KACD
Articles
- Page Path
- HOME > Restor Dent Endod > Volume 44(1); 2019 > Article
-
Research Article
In vitro evaluation of octenidine as an antimicrobial agent againstStaphylococcus epidermidis in disinfecting the root canal system -
Jia Da Chum1
, Darryl Jun Zhi Lim1, Sultan Omer Sheriff2, Shaju Jacob Pulikkotil2, Anand Suresh3, Fabian Davamani4 -
Restor Dent Endod 2019;44(1):e8.
DOI: https://doi.org/10.5395/rde.2019.44.e8
Published online: February 8, 2019
1Department of Dental Surgery, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
2Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
3Department of Conservative Dentistry and Endodontics, Penang International Dental College, Penang, Malaysia.
4School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia. JFIF d d Ducky d qhttp://ns.adobe.com/xap/1.0/ |er˭|I|-fGK.rΛp8XV1%K6mvG+tc+qE &ǸC_Nm:l=_/m5^[dߌڇ.c<%:)tQ$Ow~-aY;UJ >=F)2[nk؆?훐 M=l6[4(O.]2#-H^n#->&mp5~Fӛ+|| S,xag% qkEUzUgæBhߕP(7]kFnq?֖Cpru Z6*rEڊtS|*tI*E}7R<,nUU֫^I7Q*mSly%rdȓd8hE<9oHhMfNSRj[i7D[Rj݊+kდq{"$$H?p \̅S?㭻;t~ R߁ )^/>Qj`yt[w ԛ;² ~+ ߔ_ YW~|o] ?x^ᯛ `ʼn;g)T@vWn]>&4l p+$D̢1l|ȨF%-} .9[}w~
ԠLM9hСablfe&QoW !s ?wjLK?s7yO>(=C~_nyǜu? v 3vyo oI@qV-jeES^[9WoSܝh"l2C1a͔CiJ@3:Pճw= /7ovuk+\V;lDgն <[A+r X~d;m!_s8ݖ;;.0llUC+?i#_crʙ1~C.\q u l8Hܶ2m`ܻM3Tov|Bs rɵ"oLS-
DКw=Tv@f '6|YlD͓Y%-#Ѯo%:&!3o%\J<02;K87>^vgƓ# ;ݝmz^Y6=PS39U%~
&f#
}o!muH; ʲŇ˷yvP+&.7e[3'vR4Yj̗IZ`e˽3o[WU{
m[sUbۋZǾۆl6~9'V*.\S2<Sd*zY[aŶ`]C$n.v^Ʌ
dng>ەZ,Mmϑ :n6nϦezW qUJ4! ۇ4R! =>>F n|Q[{pRO 17ƕ~._I ''00k=b՛o}Osðc2'o\3}ݭQ^ 2 . R1yKȣtAݿ-u ܾw!`?1Whn|gzU o[ECWwjUIן)^h#1ɭ!/Z
np;o;ΗŻkXs."6E`Z1
עӐ9Kl8qd q} 2Stt;#j>;խabONŗ=fwP1j)l6J̶|gV 2`y/0E˛6+ԫ1?
6}KW c\KoKͨ2ۅFws*TԞLיuDx .kCzWXhy۶gLu|%TnupǺl-S* P RaLnT+c+*xl.v!.U=|; !_L̎뱚U=4hm:ٯ"y)$:>%(n}X'p[ȴ
^˒4kƓmzDx
\
'Nq amP7nyN݅=
- Correspondence to Sultan Omer Sheriff, BDS, MDS. Senior Lecturer, Clinical Dentistry, School of Dentistry, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia. dromersheriff@gmail.com
- Correspondence to Fabian Davamani, PhD. Senior lecturer, School of Health Sciences, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia. fabian_davamani@imu.edu.my
• Received: April 3, 2018 • Revised: May 7, 2018 • Accepted: May 14, 2018
Copyright © 2019. The Korean Academy of Conservative Dentistry
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- 3,402 Views
- 26 Download
- 21 Crossref
Abstract
-
Objectives Irrigants are imperative in endodontic therapy for the elimination of pathogens from the infected root canal. The present study compared the antimicrobial efficacy of octenidine dihydrochloride (OCT) with chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against Staphylococcus epidermidis (S. epidermidis) for root canal disinfection.
-
Materials and Methods The minimum inhibitory concentration (MIC) was obtained using serial dilution method. The agar diffusion method was then used to determine the zones of inhibition for each irrigant. Lastly, forty 6-mm dentin blocks were prepared from human mandibular premolars and inoculated with S. epidermidis. Samples were randomly divided into 4 groups of 10 blocks and irrigated for 3 minutes with saline (control), 2% CHX, 3% NaOCl, or 0.1% OCT. Dentin samples were then collected immediately for microbial analysis, including an analysis of colony-forming units (CFUs).
