14 a comparative evaluation - amu.ac.in comparative evaluation.p… · root canal irrigants.[21]...

ABSTRACT Aim- To evaluate the antimicrobial efficacy of Cinnamon, Garlic and turmeric as endodontic

irrigants against Enterococcus faecalis and Candida albicans with comparison of 5.25% NaOCl .

Material and Method: Hundred two freshly extracted intact human mandibular premolars were decoronated at

CEJ and biomechanically prepared up to F3 and stored in normal saline until autoclaving. The specimens were

inoculated with E.faecalis and Candida albicans suspension and incubated for 21 days.

Two sample were subjected for SEM (Scaning Electronic Microscope) evaluation to confirm the penetration of

microorganism into the dentinal tubule. Each groups was further divided in to five sub groups containing ten

teeth each (n=10).

Freshly prepared extracts of cinnamon, garlic and turmeric were used as an irrigating solution against

Enterococcus faecalis and Candida albicans.

5.25% Sodium hypochlorite was used as positive control group and normal saline was used as negative control.

Dentinal shavings were collected using G.G drills Number of colony was counted in suitable plate by using

digital colony counter. Statistical analysis was performed by using ANOVA and Post –hoc test.

Results : Statistically significant difference (p<0.05) was found between the groups in code- A (E.faecalis) and

Code -B(C.albicans). Order of antimicrobial activity is Garlic >Cinnamon>Turmeric against E .faecalis(Code -

A). Order of antimicrobial activity is Garlic > Cinnamon > Turmeric against C. albicans(Code-B). No

statistically significant differences (p>0.05) were found between group3 (Cinnamon) and group5(Turmeric)

against E .faecalis(Code –A) .Conclusion: Sodium hypochlorite remains the gold standard for irrigation in

primary endodontic infections. Garlic extract is advantageous in cases of secondary endodontic infections which

are dominated by organisms like E. faecalis and C. albicans. Cinnamon and Turmeic also showed good efficacy

against E. faecalis and C. albicans.

1 2 3 4 5Suresh Pandey, Rhitu Shekhar, Rohit Paul, Manoj Hans, Amit Garg 1 2 3 4,5Post Graduate Student, Reader, Professor and Head, Professor

Department of Conservative Dentistry and Endodontics,

K.D. Dental College and Hospital. Mathura. (U.P) India.

INTRODUCTION : Primary endodontic infections are

polymicrobial and are dominated by obligatory anaerobic

bacteria.[1,2] Eliminating microorganism from root canal

system is possible only by a thorough chemomechanical

preparation.[3] Which is accomplished by proper

instrumentation along with irrigants and intracanal

medicaments.[4]

However complete sterilization of pulp space is not always

achieved due to extremely complex anatomy.5 Even after

meticulous chemomechnaical preparation bacteria can still be

recovered from canals. Persistent endodontic infections are

mainly due to retention of microorganism in the dentinal

tubules.[6]

Enterococcus faecalis is the primary organism detected in

persistent asymptomatic infections.[7] Enterococcus faecalis

is a facultative anaerobic gram positive rod which can invade

the dentinal tubules endure prolonged periods of starvation

and possess certain virulence factors and lytic enzymes.[8,9]

A COMPARATIVE EVALUATION AND EFFECTIVENESS OF DIFFERENT ANTIMICROBIAL HERBAL EXTRACTS AS ENDODONTIC IRRIGANTS AGAINST ENTEROCOCCUS FAECALIS AND CANDIDA ALBICANS- AN IN-VITRO STUDY.

Journal of Dental Sciences

University

University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 75

University J Dent Scie 2018; Vol. 4, Issue 2

Research Article

Key Words:

E. faecalis C. albicans,

Garlic, Cinnamon

and Turmeric.

Source of support: Nil

Conflict of intrest : None

Irrigants not only are important for the removal of debris and

dentinal chips produced during cleaning and shaping, but are

of clinical importance in the eradication of the radicular

infection.[10]

In particular Enterococcus faecalis has gained attention in the

endodontic literature, as it can frequently be isolated from

root canals in cases of failed root canal treatments. In addition,

yeasts may also be found in root canals associated with

therapy resistant apical periodontitis.[11]

Candida albicans is the most common fungus seen in the root

canals, 21% in primary infections14 and 18% in cases of

retreatments [12] Due to the biofilm

formation and the physicochemical properties of the

microorganisms, it can survive in harsh conditions.[13]

Several irrigants have been recommended for the use in non

surgical endodontic procedures. Sodium hypochlorite has

been the gold standard as an endodontic irrigant due to its high

antimicrobial action and ability to dissolve the organic

material. However, it has various deleterious effects like

tissue toxicity, unpleasant

taste and odour, inability to remove smear layer and fully

eradicate microbes from the infected canals, staining and

corrosion of instruments and allergic potential.[14,15,16]

There has been a shift of trend towards herbal medication.

