Abstract:
Purpose: This study aimed to evaluate the antibacterial effectiveness of three
intracanal medicaments: Achyranthes aspera and Trachyspermum ammi based
novel polyherbal gel, chlorhexidine gluconate gel, and calcium hydroxide
paste, against Enterococcus faecalis in infected root canals by means of Real-
Time Polymerase Chain Reaction (qPCR) for bacterial quantification.
Methods: A triple-arm, randomized controlled trial was conducted on 45
permanent mandibular and maxillary incisor and canine teeth diagnosed with
asymptomatic apical periodontitis. Participants were randomly divided into
three equal groups (n = 15), each receiving a different intracanal medicament.
Microbiological samples were collected using sterile absorbent paper points at
two time points: before instrumentation and after 7-day of intracanal
medicament placement. The intracanal medicaments tested were a novel
polyherbal gel, 1% (w/w) chlorhexidine gluconate gel, and calcium hydroxide
paste. Total DNA of Enterococcus faecalis was extracted from these samples,
and qPCR was performed to determine the bacterial quantification at both
intervals. The primary outcome was the reduction in Enterococcus faecalis
load, indicating the antibacterial efficacy of each medicament.
Results: All the groups showed a significant reduction in Enterococcus faecalis
counts from baseline to day 7. However, the chlorhexidine gel and calcium
hydroxide paste exhibited significantly greater reductions than the polyherbal
gel (p < 0.05).
Conclusions: All three intracanal medicaments tested were effective in
significantly reducing Enterococcus faecalis counts. However, the
chlorhexidine gel and calcium hydroxide paste demonstrated significantly
greater reductions compared to the polyherbal gel. For routine endodontic
practice, chlorhexidine gel and calcium hydroxide remain more reliable choices for intracanal disinfection against Enterococcus faecalis and should be
preferred in cases with high microbial load. The polyherbal gel, while
antibacterial, may be better suited as an adjunct rather than a primary
medicament in endodontic disinfection protocols.
