The Effect of Herbal Medicine against Enterococcus faecalis on Infected Root Canal Substrate: An Ex-vivo Study

Abstract

Aim: The aim of this study was to evaluate the antimicrobial effects of ginger, cinnamon and their combination against Enterococcus faecalis located in infected root canals. Methodology: A quasi experimental pre-test post-test design was applied through microbiological testing upon prepared root canals of 50 extracted single-rooted teeth. The roots were divided into a total of 5 groups, each group consisted of 10 root canals; three groups contained extracts of ginger, cinnamon, and their combination in a gel form. In addition; a positive control group of calcium hydroxide with Iodoform paste and a negative control group of solely infected root canals. All root canals in each group were infected by Enterococcus faecalis. The colony forming units (CFU) in each root canal were recorded before and after the procedure, and the minimum inhibitory concentration for each test solution was also obtained. Comparisons between the different variables were conducted through the Kruskal Wallis, Wilcoxon and Mann Whitney U tests with the level of significance set at P ≤ 0.05. Results: Extracts of ginger, cinnamon and their combination showed a reduction in (CFU) from an initial count of 83 colonies to a mean (CFU) of 26.5, 77.8 and 49.7, respectively. Ginger showed the greatest antibacterial efficacy in comparison with the others. Upon comparison of the negative control group and the test solutions of ginger, cinnamon and their combination, significant differences were observed (P ˂ 0.05), while no statistical differences (P ˃ 0.05) were observed when comparing with the Calcium Hydroxide with Iodoform group to these test solutions. Conclusions: An inhibitory effect against Enterococcus faecalis occurred upon testing ginger, cinnamon and their combination. Ginger was found to have the highest effect in comparison to other test groups.