Antimicrobial Potential of Calcium Hydroxide Chlorhexidine, Octenidol, Endoseptone and Combination of Calcium Hydroxide and Chlorhexidine against Enterococcus faecalis as Intracanal Medicament

Evaluation of the antimicrobial efficacy of different nonsteroidal anti-inflammatory drugs alone or in combination with calcium hydroxide intracanal medicament: an in vitro study

This study explored the antimicrobial effects of ketoprofen, piroxicam, and celecoxib alone or combined with calcium hydroxide (CH) against two strains of Enterococcus faecalis (E. faecalis) and assessed the influence of such combinations on the pH of CH. Minimum inhibitory concentrations (MICs) of the three tested NSAIDs were determined. Tested pastes were placed into wells punched in seeded agar plates and the bacterial inhibition zones were measured. Antibiofilm activity was assessed against 3 weeks of biofilm induced in bovine dentine blocks. The pH of the pastes was measured at four-time intervals. MIC values were 3.12, 25, and 25 mg/ml for ketoprofen, piroxicam, and celecoxib, respectively, and were similar for both bacterial strains except for celecoxib, which showed 8% growth at the highest tested concentration against vancomycin-resistant E. faecalis. Ketoprofen had the largest mean inhibition zone that was comparable to CH. None of the six tested pastes exhibited antibiofilm activity of a significant level in comparison to CH. A noticeable increase in the antibiofilm activity was found when 20% NSAIDs were added to CH while maintaining an alkaline pH. Ketoprofen was found to be the most effective among the tested NSAIDs. Although its effect was comparable to CH, adding ketoprofen at a ratio of 20% resulted in 50% higher antimicrobial action than CH alone. Accordingly, incorporating NSAIDs in inter-appointment dressing has the potential to utilize their anti-inflammatory, local analgesic, and antibacterial actions, which overcome the limitations of CH and improve the outcome of root canal treatment.

The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers

This study aimed to compare the effect of 4 different intracanal medicaments on the push-out bond strength of two sealers (AH Plus and MTA Fillapex). 100 single-rooted extracted premolar teeth were divided into 5 groups, with 20 samples in each group, one group being the control group. After cleaning and shaping procedures, the canals were filled with 4 different medicaments: calcium hydroxide, tri-antibiotic paste (TAP), Metapex, or Chlorhexidine (2%) gel for 2 weeks. Following this, the medicaments were rinsed away, and the samples in those sub-groups were obturated with gutta-percha/AH Plus or MTA Fillapex sealers. After 2 weeks of incubation, a 2-mm-thick middle section from each root was evaluated to test push-out strength. The obtained data were tabulated, and appropriate statistical analysis was performed (two-way ANOVA and LSD test). When comparing the average values, the bond strength values of AH Plus were significantly higher than those of MTA Fillapex (p<0.05) in all medicament groups. Based on the findings, we concluded that AH Plus had comparatively higher bond strength than MTA Fillapex. We also observed that AH Plus had higher bond strength in the presence of calcium hydroxide, whereas MTA Fillapex in the presence of Chlorhexidine. A comparison of the push-out bond strength shows that irrespective of the root canal segment or the final irrigant used, AH Plus showed higher values among all groups. The limitation of the current study was that the effect of TAP on the bond strength of endodontic sealers was not negative.