TODENTJ-25-03-2019_TODENTJ-9-369 1553505898 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 2213-0886 11 12 2015 9 1 Dakshita Joy Sinha Paridhi Garg Anurag Verma Vibha Malik Edgar Richard Maccune Agrima Vasudeva Aim: This study evaluates the disinfection of dentinal tubules using Propolis, Azadirachta indica (alcoholic and aqueous extracts), 2% chlorhexidine gel and calcium hydroxide against Candida albicans biofilm formed on tooth substrate. Materials & Method: One hundred and five human teeth were infected with Candida albicans for 2 days. Samples were divided into 7 groups. Group I- Propolis, Group II- Alcoholic extract of Azadirachta indica, Group III- Aqueous extract of Azadirachta indica, Group IV- 2% Chlorhexidine, Group V- Calcium hydroxide, Group VI- Ethanol and Group VII- Saline (negative control). At the end of 1,3 and 5 days, the antimicrobial efficacy of medicaments against Candida albicans was assessed at the depths of 200 µm and 400 µm. Results: The overall percentage inhibition of fungal growth (at 200 µm and 400 µm depth) was 99.2% with 2% chlorhexidine gel. There was no statistical difference between propolis, alcoholic extract of Azadirachta indica (neem) and 2% chlorhexidine. Conclusion: Propolis and alcoholic extract of Azadirachta indica performed equally well as that of 2% Chlorhexidine. 11 12 2015 369 374 TODENTJ-9-369 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2014-12-05 2015-08-26 2015-09-13 2015-11-12 http://creativecommons.org/licenses/by-nc/3.0/ 10.2174/1874210601509010369 1553505898 https://opendentistryjournal.com/VOLUME/9/PAGE/369/ https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.pdf https://opendentistryjournal.com/contents/volumes/V9/TODENTJ-9-369/TODENTJ-9-369.xml Crit. Rev. Oral Biol. Med Love R.M. 13 171 2002 10.1177/154411130201300207 Love RM, Jenkinson HF. Invasion of dentinal tubules by oral bacteria Crit Rev Oral Biol Med 2002; 13 (2) : 171-83. Int. Endod. J Sirén E.K. 30 91 1997 10.1111/j.1365-2591.1997.tb00680.x Sirén EK, Haapasalo MP, Ranta K, Salmi P, Kerosuo EN. Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation Int Endod J 1997; 30 (2) : 91-5. Int. Endod. J Wu M.K. 39 343 2006 10.1111/j.1365-2591.2006.01092.x Wu MK, Dummer PM, Wesselink PR. Consequences of and strategies to deal with residual post-treatment root canal infection Int Endod J 2006; 39 (5) : 343-56. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Siqueira J.F. 97 632 2004 10.1016/j.tripleo.2003.12.022 Siqueira JF Jr, Sen BH. Fungi in endodontic infections Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97 (5) : 632-41. Trends Microbiol Calderone R.A. 9 327 2001 10.1016/S0966-842X(01)02094-7 Calderone RA, Fonzi WA. Virulence factors of Candida albicans Trends Microbiol 2001; 9 (7) : 327-35. Arch. Oral Biol Hagihara Y. 33 617 1988 10.1016/0003-9969(88)90138-0 Hagihara Y, Kaminishi H, Cho T, Tanaka M, Kaita H. Degradation of human dentine collagen by an enzyme produced by the yeast Candida albicans Arch Oral Biol 1988; 33 (8) : 617-9. Med. Mycol San-Blas G. 38 79 2000 10.1080/mmy.38.1.79.86 San-Blas G, Travassos LR, Fries BC, et al. Fungal morphogenesis and virulence Med Mycol 2000; 38 (Suppl. 1) : 79-86. Infect. Immun Phan Q.T. 68 3485 2000 10.1128/IAI.68.6.3485-3490.2000 Phan QT, Belanger PH, Filler SG. Role of hyphal formation in interactions of Candida albicans with endothelial cells Infect Immun 2000; 68 (6) : 3485-90. Br. J. Biomed. Sci Cotter G. 57 241 2000 Cotter G, Kavanagh K. Adherence mechanisms of Candida albicans Br J Biomed Sci 2000; 57 (3) : 241-9. Marsh P, Martin MV. Oral microbiology. 4th ed. Oxford, England: Wright 1999. Med. Mycol Calderone R. 38 125 2000 10.1080/mmy.38.s1.125.137 Calderone R, Suzuki S, Cannon R, et al. Candida albicans: adherence, signaling and virulence Med Mycol 2000; 38 (Suppl. 