Natural products have become more popular in the modern

day dentistry because of advantages like fewer side effects,

inexpensive, better patient tolerance and renewable

nature.[17]

In dentistry, Phytomedicines has been used as

antiinflammatory, antibiotic, analgesic and sedative

agents.[18,19] Herbs in dentistry have become more popular

due to easy availability, cost effectiveness, low toxicity and

lack of microbial resistance and increased shelf life.[20]

The changing trends from conventional irrigants to herbal

extracts began in

2003 when propolis was compared with saline and NaOCl as

root canal irrigants.[21]

Garlic is one of the greatest health tonics and has proven

medicinal properties. It contains a substance called allicin

which is equivalent to that of penicillin (1mg of allicin is

equated to that of 15 IU of penicillin).[22]

Allicin can destroy cell wall and cell membrane of root canal

bacteria. Garlic inhibit the growth of oral pathogens such as

Streptococcus mutans and P.gingivalis and hence used in the

management of dental infections such as periodontitis.[23,24]

Cinnamon which is a native plant of tropical islands is

considered a herb and spice

traditionally used by many ancient cultures. It has also been

found effective against Streptococcus mutans which is the

causative organism of dental caries and also against

E.faecalis.[25]

Curcuma longa (commonly called as turmeric) belonging to

Zingiberaeceae family has been used as a traditional medicine

from ancient times.[26]

Curcumin (diferuloylmethane) is the main yellow bioactive

component of turmeric and has been shown to have a wide

spectrum of actions like anti-inflammatory, antioxidant,

antibacterial, antifungal, antiprotozoal and antiviral

activities.[27,28]

The present study was undertaken keeping in mind the side

effects of sodium hypochlorite. Studies using herbs as

endodontic irrigants and medicaments are in progress and

results are promising.

MATERIALS AND METHODS : This study was carried

out in the Department of Conservative Dentistry and

Endodontics, K.D. Dental College and Hospital, Mathura,

Uttar Pradesh.

Aim- To evaluate the antimicrobial efficacy of Cinnamon,

Garlic and turmeric as endodontic irrigants against

Enterococcus faecalis and Candida albicans with comparison

of 5.25% NaOCl .

Specimen selection

A total of 102 extracted human mandibular premolar teeth

were selected for this study.

Inclusion criteria

· Single rooted premolars with fully formed apices.

· Single rooted premolars with intact crown and root.

Exclusion criteria

1. Teeth with open apex.

2. Teeth with calcified canals.

3. Fractured teeth.

4. Carious teeth and previously restored teeth.

5. Single rooted premolar with any other pathology.

SPECIMEN PREPARATION : Teeth were cleaned of

debris and soft tissue remnants using ultrasonic scaler. The

anatomical crown of all the teeth were cut away at

Cementoenamel junction (CEJ) perpendicular to the long axis

of the teeth using a water cooled diamond wheel bur (Ajex &

Turner Wire Dies Co., New Delhi, India). The remaining

roots was measured 12-14mm. All teeth were immersed in

physiological saline until required.

The exploration of the radicular canal was accomplished with



no 10 and no 15-K file (Mani, inc, Toshigi-ken, Japan). Then

the working length was determined 1 mm short from apical

foramen. Rotary protaper file was used to biomechanically

prepare the root canal (9% taper up to F3, ProTaper

(Dentsply-Maillefer, Ballaigues, Switzerland).

The canals were recapitulated and irrigated with 5.25%

NaOCl (Cmident, India), 17% EDTA (17%EDTA,Dentsply-

Maillefer, Ballaigues, Switzerland) and final rinse was with

normal saline (0.9%Nacl, Inven Pharmaceuticals, M.P.,

India). Specimens were placed in steel containers and

subjected to autoclave ( Confident Dental Equipment Ltd,

India) at 121ºC at 15 psi for 20 minutes for sterilization.

Preparation of E. faecalis and C.albicans suspension and

tooth Inoculation.

