Comparative Evaluation of Anti Microbial Efficacy of Phytomedicinal Extracts with Chemical Root Canal Irrigants against Enterococcus Faecalis: An in Vitro Study

Introduction: One of the most important objectives of root canal treatment is elimination of microorganisms from the root canal system that is achievable by augmenting mechanical preparation with antimicrobial irrigants. Enterococcus faecalis considered as the main culprit, is the primary organism detected in persistent asymptomatic infections. A myriad of chemical irrigants like sodium hypochlorite and QMix have been used widely yet the quest for ideal root canal irrigant still continues. The global scenario is now showing a trend towards the use of nontoxic plant products. Herbal products have shown a promising role as root canal irrigants. Thus, this in-vitro study intends to identify the phytoactive compounds present in the phytomedicinal extracts and to evaluate and compare the antimicrobial efficacy of the phytomedicinal extracts with chemical root canal irrigants against E. faecalis. Aim: The aim of this in vitro study is to assess and compare the antimicrobial efficacy of phytomedicinal plant extracts (Neem, Miswak, Cinnamon, Apple cider vinegar) with Sodium hypochlorite and QMix as root canal irrigants against E. faecalis using agar well diffusion assay. Methodology: The methodology was divided into two phases, first being the identification of phytoactive compounds present in the phytomedicinal extracts by gas chromatography mass spectrometry analysis and the second phase included the evaluation of antimicrobial senstivity of the test agents against E. faecalis, which was performed using agar well diffusion assay. Results: All phytomedicinal extracts showed significant antimicrobial activity against E. faecalis(p < 0.001).Cinnamon showed highest antimicrobial activityi.e. highest mean zone of inhibition among all the tested irrigants followed by miswak, QMix, 3% sodium hypochlorite, apple cider vinegar and neem. Conclusion: Hence, phytomedicinal irrigants have huge potential to be used as root canal irrigant as an alternative to chemical root canal irrigants