Comparative Evaluation of the Antimicrobial Efficacy of 20% Chlorhexidine, 3% Sodium Hypochlorite, and Dexamethasone Acetate with Thymol as a Root Canal Disinfectant against Enterococcus faecalis: An In-Vitro Feasibility Study

Endodontic treatment is aimed at eradicating bacteria from the root canal system and preventing their regrowth. Despite the widespread use of chlorhexidine gluconate, sodium hypochlorite, and steroids as root canal irrigants, the search for novel materials that enhance root canal disinfection remains ongoing.

This study aimed to evaluate the effectiveness of two newly introduced root canal irrigants, 20% chlorhexidine (Biosol) and dexamethasone acetate with thymol (Cresophene), compared to traditional irrigants, such as sodium hypochlorite.

Eighty uniradicular teeth extracted for periodontal and orthodontic reasons were divided into four groups: Group I (Biosol), Group II (Cresophene), Group III (3% NaOCl), and Group IV (Control). The teeth were inoculated with Enterococcus faecalis, treated with the respective irrigants, and sealed with sterile cotton pellets and temporary cement. After incubation at 37°C for 24 hours in Brain Heart Infusion (BHI) broth, microbiological sampling was performed at 48 hours to evaluate antimicrobial efficacy.

Group I (Biosol) exhibited the highest antimicrobial efficacy with a significant reduction of 90.15% in E. faecalis counts, followed closely by Group II (Cresophene) with an 89.85% reduction. Group III (3% NaOCl) showed a comparatively lower reduction of 75.57%. Group IV (Control) demonstrated the highest bacterial presence, confirming its limited antimicrobial effectiveness. Statistical analysis revealed significant differences between Group I and Groups III and IV (p < 0.0001), with Group I being the most effective. Additionally, standard deviation analysis indicated variability in bacterial counts within each group.

This study suggests that 20% chlorhexidine (Biosol) and dexamethasone acetate with thymol (Cresophene) are highly effective as root canal irrigants. The remarkable substantivity of biosol helps establish a long-lasting antibacterial environment in the root canal, offering valuable potential for enhancing the success rates of endodontic treatments.