In order to get a controlled and standard suspension of the

organism the following procedure was adopted. A stock

culture of ATCC 29212 E. faecalis strain( Himedia

Laboratories, Mumbai ,India) and 24433 C. albicans

strain(Himedia Laboratories, Mumbai ,India) were used.

Respectively culture was grown overnight at 37°C in BHI

broth ( Himedia Laboratories, Mumbai ,India). Microbial

growth was checked by changes in turbidity at 24 hrs. After

that 51 teeth were placed in flask containing E. faecalis

strain (code A) and remaining 51 teeth were placed in flask

containing C.albicans strain (code B). All the specimen were

incubated in incubator( Confident Dental Equipment Ltd,

India) for 21 days at 37°C.

Aqueous extraction procedure

100g of air dried, coarsely powdered herbal extract was taken

in a 1 liter round bottom flask and 400ml of water added to the

sample. The flask was shaken mixed and filtered. The filtrate

was evaporated over a water bath to 100 ml.

Antimicrobial assessment

After 21 days all the specimens were retrieved and two sample

were subjected for SEM (Carl Zeissis Microscopy, USA)

evaluation to confirm the penetration of microorganism into

the dentinal tubule.

Figure 1: Code –A (E. faecalis) SEM image(1 and 2)

Figure 2: Code –B (C.albicans)SEM image(1 and 2)

The contaminated samples were divided into two groups.

Code A (E. faecalis ) and Code B (C. albicans). Each groups

was further divided into five subgroups containing ten teeth

each. Test irrigating solutions was used as follow

Code A (E. faecalis)

Group 1 – Normal Saline, (negative control group

Group 2 - 5.25% NaOCl, (positive control group)

Group 3 – Tumeric, (expt. group)

Group 4 - Cinnamon, (expt. group)

Group 5 – Garlic, (expt. group)

Code B (C. albicans)

Group 1 – Normal Saline, (negative control group)

Group 2 - 5.25% NaOCl, (positive control group)

Group 3 – Turmeric, (expt. group)

Group 4 - Cinnamon, (expt. group)

Group 5 – Garlic, (expt. group)

Groups were irrigated with respective irrigating solutions

using 5ml syringes (Tulsi Surgicals Pvt. Ltd, U.P. India) and

was immersed in test tubes containing 2ml of the solution for

5minutes.Then dentin sample was obtained by using of G.G

drill (Dentsply Maillefer, Ballaigues, Switzerland) no. 1 to 5.

Dentinal shaving was transferred into test tube containing 1ml

sterile normal saline (10-1). From this 1ml from each

dilution was pippeted on to a sterile 100 mm diameter of

blood agar plate ( Himedia Laboratories, Mumbai ,India) for

CODE -A and SDA plate ( Himedia Laboratories, Mumbai

,India) for CODE –B . These plate was incubated for 2 days

at 37°C in incubator. After incubation the no. of colony was

counted in suitable plate by using digital colony counter

(Atico Medical Pvt. Ltd ,Ambala ,India). The no. of colonies

multiplied by the dilution factor gives the total no. of CFU

(colony forming unit) in the scrapping per tooth.

The statistical analysis was performed using SPSS software

(Statistical Package for Social Sciences) version 16.0. The

data was interpreted at a confidence interval of 95%.

Analysis of variance (ANOVA) was used to compare the

antimicrobial activity of herbal extracts with comparison of

standards. Post Hoc test followed by Scheffe Test was



performed for multiple comparisons of the specimens. (P

value < 0.05 considered as significant difference).

RESULTS : The mean values of colony forming units

(CFU)/ML obtained in the groups by digital colony counter

after 2 days of incubation of dentinal saving are presented in

Table 1 and Table 2.

Statistically significant difference (p<0.05) was found

between the groups in code- A (E.faecalis) and Code -

B(C.albicans).

O r d e r o f a n t i m i c r o b i a l a c t i v i t y i s G a r l i c

>Cinnamon>Turmeric against E .faecalis(Code -A).

Order of antimicrobial activity is Garlic > Cinnamon >

Turmeric against C. albicans(Code-B).

The antimicrobial activity of garlic extract (group-4) is

more effective against E .faecalis and C.albicans than the

cinnamon (group -3) and turmeric extract (group-5) in both

groups and the difference being statistically significant.

