Enterococcicidal activity of chlorine dioxide and lemon extract endorse them as contemporary root canal irrigants

摘要

Background and Objective: Enterococcus faecalis offers challenges when present in an anatomically challenging and inaccessible site such as root canal and are instrumental in treatment failures. This emphasizes the need for irrigants besides mechanical instrumentation in root canal treatment to reinstate tooth structure and function. We explored the efficacy of chlorine dioxide and lemon extracts as alternatives to the conventional irrigant sodium hypochlorite on E. faecalis. Materials and Methods: The anti-enterococcal activity of the test and control irrigants was detected by disk diffusion method. The time taken by the chlorine dioxide, lemon extract (undiluted and 1:1 dilution), sodium hypochlorite, and saline to produce enterococcicidal activity was estimated by contact time studies, and the colony counts of E. faecalis at the time intervals of 1, 5, 10, 30, and 60 min and 24 h following exposure with irrigants were determined. Results: Chlorine dioxide and undiluted lemon extract demonstrated better anti-enterococcal activity than conventional irrigant sodium hypochlorite. Complete enterococcicidal activity was noted after a time interval of 1 min of exposure with chlorine dioxide, undiluted lemon extract, and sodium hypochlorite and after 10 min of exposure with 1:1 diluted lemon extract. Conclusion: The nonentity in literature on studies assessing the contact time of chlorine dioxide solution and lemon extract for their possibility as root canal irrigant gave an impetus for the study. Chlorine dioxide and undiluted lemon extract exhibited bactericidal activity against E. faecalis within 1 min of exposure equivalent to the activity of customary irrigant sodium hypochlorite, thus validating their possibility to be used as root canal irrigants.