1) : 125-37. Endod. Dent. Traumatol Lindskog S. 14 186 1998 10.1111/j.1600-9657.1998.tb00835.x Lindskog S, Pierce AM, Blomlöf L. Chlorhexidine as a root canal medicament for treating inflammatory lesions in the periodontal space Endod Dent Traumatol 1998; 14 (4) : 186-90. J. Appl. Bacteriol Gélinas P. 54 243 1983 10.1111/j.1365-2672.1983.tb02613.x Gélinas P, Goulet J. Neutralization of the activity of eight disinfectants by organic matter J Appl Bacteriol 1983; 54 (2) : 243-7. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Ferreira F.B. 104 709 2007 10.1016/j.tripleo.2007.05.019 Ferreira FB, Torres SA, Rosa OP, et al. Antimicrobial effect of propolis and other substances against selected endodontic pathogens Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104 (5) : 709-16. Int. Endod. J Kandaswamy D. 43 419 2010 10.1111/j.1365-2591.2010.01696.x Kandaswamy D, Venkateshbabu N, Gogulnath D, Kindo AJ. Dentinal tubule disinfection with 2% chlorhexidine gel, propolis, morinda citrifolia juice, 2% povidone iodine, and calcium hydroxide Int Endod J 2010; 43 (5) : 419-23. Curr. Sci Kausik B. 82 1336 2002 Kausik B, Chattopadhyey I, Benerjee RK, Bandyopdyey U. Biological activities and medicinal properties of neem Curr Sci 2002; 82 : 1336-44. J. Endod Tronstad L. 7 17 1981 10.1016/S0099-2399(81)80262-2 Tronstad L, Andreasen JO, Hasselgren G, Kristerson L, Riis I. pH changes in dental tissues after root canal filling with calcium hydroxide J Endod 1981; 7 (1) : 17-21. J. Endod Torneck C.D. 9 131 1983 10.1016/S0099-2399(83)80031-4 Torneck CD, Moe H, Howley TP. The effect of calcium hydroxide on porcine pulp fibroblasts in vitro J Endod 1983; 9 (4) : 131-6. J. Endod Safavi K.E. 11 454 1985 10.1016/S0099-2399(85)80086-8 Safavi KE, Dowden WE, Introcaso JH, Langeland K. A comparison of antimicrobial effects of calcium hydroxide and iodine-potassium iodide J Endod 1985; 11 (10) : 454-6. J. Endod Hasselgren G. 14 125 1988 10.1016/S0099-2399(88)80212-7 Hasselgren G, Olsson B, Cvek M. Effects of calcium hydroxide and sodium hypochlorite on the dissolution of necrotic porcine muscle tissue J Endod 1988; 14 (3) : 125-7. J. Endod Ringel A.M. 8 200 1982 10.1016/S0099-2399(82)80354-3 Ringel AM, Patterson SS, Newton CW, Miller CH, Mulhern JM. In vivo evaluation of chlorhexidine gluconate solution and sodium hypochlorite solution as root canal irrigants J Endod 1982; 8 (5) : 200-4. J. Endod Safavi K.E. 20 127 1994 10.1016/S0099-2399(06)80057-9 Safavi KE, Nichols FC. Alteration of biological properties of bacterial lipopolysaccharide by calcium hydroxide treatment J Endod 1994; 20 (3) : 127-9. J. Dent. Res Haapasalo M. 66 1375 1987 10.1177/00220345870660081801 Haapasalo M, Ørstavik D. In vitro infection and disinfection of dentinal tubules J Dent Res 1987; 66 (8) : 1375-9. Int. Endod. J Kandaswamy D. 43 419 2010 10.1111/j.1365-2591.2010.01696.x Kandaswamy D, Venkateshbabu N, Gogulnath D, Kindo AJ. Dentinal tubule disinfection with 2% chlorhexidine gel, propolis, morinda citrifolia juice, 2% povidone iodine, and calcium hydroxide Int Endod J 2010; 43 (5) : 419-23. J. Conserv. Dent Tyagi S.P. 16 532 2013 10.4103/0972-0707.120973 Tyagi SP, Sinha DJ, Garg P, Singh UP, Mishra CC, Nagpal R. Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica (Neem) and 5% sodium hypochlorite on Candida albicans biofilm formed on tooth substrate: An in-vitro study J Conserv Dent 2013; 16 (6) : 532-5. J. Conserv. Dent Vaghela D.J. 14 182 2011 10.4103/0972-0707.82625 Vaghela DJ, Kandaswamy D, Venkateshbabu N, Jamini N, Ganesh A. Disinfection of dentinal tubules with two different formulations of calcium hydroxide as compared to 2% chlorhexidine: As intracanal medicaments against Enterococcus faecalis and Candida albicans: An in vitro study J Conserv Dent 2011; 14 (2) : 182-6. Germs Shingare