No statistically significant differences (p>0.05) were found

between group3 (Cinnamon) and group5(Turmeric) against E

.faecalis(Code –A) .

The antimicrobial activity of cinnamon solution is more than

turmeric but less than garlic solution against E .faecalis and

C.albicans.

The antimicrobial property of 5.25% NaOCl was found

maximum in both group against E.faecalis and C.albicans

therefore used as positive control group.

The antimicrobial property of 0.9% NaCl (saline) was found

least in both group against E.faecalis and C.albicans

therefore used as negative control group.

Data Code A (Enterococus faecalis )

Table-1 Enterococus faecalis colony count

Data Code B (Candida albicans)

Table-2 Candida albicans colony count

Graph.1: Comparision of bacterial colony count in Code A- E.faecalis

Graph no.2: Comparision of fungus colony count in Code B- C.albicans

Graph no. 3: Comparision of colony count in Code –A and Code- B

Code A- E.faecalis Code B- C.albicans



DISCUSSION : E.faecalis was selected as the test organism

because it is a facultative organism that is nonfastidious, easy

to grow and efficiently and rapidly colonizes in the

tubules.[29] It has been used extensively in endodontic

research because it has been reported in 63% of post treatment

diseases and due to the high level of resistance to a wide range

of antimicrobial agents. ATCC 29212 strains of E.faecalis

which has been the standard strain used in the previous studies

was selected for the present study . In this study the cementum

was left intact to simulate clinical conditions, and the canals

were enlarged up to F3 Protaper file (9% taper).[30]

Since the minimum instrumentation size required for the

penetration of irrigants in the apical third is[ 30.31] E.faecalis

can penetrate dentinal tubules to a depth of 300-400 µm within

3 weeks. Prolonged incubation period increases the number of

infected dentinal tubules but depth of penetration of bacteria

increases slowly with time.32 Hence in this study the teeth

were inoculated with the organism and incubated for 21 days.

Ingrowth or progress of bacteria into the dentinal tubules

could be delayed or prevented by the presence of smear layer.

Conditioning of dentin before exposure results in deeper

penetration.[33] 17% EDTA was used in this study for

removing the smear layer in the experimental specimens

before autoclaving and inoculation. Another important factor

for the survival of bacteria is the availability of a nutrient

source.[34]

In the present study a contact time of 5 minutes was taken as

the standard time for all the irrigants. In comparison to the

study conducted by Berber et al 5.25% NaOCl eliminated

ATCC 29212 strains of E.faecalis in a 10 minute contact

time.35 Fungi have occasionally been found in primary root

canal infections, but they seem to be more common in root-

filled teeth with failed endodontic treatment. Sundqvist et

al.36 found C. albicans in 2 out of 24 teeth with endodontic

treatment failure. Pinheiro et al.[37] studied the flora in 60

root-filled teeth with persisting periapical lesion.

Microorganisms were isolated from 51 teeth, and Candida

species from 2 teeth. Peciuliene et al.[38] studied the

occurrence of yeasts, enteric gram-negative rods, and E

faecalis, especially in root-filled teeth with chronic apical

periodontitis. C. albicans is the second most common cause

of recalcitrant infections after E. faecalis.

5.25% NaOCl showed complete inhibition of growth of E.

faecalis and C. albicans therefore it is used as as the gold

standard irrigant.

According to earlier reports, garlic has traditional dietary and

medicinal applications as an anti-infective agent.[40] In the

present study, garlic (Allium sativum) extract showed

maximum antifungal efficacy against Candida albicans and

maximum antibacterial efficacy against E.faecalis as

compared to cinnamon and turmeric. Garlic contains at least

33 sulphur compounds, several enzymes, amino acids, and

minerals such as selenium. It contains a higher concentration

of sulphur compounds than any other Allium species.[39]

In this study cinnamon showed maximum efficacy against

Candida albicans and minimum efficacy against E. faecalis

which is greater than turmeric but lower than garlic.

Comparing the antimicrobial activity of herbal extracts Garlic

had fewer colonies than Cinnamon and hence it is more

antibacterial.

