Antibacterial Efficacy of Ethyl Acetate Fraction of Siwak (Salvadora persica)-NaOCl Combination as a Root Canal Irrigant against Enterococcus faecalis: An In Vitro Study
DOI:
https://doi.org/10.31983/jkg.v12i1.13605Keywords:
Salvadora persica, root canal irrigants, sodium hypochlorite, Enterococcus faecalis, antibacterial agentsAbstract
Root canal irrigant is a very important factor in supporting the success of root canal treatment. The currently recommended combination of sodium hypochlorite (NaOCl), ethylenediamintetraacetic acid (EDTA), and chlorhexidine has many drawbacks including toxicity to periapical tissues, bad taste, negative interactions between ingredients, and extended application time. Siwak (Salvadora persica) stem extract has been widely studied in its use as a dental material, including as a root canal irrigant. This study aims to formulate the ethyl acetate fraction of siwak with low concentration NaOCl, and test its antibacterial potential against E. faecalis. This research used 9 groups, namely the ethyl acetate fraction (FEA) of siwak ethanol extract with the concentrations of 1.25 mg/ml, 2.5 mg/ml, 5 mg/ml, a combination of FEA siwak 1.25 mg/ml + NaOCl 1.25%, FEA siwak 2.5 mg/ml + NaOCl 1.25%, FEA siwak 5 mg/ml + NaOCl 1.25%, NaOCl 1,25%, saline, and chlorhexidine. Based on the number of colony counts, the most significant inhibition was seen in the combination group of FEA siwak 5 mg/ml + NaOCl 1.25%. Data analysis was carried out using the One Way ANOVA test with a significance value of 0.00 (p <0.05) followed by the Post Hoc LSD test with a significance value of 0.130 (p>0.05) in the comparison between the combination group of FEA siwak 5 mg/ml + NaOCl 1.25% with chlorhexidine. The combination of FEA siwak 5 mg/ml + NaOCl 1.25% has the same effectiveness as chlorhexidine 2% in inhibiting E. faecalis bacteria, and potential as a root canal irrigant.
References
World Health Organization, Global oral health status report: towards universal health coverage for oral health by 2030. In Global oral health status report: towards universal health coverage for oral health by 2030, 2022.
Berman, L. H. and Hargreaves, K. M., Cohen's Pathways of the Pulp. 12thed., 2021.
Ali, A., Bhosale A., Pawar S., Kakti A., Bichpuriya A., and Agwan M.A., Current Trends in Root Canal Irrigation, Cureus, 14(5), pp. 1-8, 2022. doi: 10.7759/cureus.24833.
Srikhakollu, R. Narra V., Ramanan V., Tatikonda S., Dham A., and Jayaprakash H., 'Root Canal Irrigants - What Are We Up to!', Acta sci. dent. sci., 6(6), pp. 129-131, 2022..
Wright, P. P., Kahler, B., and Walsh, L. J., Alkaline sodium hypochlorite irrigant and its chemical interactions. Materials, 10(10), 1147, 2017.
Hegde, A., Shetty, P., & Bhat, R., Insight on the Use and Abuse of Sodium Hypochlorite in Endodontics: A Review. Int J Dent Oral Sci., 8(8), 4028-31, 2021.
Abuhaimed, T. S. and Neel, E. A. A., Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin, BioMed Res. Int., 2017. doi: 10.1155/2017/1930360.
Rossi-Fedele, G., Doramac A., Gustalli A. R., Steier L., and Figueiredo J. A., Antagonistic Interactions Between Sodium Hypochlorite, Chlorhexidine, EDTA, and Citric Acid, Journal of Endodontics, 38(4), pp. 426-431, 2012.
Karataş, E., Özsu Kirici, D. and Arslan, H., Postoperative pain after the use of sodium hypochlorite gel and solution forms: a randomized clinical study, Eur. Endod. J., 6(1), pp. 34-37, 2021, doi: 10.14744/eej.2020.08370.
Tekin B., and Demirkaya K., Natural Irrigation Solution in Endodontics, Gulhane Med. J., 62: 133-8, 2020.
Jain, P., and Ranjan M., Role of herbs in root canal irrigation-a review, IOSR J. Pharm. Biol. Sci., 9(2), pp. 06-10, 2014, doi: 10.9790/3008-09260610.