P. 1 12 2011 10.11599/germs.2012.1004 Shingare P, Chaugule V. Comparative evaluation of antimicrobial activity of miswak, propolis, sodium hypochlorite and saline as root canal irrigants by microbial culturing and quantification in chronically exposed primary teeth Germs 2011; 1 (1) : 12-21. Ind J Dent Adv Dubey S. 4 740 2012 Dubey S, Chaodary M, Gupta P. Comparative study of the antimicrobial efficiency of neem leaf extract, sodium hypochlorite and biopure MTAD: An in vitro study Ind J Dent Adv 2012; 4 : 740-3. IJRAP Nayak A. 2 230 2011 Nayak A, Nayak RN, Somya GB, Kishore B, Mithun K. Evaluation of antibacterial and anticandidial efficacy of aqueous and alcoholic extract of Neem (Azadirachta indica) an in vitro study IJRAP 2011; 2 : 230-5. J. Endod Krithikadatta J. 33 1473 2007 10.1016/j.joen.2007.08.016 Krithikadatta J, Indira R, Dorothykalyani AL. Disinfection of dentinal tubules with 2% chlorhexidine, 2% metronidazole, bioactive glass when compared with calcium hydroxide as intracanal medicaments J Endod 2007; 33 (12) : 1473-6. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Simon S.T. 80 459 1995 10.1016/S1079-2104(05)80371-3 Simon ST, Bhat KS, Francis R. Effect of four vehicles on the pH of calcium hydroxide and the release of calcium ion Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80 (4) : 459-64. Retina Fernandez-Vigo J. 10 148 1990 10.1097/00006982-199004000-00012 Fernandez-Vigo J, Refojo MF, Verstraeten T. Evaluation of a viscoelastic solution of hydroxypropyl methylcellulose as a potential vitreous substitute Retina 1990; 10 (2) : 148-52. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Basrani B. 96 618 2003 10.1016/S1079-2104(03)00166-5 Basrani B, Tjäderhane L, Santos JM, et al. Efficacy of chlorhexidine- and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96 (5) : 618-24. J. Endod Lynne R.E. 29 187 2003 10.1097/00004770-200303000-00006 Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TB, McPherson JC. In vitro antimicrobial activity of various medication preparations on E. faecalis in root canal dentin J Endod 2003; 29 (3) : 187-90. J. Endod Love R.M. 22 290 1996 10.1016/S0099-2399(96)80261-5 Love RM. Regional variation in root dentinal tubule infection by Streptococcus gordonii J Endod 1996; 22 (6) : 290-3. Dent. Traumatol Lin S. 21 42 2005 10.1111/j.1600-9657.2004.00293.x Lin S, Tsesis I, Zukerman O, Weiss EI, Fuss Z. Effect of electrophoretically activated calcium hydroxide on bacterial viability in dentinal tubules--in vitro Dent Traumatol 2005; 21 (1) : 42-5. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Neelakantan P. 104 e138 2007 10.1016/j.tripleo.2007.04.035 Neelakantan P, Sanjeev K, Subbarao CV. Duration-dependent susceptibility of endodontic pathogens to calcium hydroxide and chlorhexidene gel used as intracanal medicament: an in vitro evaluation Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104 (4) : e138-41. J. Endod Beltes P.G. 23 413 1997 10.1016/S0099-2399(97)80292-0 Beltes PG, Pissiotis E, Koulaouzidou E, Kortsaris AH. In vitro release of hydroxyl ions from six types of calcium hydroxide nonsetting pastes J Endod 1997; 23 (7) : 413-5. J. Endod Baumgartner J.C. 26 695 2000 10.1097/00004770-200012000-00003 Baumgartner JC, Watts CM, Xia T. Occurrence of Candida albicans in infections of endodontic origin J Endod 2000; 26 (12) : 695-8. J. Dent. Res Siqueira J.F. 88 969 2009 10.1177/0022034509346549 Siqueira JF Jr, Rôças IN. Diversity of endodontic microbiota revisited J Dent Res 2009; 88 (11) : 969-81. