Time-dependent antibacterial effects of Aloe vera and Zataria multiflora plant essential oils compared to calcium hydroxide in teeth infected with Enterococcus faecalis

Anti-bacterial efficacy of Aloe vera against E. Faecalis in comparison to other intracanal medicaments: A systematic review and meta-analysis

Introduction

This review article aims to evaluate the antibacterial efficacy of Aloe vera against Enterococcus faecalis (E. faecalis) in comparison to other intracanal medicaments by assessing experimental in-vitro studies associated with the objective, many of which performed bacterial inoculation on extracted human teeth or directly on laboratory petri dishes.

Materials & Methods

Publications from 2012 to 2022 were retrieved from databases, including PubMed, Scopus, and Cochrane Library, and they were screened against our inclusion criteria, leading to the incorporation of 18 studies into the systematic review and nine into the meta-analysis. Colony-forming units (CFUs) in the Aloe vera group were compared with saline, sodium hypochlorite (NaOCl), chlorhexidine (CHX), and calcium hydroxide (CaOH) using a meta-analysis (Stata software version 16.0), and forest plots were computed to record the sample size, mean and standard deviation value of the outcome CFU, and 95% confidence intervals.

Results

This systematic review indicates that Aloe vera demonstrates bactericidal properties that are higher than or similar to those of saline and CaOH, but CHX, NaOCl, and propolis exhibited higher antibacterial properties against E. faecalis than Aloe vera. In a meta-analysis, Aloe vera showed a non-significantly lower CFU count than CaOH and saline (p > 0.05), while Aloe vera had a higher CFU count than CHX and NaOCl (p > 0.05).

Conclusion

In summary, Aloe vera exhibits antibacterial capabilities against E. faecalis that are superior or equal to those of saline and CaOH, respectively, while CHX and NaOCl showed greater antibacterial efficacy against E. faecalis than Aloe vera (PROSPERO registration no. CRD42022314790).

Essential oils as adjuvants in endodontic therapy: myth or reality?

To enhance endodontics, the search for new antibacterials that can improve infected tooth root canal treatment is ongoing. As potent antibacterial and antibiofilm agents, essential oils (EOs) have been suggested as novel endodontic materials. Several studies indicate that EO-based irrigants and medicaments show promising reductive potential against the most important intracanal pathogen, Enterococcus faecalis, and notably contribute to intracanal biofilm eradication. In terms of additional benefits that EO-based endodontic materials can provide, their antioxidant and anti-inflammatory potential are also important, but they have only scarcely been explored in research. Investigations into the benefits of EO-based endodontic materials together with their biocompatibility are needed. The results presented in this review strongly encourage further research on this topic.

Caribbean Women's Health and Transnational Ethnobotany

Caribbean Women's Health and Transnational Ethnobotany. Immigrants from the Dominican Republic (DR) and Haiti are among the top foreign-born communities in New York City (NYC). As people migrate to new countries, they bring their ethnomedical beliefs and practices, and adapt their plant pharmacopoeias. Haiti and the DR share a flora on the island of Hispaniola. In NYC, the flora is limited to what is available in the city. We selected plants for future laboratory research based on ethnobotanical data from two surveys among Dominicans in the DR and NYC, and a Haitian literature review. In both Dominican datasets, gynecological infections were the top women's health condition treated with plants. We identified 10 species for this purpose reported by Dominicans that are also known medicines in Haitian culture, although not yet documented for women's health. Plants for gynecological infections potentially cause dysbiosis of the vaginal microbiota, and may increase rather than prevent disease. There is a public health need to assess traditional medicines for their ability to inhibit pathogenic bacteria, while causing minimal disruption to the vaginal flora. Several species are known antibacterials, but remain to be tested for their efficacy. These results also provide a foundation for a planned ethnobotanical survey among NYC Haitian women.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12231-021-09526-3.

A Review on Health Benefits of Malva sylvestris L. Nutritional Compounds for Metabolites, Antioxidants, and Anti-Inflammatory, Anticancer, and Antimicrobial Applications

The utilization of medicinal plants and their derivatives in treating illnesses is more appropriately recognized as herbal remedy than traditional medicine. For centuries, medicinal herbs have been used for the treatment of diseases in many countries. Malva sylvestris L. is a kind of mallow derived from Malvaceae species and is recognized as common mallow. This amazing plant has antimicrobial, hepatoprotective, anti-inflammatory, and antioxidant properties and is considered as one of the most promising herbal medicinal species. This plant's traditional use in treating many diseases and preparing pharmaceutical compounds can show us how to know in depth the plant origin of drugs used to produce antibiotics and other therapeutic agents.

