Dentinal tubule disinfection with 2% chlorhexidine, garlic extract, and calcium hydroxide against Enterococcus faecalis by using real-time polymerase chain reaction: In vitro study

J Conserv Dent. 2013 May;16(3):194-8. doi: 10.4103/0972-0707.111312.

Abstract

Aim: To compare the efficacy of garlic extract with 2% chlorhexidine (CHX) and calcium hydroxide Ca(OH)2 in disinfection of dentinal tubules contaminated with Enterococcus faecalis by using real-time polymerase chain reaction (PCR).

Materials and methods: Agar diffusion test was done to evaluate the minimum inhibitory concentration of garlic extract against E. faecalis. Forty human extracted mandibular premolar teeth were selected for this study, access cavity was prepared and cleaning and shaping was done. Middle third of the root was cut using a rotary diamond disc. The teeth specimens were inoculated with E. faecalis for 21 days. Specimens were divided into four groups---Group 1: 2% CHX, Group 2: Garlic extract, Group 3: Ca(OH)2, and Group 4: Saline (negative control). The intracanal medicaments were packed inside the tooth specimens and incubated for 5 days. The dentinal chips were collected at 400 μm depth using a Gates-Glidden drill, following which DNA isolation was done. The specimens were analyzed using real-time PCR. The results were then statistically analyzed using one-way analysis of variance, followed by post hoc Tukey's honestly significant difference (HSD) multiple comparison of means.

Results: Threshold cycle (Ct) values of 2% CHX was found to be 32.4, garlic extract to be 27.5, and Ca(OH)2 to be 25.6.

Conclusion: A total of 2% CHX showed the maximum efficacy against E. faecalis, followed by garlic extract and Ca(OH)2.

Keywords: Calcium hydroxide; dentinal tubules; garlic extract; intracanal medicament; real- time polymerase chain reaction 2% CHX.