Anti-microbial efficacy of four dental medicaments against Enterococcus faecalis and candida albicans

Summary: Role of microbes in pulpal or peri-apical infection is well established. Most common cause of root canal treatment failure is re-contamination of root canals and peri-apical tissues by microbial contamination which leads to apical periodontitis. Enterococcus-faecalis and candida- albicans are most commonly found microbes in root canal failure cases. Calcium-hydroxide is most commonly used as intra-canal medicament to control infections; studies have declared that Enterococcus-faecalis and candida-albicans have developed resistant against Calcium-hydroxide. 0.02% chloro-hexidine gel, 1% metronidazole gel and a bio polymer chitosan are being used as medicament for different oral infections like gingivitis, ulcers and in intra-canal irrigations. 0.12% and 0.2 % chloro-hexidine and chitosan are also being used in tooth pastes and mouth washes but so far their role as intra-canal medicament is not established so the aim of this study was to find out their role as intra-canal medicament. Objective was to determine the anti-microbial efficacy of Calcium-hydroxide, chloro-hexidine, metronidazole and chitosan against Enterococcus-faecalis and candida-albicans. Sensitivity of each agent was determined by Agar diffusion test method. Enterococcus-faecalis and candida-albicans were cultured and then inoculated on ten agar plates along with anti-microbial agents in an incubator at 37 0 C. Zones of growth inhibition were measured in mille meters around the agents after 24 hours and 48 hours. Data was analyzed on SPSS. Mean values of inhibitory zones were calculated with p value less than 0.05. Results: Mean values of inhibitory zones around 1% metronidazole gel, calcium- hydroxide and chitosan were about 6 to 7 mm against e-faecalis and candida-albicans. Inhibitory zones around 0.02 % chloro-hexidine gel against e-faecalis were 16 mm and against candida- albicans were 18 mm. conclusion: 0.02 % chloro hexidine gel determines significantly much higher antimicrobial efficacy against e,faecalis and candida-albicans than 1% metronidazole gel, calcium hydroxide and chitosan.