However, several disadvantages of herbal irrigants like fresh

solutions has to be prepared each time, the unacceptable

odour and taste, short shelf life have to be overcome .The

smell and taste of the herbal irrigants has to be modified by

adding flavouring agents to make it palatable and acceptable

by the patient. More research for prolonging the shelf life of

these irrigants has to be done so that these irrigants are more

widely accepted.[40]

CONCLUSION

Standard irrigants 5.25% NaOCl showed complete inhibition

and remain as the standard irrigants. With ever increasing

resistance to synthetic drugs and typical features of E.faecalis

and C.albicans, herbal extracts can be an alternative option

provided all the ideal properties of an irrigant are satisfied. On

the basis of the results obtained in this study, the following can

be concluded: Sodium hypochlorite remains the gold standard

for irrigation in primary endodontic infections. Garlic extract

is advantageous in cases of secondary endodontic infections

which are dominated by organisms like E. faecalis and C.

albicans. Cinnamon and Turmeic also showed good efficacy

against E. faecalis and C. albicans. However in -vivo studies

will also be required or recommending ideal clinical protocols

using these materials.

REFERENCES

1. Kakehashi S, Stanley H R, Fitzgerald R J. The effects of

surgical exposure of dental pulps in germ-free and

conventional laboratory rats. Oral surg, Oral med and

Oral Pathol 1965; 20:34-5.

2. Sundqvist G. Ecology of the root canal flora. J Endod

1992;18:142-149.



3. Sjogren U, Figdor D, Spangberg L, Sundqvist G.

Influence of infection at the time of root filling on the

outcome of endodontic treatment of teeth with apical

periodontitis. Int Endod J 1997; 30:297-306.

4. Bystrom A, Sundqvist G. Bacteriologic evaluation of

0.5% NaOCl in endodontic therapy.Oral surg,Oral med

and Oral pathol 1983; 55:307-312.

5. Haapasalo M,Orstavik D. In- vitro infection and

disinfection of dentinal tubules. Journal of Dental

Research 1987; 66:1375-1379.

6. Engstrom B. The Significance of Enterococci in Root

Canal Treatment. Odontologisk Rev 1964; 15: 87-106.

7. R.M. Love. Enterococcus faecalis- A mechanism for its

role in endodontic failure. Int Endod J 2001; 34: 399-405.

8. Sebeena M, Boopathy. Enterococcus faecalis – An

endodontic challenge. JIADS 2010;1:33-37

9. Isabelle P, Tuomnos M T, Waltimo, Haapasalo M.

Enterococcus Faecalis – the root canal survivor and 'star'

in post – treatment disease. Endodontic Topics 2003;

6:135-159.

10. Jaju S, Jaju P. Newer Root Canal Irrigants In Horizon: A

Review. International Journal of Dentistry 2011;5:1-9.

11. Matthias Z. Root Canal Irrigants, J Endod, 2006;32:389-

398.

12. Baumgartner JC, Watts CM, Xia T. Occurrence of

Candida albicans in infections of endodontic origin. J

Endod 2000;26 :695-698.

13. Siqueira JF Jr., Rôças IN. Diversity of endodontic

microbiota revisited. J Dent Res 2009;88: 969-981.

14. Waltimo TM, Haapasalo M, Zehnder M, Meyer J.

Clinical aspects related to endodontic yeast infections.

Endod Topics. 2004;9:66-78.

15. Spangberg L , Engström B, Langeland K. Biologic

effects of dental materials. Toxicity and antimicrobial

effect of endodontic antiseptics in vitro. Oral Surg Oral

Med Oral Pathol 1973;36: 856- 871.

16. McComb D, Smith DC. A preliminary scanning electron

microscopic study of root canals after endodontic

procedures. J Endod1975; 1:238- 242.

17. Mohammadi Z. Sodium hypochlorite in endodontics: An

update review. Int Dent J 2008; 58: 329- 341.

18. Vermani K, Garg S. Herbal medicines for sexually

transmitted diseases and AIDS. J Ethnopharmacol 2002;

80: 49-66.

19. Francisco C G et al. Phytotherapy Research 2008;

22:993–998.

20. Pujar M, Patil C, Kadam A. Comparison of antimicrobial

efficacy of Triphala, Green tea polyphenols and 3%

Sodiumhypochlorite on Enterococcus faecalis biofilims

formed on tooth substrate – In vitro. JIOH 2011; 3: 23-29.

21. Pujar M, Makandar S. Herbal usage in endodontics - A

Review. Int. Journal of Contemporary Dentistry 2011; 2

:34-37.

22. Pundir R, Jain P, Sharma C. Antimicrobial activity of

ethanolic extracts of Syzygium Aromaticum and Allium

Sativum against food associated bacteria and fungi.