-
Results The MICs of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. All tested irrigants showed concentration-dependent increase in zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). There were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples.
-
Conclusions This study showed that OCT was comparable to or even more effective than CHX and NaOCl, demonstrating antimicrobial activity at low concentrations against S. epidermidis.
INTRODUCTION
Bacteria have been identified as the main cause of pulp infection and periapical disease [1,2]. It has been established that irrigants, coupled with mechanical instrumentation, are mandatory to ensure the elimination or greatest possible reduction of pathogens from the infected root canal. Irrigants have varying degrees of antimicrobial activity. The characteristics of an ideal endodontic irrigant includes good antimicrobial activity, non-cytotoxicity towards the surrounding periapical tissue, and the ability to inactivate endotoxins, to act as a lubricant, and to dissolve organic tissue remnants [3,4,5,6]. The present study focused on the antimicrobial aspect of irrigants, as there are over 700 bacterial species in the oral cavity, with any individual harboring 100–200 species [7]. Furthermore, it has also been proven beyond doubt that the presence of bacteria is a major contributor to endodontic infections.
Sodium hypochlorite (NaOCl) has long been the gold-standard endodontic irrigant due to its good antimicrobial activity and tissue-dissolving capability [3,5]. However, it has been found to cause severe inflammatory reactions when placed in contact with vital tissues [8]. Chlorhexidine (CHX) is a widely used antimicrobial agent that has emerged as an endodontic irrigant. It has also been used as an inter-appointment medication during the endodontic treatment of teeth with apical periodontitis. As an irrigant, CHX has shown antimicrobial effectiveness comparable to NaOCl in several clinical and laboratory studies [9,10,11,12,13]. However, CHX has shown cytotoxic potential, although to a lesser extent than NaOCl. Therefore, adequate precautions should be taken when CHX is used in oral treatments at higher concentrations or for a longer duration [14,15].
Octenidine dihydrochloride (OCT; N,N′-[1,10 decanediyldi-1[4H]-pyridinyl-4ylidene]bis[1-octanamine]dihydrochloride) is a bispyridine antimicrobial compound that carries 2 cationic active centers per molecule and demonstrates broad-spectrum antimicrobial effects, covering both gram-positive and gram-negative bacteria, fungi, and several viral species [16]. It exerts bactericidal/fungicidal effects by interfering with cell walls and membranes. OCT is currently widely used in the medical field for skin burns and decontaminating mucous membranes and open wounds [17]. It is also used in mouthwash formulations and other dental applications. Nonetheless, OCT is not currently popular as an endodontic irrigant because insufficient information is available about its properties in vivo. OCT is unique due to its relative non-cytotoxicity at the site of action [18] and good antimicrobial activity. These characteristics make OCT attractive as a potential alternative antimicrobial agent in the field of endodontics.
Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) have repeatedly been found in root canals undergoing retreatment due to persistent infections [12]. Extensive research has been performed on E. faecalis and C. albicans. However, recent studies have identified Staphylococcus epidermidis (S. epidermidis) as one of the most prevalent species in cases of post-endodontic treatment disease with endodontic failure, along with E. faecalis [19]. S. epidermidis is known to be a facultative anaerobe that can grow through aerobic respiration or fermentation in anaerobic conditions [20]. The aim of the present study was to compare the antimicrobial effects of OCT with 3% NaOCl and 2% CHX as root canal irrigants against S. epidermidis.
MATERIALS AND METHODS
The present study was approved by the International Medical University Ethics Committee (project number: BDS I1-12(03)2015). The model proposed by Haapasalo and Ørstavik [21] was modified for the present study.
Sterilized trypticase soy broth/agar (Hadry Diagnostics, Santa Maria, CA, USA) was prepared following the manufacturer's instructions, and the agar media was poured into a sterilized petri dish to a depth of 5 mm, under a laminar flow hood. The poured plates were allowed to solidify and were refrigerated until use. S. epidermidis was initially grown on a trypticase soy agar plate at 37°C for 24 hours. A single colony was then suspended in 5 mL of trypticase soy broth and grown overnight at 37°C. Its turbidity was then adjusted to a McFarland standard of 0.5.
The minimum inhibitory concentration (MIC) was determined using serial dilutions of 0.1% OCT, 2% CHX, and 3% NaOCl. S. epidermidis was prepared to obtain the 0.5 McFarland turbidity. The 96-well plate was then incubated in a rotary incubator (180 rpm) at 37°C for 24 hours. The MIC was defined as the lowest concentration of each irrigant in which no visible turbidity was noted.