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Sen B.H. 84 68 1997 10.1016/S1079-2104(97)90298-5 Sen BH, Safavi KE, Spångberg LS. Growth patterns of Candida albicans in relation to radicular dentin Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84 (1) : 68-73. Int. Endod. J Waltimo T.M. 30 96 1997 10.1111/j.1365-2591.1997.tb00681.x Waltimo TM, Sirén EK, Torkko HL, Olsen I, Haapasalo MP. Fungi in therapy-resistant apical periodontitis Int Endod J 1997; 30 (2) : 96-101. Endod. Dent. Traumatol Ørstavik D. 6 142 1990 10.1111/j.1600-9657.1990.tb00409.x Ørstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules Endod Dent Traumatol 1990; 6 (4) : 142-9. Int. Endod. J Mohammadi Z. 42 288 2009 10.1111/j.1365-2591.2008.01540.x Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics Int Endod J 2009; 42 (4) : 288-302. J. Conserv. Dent Bhardwaj A. 15 293 2012 10.4103/0972-0707.97964 Bhardwaj A, Ballal S, Velmurugan N. Comparative evaluation of the antimicrobial activity of natural extracts of Morinda citrifolia, papain and aloe vera (all in gel formulation), 2% chlorhexidine gel and calcium hydroxide, against Enterococcus faecalis: An in vitro study J Conserv Dent 2012; 15 (3) : 293-7. Int. Endod. J Gomes B.P. 36 267 2003 10.1046/j.1365-2591.2003.00634.x Gomes BP, Souza SF, Ferraz CC, et al. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro Int Endod J 2003; 36 (4) : 267-75. J. Endod Siqueira J.F. 23 167 1997 10.1016/S0099-2399(97)80268-3 Siqueira JF Jr, de Uzeda M. Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine, metronidazole, and calcium hydroxide associated with three vehicles J Endod 1997; 23 (3) : 167-9. Saudi Endod J Garg P. 4 122 2014 10.4103/1658-5984.138141 Garg P, Tyagi SP, Sinha DJ, Singh UP, Malik V, Maccune ER. Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica, triphala, green tea polyphenols and 5.25% sodium hypochlorite against Enterococcus faecalis biofilm Saudi Endod J 2014; 4 : 122-7. Planta Med Takaisi-Kikuni N.B. 60 222 1994 10.1055/s-2006-959463 Takaisi-Kikuni NB, Schilcher H. Electron microscopic and microcalorimetric investigations of the possible mechanism of the antibacterial action of a defined propolis provenance Planta Med 1994; 60 (3) : 222-7. J. Ethnopharmacol Kujumgiev A. 64 235 1999 10.1016/S0378-8741(98)00131-7 Kujumgiev A, Tsvetkova I, Serkedjieva Y, Bankova V, Christov R, Popov S. Antibacterial, antifungal and antiviral activity of propolis of different geographic origin J Ethnopharmacol 1999; 64 (3) : 235-40. Arch. Oral Biol Koo H. 45 141 2000 10.1016/S0003-9969(99)00117-X Koo H, Gomes BP, Rosalen PL, Ambrosano GM, Park YK, Cury JA. In vitro antimicrobial activity of propolis and Arnica montana against oral pathogens Arch Oral Biol 2000; 45 (2) : 141-8. Gen. Dent Oncag O. 54 319 2006 Oncag O, Cogulu D, Uzel A, Sorkun K. Efficacy of propolis as an intracanal medicament against Enterococcus faecalis Gen Dent 2006; 54 (5) : 319-22. Asian Pharm Clin Res Ghosh A. 2 87 2009 Ghosh A. Chakrabarti, Roy P, Bhadury S, Nag T, Sarkar S. Bioremidation of heavy metals from neem leaf extract by chelation with dithizone Asian Pharm Clin Res 2009; 2 : 87-92. Curr. Sci Biswas K. 82 1336 2002 Biswas K, Chattopadhyay I, Banerjee RK, Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadirachta indica) Curr Sci 2002; 82 : 1336-45. Ethnobotanical Leaflets Rajasekaran C. 12 1213 2008 Rajasekaran C, Meignanam E, Vijayakumar V, et al. Investigations on antibacterial activity of leaf extracts of Azadirachta indica A.Juss (Meliaceae): A traditional medicinal plant of India Ethnobotanical Leaflets 2008; 12 : 1213-7. Int. Endod. J Waltimo T.M. 32 421 1999 10.1046/j.1365-2591.1999.00237.x Waltimo TM, Ørstavik D, Sirén EK, Haapasalo MP. In vitro susceptibility of Candida albicans to four disinfectants and their combinations Int Endod J 1999; 32 (6) : 421-9. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod Sen B.H. 90 651 2000 10.1067/moe.2000.109640 Sen BH, Akdeniz BG, Denizci AA. The effect of ethylenediamine-tetraacetic acid on Candida albicans Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90 (5) : 651-5.