Comparative Evaluation of Antimicrobial Efficacy of Silver Nanoparticles, Calcium Hydroxide with Silver Nanoparticles, Triple Antibiotic Paste as an Intracanal Medicament against Enterococcus faecalis: An In Vitro Study.

Abstract

Introduction: Enterococcus faecalis is frequently implicated in pulpal and periapical infections, particularly due to its ability to form resilient biofilms. Mechanical instrumentation alone is often inadequate for complete elimination of these microorganisms. Hence, chemical irrigation along with the use of intracanal medicaments plays a vital role in achieving effective disinfection. These medicaments help in reducing microbial load, removing toxic byproducts, and clearing residual debris between treatment appointments. In this context, the present study aims to evaluate and compare the antimicrobial potential of different intracanal medicaments against E. faecalis.

Objective: To comparatively analyze the antimicrobial efficacy of silver nanoparticles, a combination of silver nanoparticles with calcium hydroxide, and triple antibiotic paste when used as intracanal medicaments against Enterococcus faecalis.

Materials and Methodology: A pure strain of Enterococcus faecalis was selected as the test organism. Following 24 hours of incubation, bacterial colonies were isolated and inoculated into 5 ml of infusion broth, which was further incubated at 37°C for 4 hours. The bacterial suspension was then standardized to 0.5 McFarland turbidity. Using a sterile swab, the culture was evenly spread onto blood agar plates. Three wells were prepared in each plate using a sterile pipette, into which the respective intracanal medicaments were placed for evaluation.

Results: The findings of the study demonstrated a statistically significant difference between Group I and Groups II and III (p < 0.001). A highly significant increase in the mean zone of inhibition was observed in Groups II and III when compared to Group I (p < 0.001). However, no statistically significant difference was noted between Groups II and III (p > 0.05).

Conclusion: Within the limitations of this in vitro study, it can be concluded that the combination of silver nanoparticles with calcium hydroxide exhibited superior antimicrobial efficacy against E. faecalis biofilm compared to the other groups. Nevertheless, further in vivo studies are recommended to validate these findings under clinical conditions.