RG, Vettore MV. The effect of sodium hypochlorite and chlorhexidine as irrigant solutions for root canal disinfection: A systematic review of clinical trials. J Endod. 2016 Apr;42(4):527-32.
14. Okino LA, Siqueira EL, Santos M, Bombana AC, Figueiredo JAP. Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel. Int Endod J. 2004 Jan;37(1):38-41.
15. Sandasi M, Leonard CM, Van Vuuren SF, Viljoen AM. Peppermint (Mentha piperita) inhibits microbial biofilms in vitro. S. Afr J Bot. 2011 Jan;77(1):80-5.
16. Ashrafi B, Rashidipour M, Marzban A, Soroush S, Azadpour M, Delfani S, et al. Mentha piperita essential oils loaded in a chitosan nanogel with inhibitory effect on biofilm formation against S. mutans on the dental surface. Carbohydr Polym. 2019 May;212:142-9.
17. Beyki M, Zhaveh S, Khalili ST, Rahmani-Cherati T, Abollahi A, Bayat M, et al. Encapsulation of Mentha piperita essential oils in chitosan–cinnamic acid nanogel with enhanced antimicrobial activity against Aspergillus flavus. Ind Crops Prod. 2014 Mar;54:310-9.
18. Ravanshad S, Basiri E, Mohammadzadeh M. In vitro evaluation of the antimicrobial effectiveness of Zataria multiflora as an irrigant in infected root canals with Enterococcus faecalis. J Dent. 2009 Jun;10(2):92-8.
19. Kranz S, Guellmar A, Braeutigam F, Tonndorf-Martini S, Heyder M, Reise M, et al. Antibacterial effect of endodontic disinfections on Enter-ococcus faecalis in dental root canals-An in-vitro model study. Materials. 2021 May;14(9):2427.
20. Heidari AR. Comparative evaluation of antiseptic effects of sodium hypochlorite, thyme essence and normal saline in root canal irrigation of primary teeth. J Dent Med. 2014;27(3):161-7.
21. Hasheminiya SM, Havaee SA, Rajabi M. Antibacterial and substantivity evaluation of 2.5% sodium hypochlorite, 0.2% cholorhexidine and distilled water as root canal irrigants (In - vitro). J Islam Dent Assoc Iran. 2005 Aug;17(5):38-45.
22. Almyroudi A, Mackenzie D, McHugh S, Saunders WP. The effectiveness of various disinfectants used as endodontic intracanal medications: An in vitro study. J Endod. 2002 Mar;28(3):163-7.
23. Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TB, McPherson JC. In vitro antimicrobial activity of various medication preparations on E. faecalis in root canal dentin. J Endod. 2003 Mar;29(3):187-90.
24. Shabahang S, Torabinejad M. Effect of MTAD on Enterococcus faecalis–contaminated root canals of extracted human teeth. J Endod. 2003 Sep;29(9):576-9.
25. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, et al. A new solution for the removal of the smear layer. J Endod. 2003 Mar;29(3):170-5.
26. Önçağ Ö, Hoşgör M, Hilmioğlu S, Zekioğlu O, Eronat C, Burhanoğlu D. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J. 2003 Jun;36(6):423-32.
27. Faria G, Nelson-Filho P, Freitas AC, Assed S, Ito IY. Antibacterial effect of root canal preparation and calcium hydroxide paste (Calen) intracanal dressing in primary teeth with apical periodontitis. J Appl Oral Sci. 2005;13(4):351-5.
28. Khosravi Eghbal R, Akhavan Sepahy A, Khanafari A. Comparison of antimicrobial effects of silver and cooper nanoparticles and chlorinated chemicals on Bacillus subtilis and Bacillus cereus spores and vegetative cells. J Microbiol Biotechnol. 2011;2(7):37-44.
29. Javidi M, Behravan J, Goodarzi M, Bagherpoor Z. An In Vitro Evaluation of Antimicrobial Activity of NaClO and Chlorhexidine as Intracanal Irrigants on Streptococcus Faecalis. J Mashhad Dent Sch. 2007;31(3):177-82.
30. Khayat A, Sahebi S, Moazami F. Antimicrobial effect of naocl, hydrated Ca (OH2), thyme oil and normal saline as irrigating solutions on black pigmented and strep viridance. J Dent (Shiraz). 2019 Jan;4(3):19-28.
31. Mallya L, Shenoy R, Mala K, Shenoy S. Evaluation of the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis: An in-vitro study. J Conserv Dent. 2019 Jul;22(4):367-70.
32. Nourzadeh M, Amini A, Fakoor F, Raoof M, Sharififar F. Comparative Antimicrobial Efficacy of Eucalyptus Galbie and Myrtus Communis L. Extracts, Chlorhexidine and Sodium Hypochlorite against Enterococcus Faecalis. Iran Endod J. 2017;12(2):205-10.
33. Sedigh-Shams M, Badiee P, Adl A, Sarab MD, Abbaszadegan A, Nabavizadeh M. In vitro comparison of antimicrobial effect of sodium hypochlorite solution and Zataria multiflora essential oil as irrigants in root canals contaminated with Candida albicans. J Conserv Dent. 2016 Jan;19(1):101-5.
34. Mathew J, Pathrose S, Kottoor J, Karaththodiyil R, Alani M, Mathew J. Evaluation of an Indigenously Prepared Herbal Extract (EndoPam) as an Antimicrobial Endodontic Irrigant: An Ex Vivo Study. J Int Oral Health. 2015 Jun;7(6):88-91.
35. Sharififar F, Moshafi MH, Mansouri SH, Khodashenas M, Khoshnoodi M. In vitro evaluation of antibacterial and antioxidant activities of the essential oil and methanol extract of endemic Zataria multiflora Boiss. Food Control. 2007 Jul;18(7):800-5.
36. Haindongo N, Anyogu A, Ekwebelem O, Anumudu C, Onyeaka H. Antibacterial and antibiofilm effects of garlic (Allium sativum), ginger (Zingiber officinale) and mint (Mentha piperta) on Escherichia coli biofilms. Food Sci Appl Biotechnol. 2021 Oct;4(2):166-76.
37. Sivropoulou A, Kokkini S, Lanaras T, Arsenakis M. Antimicrobial activity of mint essential oils. J Agric Food Chem. 1995 Sep;43(9):2384-8.
38. Joy Sinha D, K DSN, Jaiswal N, Vasudeva A, Prabha Tyagi S, Pratap Singh U. Antibacterial Effect of Azadirachta indica (Neem) or Curcuma longa (Turmeric) against Enterococcus faecalis Compared with That of 5% Sodium Hypochlorite or 2% Chlorhexidine in vitro. Bull Tokyo Dent Coll. 2017;58(2):103-9.
39. da Silva TM, Alves FR, Lutterbach MT, Paiva MM, Ferreira DdC. Comparison of antibacterial activity of alexidine alone or as a final irrigant with sodium hypochlorite and chlorhexidine. BDJ Open. 2018 Jun 1:4:18003.
40. Zehnder M. Root Canal Irrigants. J Endod. 2006 May;32(5):389-98.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v21i19.15682 | |
| Keywords | ||
| Root Canal Irrigants Tooth Deciduous Root Canal Therapy Herbal Medicine | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Pordel E, Kiani M, Jafari A, Heidari AR, Bakhtiari R. Antimicrobial Efficacy of Saline, Chlorhexidine, and Zataria Multiflora and Mentha Piperita Essential Oils in Root Canal Irrigation of Primary Molars. Front Dent. 2024;21.