Al Qarni, F. M., ElFasakhany, F. M., Kenawi, L. M., & Moustafa, A. M., Antimicrobial activity of Azadirachta indica (neem) and Salvadora persica (siwak) extracts as endodontic irrigants, Endodontic Practice Today, 13(3), 2019.
Tabatabaei F., Moezizadeh, M., and Javand, F., Effects of extracts of Salvadora persica on proliferation and viability of human dental pulp stem cells. J. Conserv. Dent., 18(4), 315, 2015.
Girji, S. S., Nadig, R. R. and Pai, V. S., Root canal irrigant combining salvadora persica with sodium hypochlorite - antimicrobial, tissue dissolution, chelating action & changes in Ca/P of root dentin: in vitro study, Int. J. Sci. Res., pp. 1-5, June 2022, doi: 10.36106/ijsr/2026962.
Vedavathi, B., Evaluation of antimicrobial action, pulp tissue dissolution, and smear layer removal of an experimental irrigant combining Salvadora persica and sodium hypochlorite with and without ultrasonic activation: An in vitro study. Int. J. Preventive Clin. Dent. Res., 9(3), 63, 2022.
Abdel-Kader MS, Alam P, Kamal YT, Alkharfy KM, Foudah AI, Alqasoumi SI. Optimization of the extraction conditions for benzyl isothiocyanate contents in Salvadora persica roots "Siwak". Saudi Pharmaceutical Journal: SPJ, Apr 2019, 20;27(6):753.
Maslahah N. Standard of Simplisia of Medicinal Plants as Herbal Preparation Materials. Warta BSIP Perkebunan, 31;2(2):1-4, Aug 2024.
Indonesian Ministry of Health. Indonesian Herbal Pharmacopoeia (II). Ministry of Health of the Republic of Indonesia, 2017.
Prasetya IW, Putra GG, Wrasiati LP. Effect of Solvent Type and Maceration Time on Cocoa Bean Shell Extract (Theobroma Cacao L.) as an Antioxidant Source. Journal of Agroindustry Engineering and Management, ISSN:2503:150-9, 2020.
Abubakar AR, Haque M. Preparation of medicinal plants: Basic extraction and fractionation procedures for experimental purposes. Journal of Pharmacy and Bioallied Sciences, 1;12(1):1-0, Jan 2020.
Balouiri M, Sadiki M, Ibnsouda SK. Methods for in vitro evaluating antimicrobial activity: A review, Journal of pharmaceutical analysis, 1;6(2):71-9, Apr 2016.
Gonzalez-Pastor R, Carrera-Pacheco SE, Zúñiga-Miranda J, RodrÃguez-Pólit C, Mayorga-Ramos A, Guamán LP, Barba-Ostria C. Current landscape of methods to evaluate antimicrobial activity of natural extracts. Molecules, 28(3):1068, Jan 2023.
Al-Sohaibani, S. A., Antimicrobial activity of Salvadora persica L. extracts against some isolated oral pathogens. Journal of Medicinal Plants Research, 4(16), 1604-1609, 2010.
Elvin-Lewis, M., Plants used for teeth cleaning throughout the world. Journal of Preventive Dentistry, 6(6), 61-70, 1980.
Cushnie, T. P. T., & Lamb, A. J., Antimicrobial activity of flavonoids. International Journal of Antimicrobial Agents, 26(5), 343-356, 2005.
Thiruppathi, S., et al., Antibacterial effect of Salvadora persica (siwak) extracts against oral pathogens: An in vitro study. Journal of Pharmacology & Bioallied Sciences, 4(Suppl 2), S400-S404, 2012.
Haapasalo, M., et al., Endodontic biofilms: How to treat and eradicate them. Journal of Endodontics, 33(11), 1001-1015, 2007.
Mohammadi, Z., & Shalavi, S., Is chlorhexidine an ideal root canal irrigant? Iranian Endodontic Journal, 9(3), 151-158, 2014.
Karim, A., et al., Antimicrobial efficacy of Salvadora persica extract combined with sodium hypochlorite against Enterococcus faecalis. Journal of Endodontic Research, 2022.
Girji, M., et al., Synergistic effect of Salvadora persica extracts and sodium hypochlorite on biofilm disruption. International Journal of Dental Sciences, 2020.
Cowan, M. M., Plant products as antimicrobial agents. Clinical Microbiology Reviews, 12(4), 564-582, 1999.
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