Cymbopogon citratus essential oil: an active principle of nanoemulsion against Enterococcus faecalis root canal biofilm

Aim: The objective was to formulate and characterize the nanoemulsion based on Cymbopogon citratus oil, intended for use in infected teeth root canal therapy. The investigation of the antioxidant and antibiofilm potential toward Enterococcus faecalis was aimed as well. Materials & methods: Characterization of oil (by GC/MS analysis) and nanoemulsion (by dynamic light scattering instrument), and determination of antibacterial (by microdilution assay), antibiofilm (by crystal violet assay) and antioxidant properties (by 2,2-diphenyl-1-picryl-hydrazyl-hydrate and thiobarbituric acid assay methods) were provided. Antibiofilm efficacy of irrigation procedure including nanoemulsion was screened on extracted teeth (by CFU-counting assay). Results: Notable antibacterial and antibiofilm activity, both against forming and preformed biofilms of oil, was observed. Irrigation involved nanoemulsion showed remarkable antibiofilm potential. Both substances induced some antioxidant activity. Conclusion: Results encourage further research with the aim of application of the nanoemulsion in dental practice.

Safety evaluation of Aloe vera soft capsule in acute, subacute toxicity and genotoxicity study

Aloe vera has been widely used in health and nutritional supplements in Chinese herbal medicine. Furthermore, Aloe vera production has been an emerging industry for making cosmetics and functional food. However, the reported adverse effects raised questions as to whether Aloe vera and its products were safe enough to be used in medicine and health care. In view of this, the safety evaluation of Aloe vera products before marketing is very important. The present study aimed to assess the toxicological profile of Aloe vera soft capsule (ASC), through acute, subacute toxicity and genotoxicity tests. Male and female ICR mice were received by oral gavage 15000 mg/kg bodyweight of ASC in the acute toxicity test. Male and female SD rats were fed on diet blended with different doses of ASC (equivalent to 832.5, 1665 and 3330 mg/kg bodyweight of ASC) for the subacute toxicity test. In the acute toxicity study, no mortality or behavioral changes were observed, indicating the LD₅₀ was higher than 15000 mg/kg bodyweight. In the subacute toxicity test, no significant changes were observed in bodyweight, food consumption, hematological, biochemical or histopathological parameters in the rats exposed. These data suggested that ASC used in this study did not produce any marked subacute toxic effects up to a maximum concentration of 3330 mg/kg bodyweight. In the genotoxicity study, ASC showed no mutagenic activity in the Ames test and no evidence of potential to induce bone marrow micronucleus or testicular chromosome aberrations in ICR mice exposed to 10000 mg/kg bodyweight. Collectively, ASC could be considered safe before it was marketed as a laxative and moistening health food.

Efficacy Prediction of Four Pharmaceutical Formulations for Intramammary Administration Containing Aloe vera (L.) Burm. f. Combined With Ceftiofur or Cloxacillin in Lactating Cows as an Alternative Therapy to Treat Mastitis Caused by Staphylococcus aureus

Synergy or additive effect between Aloe vera (L.) Burm.f. and beta-lactam (β-lactam) antibiotics has been reported against Staphylococcus aureus, one of the most important etiological agents of cow mastitis. The goal of the present study was to predict the efficacy of intramammary formulations containing the Aloe vera gel extract in the combination with cloxacillin or ceftiofur at low concentrations in lactating cows as an alternative therapy. Each quarter of 20 healthy Holstein Friesian lactating cows were treated with a single dose of one of the following formulations, corresponding to one of these treatment groups: A1, A2, A3, and A4. A1 and A2 contained cloxacillin at 0.25 and 0.5 mg/ml, whereas A3 and A4 contained ceftiofur 0.25 and 0.5 mg/ml, respectively. In addition, all formulations contained 600 mg/ml of an alcoholic extract of Aloe vera. Milk samples were taken at predefined time points. Antibiotics and aloin (active compound of Aloe vera) concentrations were assessed by liquid chromatography mass spectrometry system (LC-MS/MS). Pharmacokinetic profiles were obtained, and the efficacy index, the fraction of dosing interval in which the antimicrobial concentration remains above the minimum inhibitory concentrations (MICs) (T > MIC) for each formulation, was calculated considering MIC values against Staphylococcus aureus ATCC 29213 as obtained for the combination Aloe vera + antibiotic and aloin concentration in the extract. Mammary gland safety assessment was performed for each combination. Values of the main efficacy index for this study, T > MIC (h) for Aloe vera were 23.29, 10.50, 27.50, and 13.89, whereas for cloxacillin or ceftiofur were 19.20, 10.9, 19.74, and 15.63, for A1, A2, A3, and A4, respectively. Only A1 and A3 reached aloin and antibiotic recommended values as predictors of clinical efficacy for cloxacillin, ceftiofur, and aloin (50, 70, and 60%, respectively), assuming a dose interval of 24 h. The efficacy index values obtained suggest that A1 and A3 might be an effective therapy to treat bovine mastitis caused by S. aureus after a single dose. Nevertheless, further trials in S. aureus mastitis clinical cases are mandatory to confirm the efficacy of Aloe vera formulations.