Ethnobotanical Leaflets 2010;14:344-360.

23. Durairaj S, Srinivasan S, Lakshmanaperumalsamy P.

Invitro antibacterial activity and stability of Garlic

extract at different pH and temperature. Electronic

Journal of Biology 2009; 5 : 5-10.

24. Dhinahar S, Lakshmi T. Role of botanicals as

antimicrobial agent in management of dental infections –

A Review. International Journal of Pharma And

Biosciences 2011; 4: 690-704.

25. Enzo A , Palombo. Traditional medicinal plant extract

and natural products with activity against oral bacteria.

Potential application in the prevention and treatment of

oral Diseases. Evidence Based Complementary and

Alternative Medicine 2011;7 : 1-12.

26. Dhanyakumar N, PreenaSidhu M. The antimicrobial

activity of Azadirachta indica, Cinnamum zeylanicum,

Syngium aromaticum, Accacia nilotica on Streptococcus

mutans and Enterococccus faecalis: An in-vitro study.

Endodontology 2009;4:18-25.

27. Chaturvedi TP. Uses of turmeric in dentistry –an update.

Indian J Dent Res 2009; 20:107-109.

28. Neelakantan P, Subbarao C, Subbarao CV. Analysis of

Antibacterial Activity of Curcumin against Enterococcus

faecalis. Int J Curr Res Rev 2011; 3: 37- 42.

29. Orstavik D, Haapasalo M. Disinfection by endodontic

irrigants and dressings of experimentally infected

dentinal tubules. Endodontics and Dental Traumatology

1990;8 :142-149.

30. Russell S. E, Anthony P J, Roberts S, Thomas. B,

Frederick L. An In vitro evaluation of the antibacterial

efficacy of Chlorine Dioxide on E. Faecalis in bovine

Incisors. J Endod 2005; 31 : 672-675.

31. Khademi A, Yazdizadeh M, Feizianfard M.

Determination of the minimum instrumentation size for

penetration of irrigants to the apical third of root canal

systems. J Endod 2006; 32:417-420.



32. Haapasalo M,Orstavik D. In- vitro infection and

disinfection of dentinal tubules. Journal of Dental

Research 1987; 66:1375-1379.

33. Safavi KE, Spanberg L, Langeland K. Smear layer

removal effects on root canal dentin tubule disinfection. J

Endod 1989; 15:175-176.

34. Adriaens PA, de Boever JA, Loesche WJ. Bacterial

invasion in root cementum and radicular dentine of

periodontally teeth in humans. Journal of Periodontology

1988; 59: 222-230.

35. Sena NT , Gomes A, Vianaa ME, Berber VB, Zaia AA,

Ferraz C R. In- vitro antimicrobial activity of sodium

hypochlorite and chlorhexidine against selected single-

species biofilm. Int Endod J 2006; 39 :878-885.

36. Sundqvist G, Figdor D, Persson S, Sjogren U.

Microbiologic analysis of teeth with failed endodontic

treatment and the outcome of conservative retreatment.

Oral Surg Oral Med Oral Pathol 1998; 85: 86-92.

37. Pinheiro ET, Gomes BP, Ferraz CC, Teixeira FB, Zaia

AA, Souza Filho FJ. Evaluation of root canal

microorganisms isolated from teeth with endodontic

failure and their antimicrobial susceptibility. Oral

Microbiol Immunol 2003; 18: 100-3.

38. Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M.

Isolation of yeasts and enteric bacteria in root filled teeth

with chronic apical periodontitis. Int Endod J 2001; 34:

429-34.

39. Rees LP, Minney SF, Plummer NT, Slater JH, Skyrme

DA. A quantitative assessment of the antimicrobial

activity of garlic (Allium sativum). World J Microbiol

Biotechnol 1993;9:303-7.

40. Hegde V, Kesaira DP. Comparative evaluation of

antimicrobial activity of neem, propolis, turmeric,

liquorice and sodium hypochlorite as root canal irrigants

against E. faecalis and C. albicans - An invitro study.

Endodontology 2013;25 :38-45.

CORRESPONDENCE AUTHOR :

Dr. Suresh Kumar Pandey

Department of Conservative Dentistry and Endodontics,

K.D. Dental College and Hospital. Mathura -281006,

(U.P) India.

Email- sureshpandey118@gmail .com



14 a comparative evaluation - amu.ac.in comparative evaluation.p… · root canal irrigants.[21]...

Documents