title: Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study.
abstract: BACKGROUND
  The purpose of this study was to evaluate the antimicrobial efficacy of Triphala, green tea polyphenols (GTP), MTAD, and 5% sodium hypochlorite against E. faecalis biofilm formed on tooth substrate.
  
  
  METHODS
  Extracted human teeth were biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of the 3rd and 6th weeks all groups were treated for 10 minutes with the test solutions and control and were analyzed qualitatively and quantitatively.
  
  
  RESULTS
  Qualitative assay with 3-week biofilm showed complete inhibition of bacterial growth with Triphala, MTAD and NaOCl, except GTP and saline, which showed presence of bacterial growth. In quantitative analysis, GTP- and saline-treated tooth samples have shown 1516 +/- 17.2 CFU/mL, 156.4 x 10(9) +/- 3.1 x 10(9) CFU/mL respectively. Qualitative assay with 6-week biofilm showed growth when treated with Triphala, GTP and MTAD whereas NaOCl has shown complete inhibition. All groups except NaOCl showed eight log reduction when compared to control when analyzed quantitatively.
  
  
  CONCLUSIONS
  5% sodium hypochlorite showed maximum antibacterial activity against E. Faecalis biofilm formed on tooth substrate. Triphala, green tea polyphenols and MTAD showed statistically significant antibacterial activity. The use of herbal alternatives as a root canal irrigant might prove to be advantageous considering the several undesirable characteristics of NaOCl.
authors.affiliation: Department of Conservative Dentistry, Tagore Dental College and Hospital, Chennai, India. drpriyaprabhakar@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Prabhakar
authors.forename: M
authors.initials: M
authors.lastname: Senthilkumar
authors.forename: M S
authors.initials: MS
authors.lastname: Priya
authors.forename: K
authors.initials: K
authors.lastname: Mahalakshmi
authors.forename: P K
authors.initials: PK
authors.lastname: Sehgal
authors.forename: V G
authors.initials: VG
authors.lastname: Sukumaran
mesh_terms: D000891:Anti-Infective Agents, Local / Q000737:chemistry / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D019343:Citric Acid / Q000494:pharmacology; D015169:Colony Count, Microbial; D052978:Disk Diffusion Antimicrobial Tests; D004318:Doxycycline / Q000494:pharmacology; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000502:physiology; D005419:Flavonoids / Q000494:pharmacology*; D006801:Humans; D050296:Microbial Viability / Q000187:drug effects; D010636:Phenols / Q000494:pharmacology*; D010936:Plant Extracts / Q000494:pharmacology*; D059808:Polyphenols; D011136:Polysorbates / Q000494:pharmacology; D012388:Root Canal Irrigants / Q000737:chemistry / Q000494:pharmacology*; D012973:Sodium Hypochlorite / Q000494:pharmacology; D013662:Tea / Q000737:chemistry*
chemical_list: D000891:Anti-Infective Agents, Local; D005419:Flavonoids; C475043:MTAD (intracanal irrigant); D010636:Phenols; D010936:Plant Extracts; D059808:Polyphenols; D011136:Polysorbates; D012388:Root Canal Irrigants; D013662:Tea; C520904:triphala; D019343:Citric Acid; D012973:Sodium Hypochlorite; D004318:Doxycycline