Screening the antifungal activities of monoterpenes and their isomers against Candida species

AIM

Increasing the occurrence of non-albicans Candida species with intrinsic or acquired resistance to antifungals as well as the emergence of multidrug Candida species coupled with the limited antifungal agents challenges the treatment of candidiasis. Consequently, a class of secondary metabolites of plants exhibiting decent antifungal activity. Therefore, this study aimed to evaluate the antifungal potential of various monoterpenes including Carvone, Limonene, Pinene, Menthone, Menthol, Camphor, Thujone, Citronellol, and Piperitone against standard and clinical isolates of Candida.

METHODS AND RESULTS

Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of compounds were determined, using the broth Microdilution method based on M27-A3 protocol documented by clinical laboratory standard institute (CLSI). Amongst the tested monoterpenes, oxygenated terpenoids showed strong antifungal activity. Specifically, alcoholic terpenoids such as (±)-Citronellol possess more efficacy than the corresponding ketonic ones with MICs ranging from 0·03 to 2·00 μl ml^-1 (0·16-10·80 mmol l^-1 ). Among the examined yeasts, Candida tropicalis was the most susceptible species to (±)-Citronellol. Moreover, the examined monoterpenes successfully inhibited the growth of fluconazole-resistant Candida species. Moreover, statistical analysis showed no statistically significant difference between the (+) and (-) isomers, except for (±)-α-Pienene and (±) Menthone (ρ-value < 0·05).

CONCLUSION

Among the tested monoterpenes, (±)-Citronellol was the most potent compounds followed by (+)-α-Pinene and Menthol. Considering the significant antifungal activity of the examined monoterpenes, they could be used in controlling or treating candidiasis. Those potent antifungal monoterpenes with GRAS status in addition to their pleasant taste and odour make them appropriate additive or preservative compounds in food and cosmetics products. Furthermore, these data might help researchers to predict EOs antifungal activities, after determining its constituents.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides new information about the antifungal activities of monoterpenes and their isomers presented widely in essential oils. Screening results against pathogenic yeasts confirm the correlation between the chemical structure of tested monoterpenes and their antifungal effects. The present findings might be helpful to anticipate the antifungal activity of essential oils.

Rapid Extraction and Analysis of Volatile Solutes with an Effervescent Tablet

Extraction of volatile compounds from complex liquid matrices is a critical step in volatile compound analysis workflows. Recently, green chemistry principles are increasingly implemented in extraction processes. Some of the available approaches are solvent-free but still require concentration or trapping of analytes. Here, we propose effervescent tablet-induced extraction (ETIE) as a method of transferring volatile/semivolatile compounds from liquid matrices to the gas phase for analysis. This technique relies on the release of carbon dioxide produced in situ during a neutralization reaction, which occurs when a tablet is inserted into an aqueous sample matrix. In this process, many bubbles of carbon dioxide are instantly formed in the sample matrix. The bubbles rapidly extract and liberate volatile compounds from the sample. The gaseous effluent is then immediately transferred to a detector (atmospheric pressure chemical ionization mass spectrometry (MS) or gas chromatography (GC) hyphenated with MS). ETIE-GC-MS can be used for analysis of volatile compounds present in real samples. The method was validated for analysis of selected ethyl esters present in a yogurt drink. The calibration data set was linear over a range from 5 × 10^-7 to 1 × 10^-5 M. The limits of detection ranged from 1.51 × 10^-7 to 6.82 × 10^-7 M, while the recoveries ranged from 71 to 118%. Inter- and intraday precision of selected ethyl esters in aqueous solution was satisfactory (relative standard deviation, 3.6-18.3%). Furthermore, it is shown that ETIE improves the performance of headspace solid-phase microextraction while eliminating the need for heating and shaking samples.

