Comparative Evaluation of Antimicrobial Efficacy of Terminalia Chebula and Commercially Available Intracanal Medicament Against Enterococcus faecalis - An In Vitro Study
Abstract
Purpose: The purpose of the paper was in vitro evaluation of antimicrobial activity of different extracts of Terminalia chebula fruit in comparison with commercially available intracanal medicament Ca(OH)2 against Enterococcus faecalis after quantitative determination of the phytochemical constituents of Terminalia chebula.
Materials and Methods: T. chebula fruit was Procured from Mysuru District and Ultrasonic Assisted Extraction (UAE) was carried out using three different solvents (ethanol, methanol, aqueous), quantitative determination of the phenolics was carried out by Folin-Ciocalteu colorimetric method, and flavonoids by Aluminium chloride colorimetric method for the different extracts of T. chebula and In vitro evaluation of antimicrobial activity of different extracts of T. chebula against E faecalis was carried out by disc diffusion assay( Zone of Inhibition) and compared with calcium hydroxide.
Results: Experiments were carried out in triplicates and analysed using SPSS for Windows version 17.0.Continuous data was represented as mean and standard deviation. P-value by analysis of variance (ANOVA) with Bonferroni’s multiple group comparisons in order to ascertain statistical significance of different groups was done. p value<0.05 was considered as statistically significant. The highest total extraction yield was obtained for Ethanolic extract. The lowest yield was obtained with the Aqueous Extract by UAE. Quantitative analysis of the TPC (Total Phenolic Content) and TFC (Total Flavonoid Content) revealed that the highest amount of TPC (156.61±0.046 mg GAE/g) and TFC (81.82±0.001 mg QE/g) was found in the AETC followed by METC and EETC. EETC 100%,(19.67±1.5mm) 50%(15±1mm), 25%(7±1mm) has shown better antimicrobial efficacy (Zone of inhibition) when compared to METC and AETC extracts. Zone of Inhibition at 100 % concentration of EETC (19.67±1mm) was comparable to the standard intracanal medicament calcium hydroxide (20±1mm).
Conclusion: T. chebula extract proved to be a potent antimicrobial agent against Enterococcus faecalis, with active phytoconstituents such as phenols and flavonoids. It can be develop to form an effective and safe oral care product.
NOVELTY OF THE WORK:
Despite breakthroughs in root canal equipment and instrumentation techniques, endodontic failures still occur. Treatment-resistant bacteria cause re-infection. In untreated canals, gram-positive facultative anaerobe Enterococcus faecalis causes infections. It's an endodontic pathogen that may persist in alkaline settings as a monoculture. Calcium hydroxide is a successful intracanal medicament, however it's hard to remove from root canal walls before obturation, harming the apical seal. Recent research reveals alkalinity denatures carboxylate and phosphate groups, producing dentine collapse. Multiple studies demonstrate E. faecalis is resistant to Ca(OH)2's alkaline environment. Ca(OH)2 is used for permanent teeth but not deciduous teeth since it produces inflammation and odontoclasts. ms have been used to heal for ages. Considering the shortcomings of the above, in an attempt to develop a resistance free, effective intracanal medicament for the use in dentistry. Therefore the aim of the study was to evaluate the Terminalia chebula yield obtained under three different solvent extractions, determination of the total phenolic content and the total flavonoid content; and to compare the antimicrobial efficacy of T. chebula with commercially available Intracanal medicament against Enterococcus faecalis.