Protection by pure and genistein fortified extra virgin olive oil, canola oil, and rice bran oil against acetic acid-induced ulcerative colitis in rats

Conjugation of genistein and dietary oils improves the anti-inflammatory and antioxidant effects of genistein on colitis in rats.

Avaliação da dissociação iônica do hidróxido de cálcio associado ao Aloe vera como veículo

Resumo Introdução O hidróxido de cálcio é considerado uma medicação intracanal padrão ouro e diferentes substâncias podem ser empregadas como veículo para melhorar suas propriedades. O Aloe vera é um fitoterápico popularmente conhecido por babosa e que se destaca pela sua capacidade imunorreguladora, antimicrobiana, cicatrizante e pela biocompatibilidade celular. Objetivo Avaliar a dissociação iônica do hidróxido de cálcio, tendo o Aloe vera como veículo. Material e método O extrato de Aloe vera foi obtido diretamente da folha, submetido à filtração e armazenado em tubo Falcon estéril. Foram preparados dois grupos de medicação intracanal: o grupo controle, com hidróxido de cálcio e soro fisiológico, e o grupo experimental, com hidróxido de cálcio e Aloe vera como veículo. Resultado Não foi verificada uma diferença estatisticamente significativa entre as médias de liberação de cálcio dos grupos (p=0,944). Quando comparados os valores de forma pareada, considerando as diferentes avaliações ao longo do tempo, foi identificada uma diferença estatisticamente significativa (p=0,015) para o grupo experimental, de modo que os valores médios da liberação de cálcio foram superiores até o 21º dia do estudo. Conclusão O hidróxido de cálcio, quando associado ao Aloe vera, apresentou maior dissociação iônica que quando utilizado com água destilada. Tal resultado, associado às propriedades inerentes deste fitoterápico, sugerem que a pasta de hidróxido de cálcio e Aloe vera pode ser uma alternativa viável e promissora como medicação intracanal, e melhorar o reparo apical e periapical.

Natural Therapeutic Options in Endodontics - A Review

Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer.

Antiviral activity of the oseltamivir and Melissa officinalis L. essential oil against avian influenza A virus (H9N2)

Lemon balm derivatives are going to acquire a novelty as natural and potent remedy for treatment of viral infections since the influenza viruses are developing resistance to the current antivirals widely. Oseltamivir, Melissa officinalis essential oil (MOEO) and their synergistic efficacy against avian influenza virus (AIV) subtype H9N2 were evaluated in vitro in MDCK cells at different time exposure by using TCID50, HA, Real Time PCR and HI assay. The results showed that MOEO could inhibit replication of AVI through the different virus replication phase (P ≤ 0.05). Also the highest antiviral activity of MOEO was seen when AIV incubated with MOEO before cell infection. The TCID50/ml was reduced 1.3-2.1, 2.3-2.8, 3.7-4.5 log 10 than control group (5.6 log 10), HAU/50 µl was decreased 85-94, 71.4-94, 71.4-94 % and viral genome copy number/µl was brought down 68-95, 90-100, 89.6-99.9 % at pre-infection, post-infection and simultaneous stage, respectively. Hemagglutination inhibition result showed the MOEO was not able to inhibit agglutination of the chicken red blood cell (cRBC). Replication of the AVI was suppressed by the different concentration of oseltamivir completely or near 100 %. Also oseltamivir showed a synergistic activity with MOEO especially when oseltamivir concentration reduced under 0.005 mg/ml. The chemical composition was examined by GC-MS analysis and Its main constituents were identified as monoterpenaldehydes citral a, citral b. In conclusion, the findings of the study showed that lemon balm essential oil could inhibit influenza virus replication through different replication cycle steps especially throughout the direct interaction with the virus particles.

In vitro comparison of antimicrobial effect of sodium hypochlorite solution and Zataria multiflora essential oil as irrigants in root canals contaminated with Candida albicans

INTRODUCTION

This study compared the antifungal effect of Zataria multiflora essential oil (EO) with that of sodium hypochlorite (NaOCl) as an irrigant for root canals infected with Candida albicans.

MATERIALS AND METHODS

Sixty mandibular premolars were infected with C. albicans suspension. After 72 h of incubation, the samples were divided into four groups. Teeth in Group 1 were irrigated with minimum fungicidal concentration (MFC) of Z. multiflora EO, in Group 2 with twice the MFC of Z. multiflora, in Group 3 with MFC of NaOCl, and in Group 4 with distilled water (DW). Pre- and post-operative samples were cultured, and fungal colony count of each specimen was obtained. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests (P < 0.05).

RESULTS

NaOCl at MFC and Z. multiflora EO at twice the MFC showed the highest antifungal efficacy, with no significant difference (P > 0.05). However, antifungal efficacies of these irrigants were significantly different from those of Z. multiflora EO at MFC and DW (P < 0.05).

CONCLUSION

Our results showed that Z. multiflora EO at twice the MFC had the same antifungal efficacy as NaOCl at MFC.

Antimicrobial and Cytotoxic Activity of Cinnamomum zeylanicum, Calcium Hydroxide, and Triple Antibiotic Paste as Root Canal Dressing Materials

OBJECTIVE

The aim of this article was (i) to define the chemical constituents of Cinnamomum zeylanicum essential oil (CEO), (ii) to compare the antimicrobial activity of CEO with triple antibiotic paste (TAP) and calcium hydroxide [Ca(OH)2] on planktonic and biofilm Enterococcus faecalis; and (iii) to compare the cytotoxicity of these medicaments on L929 fibroblasts.

MATERIALS AND METHODS

Gas chromatography-mass spectrometry was used to define the constituents of CEO. Zone of inhibition, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill tests were performed. Further, 108 human teeth were infected with E. faecalis and treated with the medicaments for 1, 7, and 14 days. Cytotoxicity was assessed by exposing L929 fibroblasts to the medicaments.

RESULTS

Cinnamaldehyde was the main component of CEO. Triple antibiotic paste had the greatest zone of inhibition and the smallest MIC and MBC. Triple antibiotic paste and CEO eradicated planktonic E. faecalis after 4 and 24 hours, while Ca(OH)2 failed to achieve 100% killing after 24 hours. Cinnamomum zeylanicum essential oil and TAP eradicated biofilm E. faecalis after 7 and 14 days, but Ca(OH)2 could not eliminate E. faecalis after 14 days. Cinnamomum zeylanicum essential oil was the most biocompatible medicament.

CONCLUSION

Cinnamomum zeylanicum essential oil is an efficient antibacterial agent against planktonic and biofilm E. faecalis and it was cytocompatible to L929 fibroblasts. Therefore, CEO has the potential to be used as an antimicrobial agent in root canal treatment.

Antimicrobial and Cytotoxic Activity of Cuminum Cyminum as an Intracanal Medicament Compared to Chlorhexidine Gel

Introduction:

The aims of this study were i) to define the chemical constituents of Cuminum cyminum (cumin) essential oil, ii) to compare the antimicrobial activity of this oil to that of chlorhexidine (CHX) and co-trimoxazole on planktonic and biofilm forms of bacteria isolated from the teeth with persistent endodontic infection and iii) to compare the cytotoxicity of these medicaments on L929 fibroblasts.

Methods and Materials:

Three groups of microorganisms [aerobic bacterial mixture, anaerobic bacterial mixture and Enterococcus faecalis (E .faecalis)] were isolated from the teeth with persistent apical periodontitis. Zone of inhibition (ZOI), minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC) and time-kill tests were performed to assess the antimicrobial efficacy of the medicaments. Further, a cytocompatibility analysis of the medicaments was performed on L929 fibroblasts. The results obtained from disc diffusion test and mean cell viability values of the experimental medicaments were analyzed using two-way and one-way analysis of variance (ANOVA).

Results:

Seventeen constituents were recognized in cumin oil (predominantly cumin aldehyde and γ-terpinene). Co-trimoxazole showed the greatest ZOI followed by cumin and CHX. The smallest MIC and MBC belonged to co-trimoxazole followed by cumin and CHX for all groups of bacteria except for E. faecalis for which the MBC of cumin was smaller than co-trimoxazole. The results of time-kill assay revealed that all medicaments totally inhibited the bacterial growth in all groups after 24 h. CHX was the most cytotoxic solution while there were no significant differences between the cytocompatibility of different concentrations of cumin essential oil and co-trimoxazole.

Conclusion:

Cumin exhibited a strong antimicrobial efficiency against the microbial flora of the teeth with failed endodontic treatments and it was biocompatible for L929 mouse fibroblasts.