The agar diffusion method was used to determine the zone of inhibition. S. epidermidis was subcultured onto trypticase soy agar plates and incubated at 37°C for 24 hours. The colonies were suspended in broth and the turbidity was adjusted, corresponding to a McFarland standard of 0.5. The bacterial suspension was then spread evenly over the surfaces of the trypticase soy agar plate and left for 5 minutes to dry. Pre-sterilized Whatman discs (6 mm in diameter) were soaked in 20 µL of different concentrations of each irrigant: 1%, 2% and 3% of NaOCl; 0.5%, 1% and 2% of CHX; 0.0125%, 0.025%, 0.05% and 0.1% of OCT; saline as a control. The discs were then placed on the trypticase soy agar plate with sufficient distance between them and incubated at 37°C for 24 hours. The zones of inhibition were then measured using a transparent ruler and recorded. Triplicate data for each concentration were obtained and the results were averaged.
After obtaining informed consent from patients attending the Oral Health Clinic of International Medical University, 40 non-carious single-rooted human mandibular premolars extracted for orthodontic or periodontal reasons were collected. The calculus and tissue remnants on the exterior root surface were removed using a curette. The teeth were then embedded in cubical blocks of auto-polymerizing custom tray resin. The blocks were mounted and de-coronated using a high-speed precision diamond disc under water cooling. Then, 6 mm dentin blocks were cut from the cementoenamel junction. The samples were kept in a moist environment during all the procedures to prevent dehydration.
The inner diameter of the root canals of each sample was standardized using a Gates Glidden size 3 drill at 300 rpm with a lowspeed handpiece. The dentin blocks were cleaned in an ultrasonic water bath for 3 cycles of 20 minutes to remove the smear layer. The dentin blocks were then autoclaved, and the external surfaces of the samples were coated with nail varnish, placed in 70% alcohol for sterilization, and allowed to dry at room temperature for 1 hour in a biosafety cabinet under aseptic conditions. The tooth samples were pretreated with plain culture media before contamination. All procedures were done in a biosafety cabinet (biosafety level II) under aseptic conditions.
A McFarland standard of 0.5 of S. epidermidis was used for contaminating the dentin blocks. The dentin blocks were then inoculated by immersing them in the bacterial suspension in pre-sterilized containers at 37°C for 21 days, with a change of the bacterial suspension once every 3 days.
After incubation for 21 days, the dentin blocks were removed from the bacterial suspension using sterilized artery forceps. The excess culture was removed from the surface of the dentin samples using sterile paper. The samples were then randomly divided into 4 groups of 10 blocks: saline, 2% CHX, 3% NaOCl, and 0.1% OCT. Each group was then irrigated with 5 mL of its respective irrigant for a period of 3 minutes. The excess irrigant was then removed with sterile paper points from each dentin block.
Dentin chips were harvested from the root canal by circumferential removal using a lowspeed handpiece with a Gates Glidden size 4 drill. The dentin chips obtained were collected in Eppendorf tubes containing 0.5 mL of saline. The suspension was then homogenized by vigorous vortexing to release the adhered bacteria and left for 5 minutes to allow sedimentation of the dentin chips. The supernatant, which contained the bacterial suspension, was then used for microbiological analysis to determine the amount of colony-forming units (CFUs).
A Kruskal Wallis test was conducted on the data of zones of inhibitions and CFUs to evaluate differences among the groups studied. Post hoc tests were conducted to evaluate pairwise comparisons among the groups by using Duncan's test of multiple comparisons. The data was statistically analyzed with a level of significance set at 5% (IBM SPSS statistics software version 20.0, IBM, Armonk, NY, USA).
RESULTS
The MIC values of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. The inhibition zones of CHX, NaOCl, and OCT at each tested concentration are presented in the Figure 1. All tested irrigants showed concentration-dependent increase of zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). OCT in 0.0125% solution showed significantly larger zone of inhibition than 0.5% and 1% CHX (p < 0.05), and 0.025% OCT showed similar zone of inhibition with 2% CHX and 1% NaOCl.
Figure 1
Measurements of the inhibition zones of the irrigants (mm).
CHX, chlorhexidine; NaOCl, sodium hypochlorite; OCT, octenidine dihydrochloride.
Different lower superscript letters indicate statistically significant differences.
CFUs evaluated in dentin block model showed significant antibacterial effect of tested irrigants on S. epidermidis compared to saline (p < 0.05). However, there were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples (Figure 2).
Figure 2
Colony-forming unit (CFU) values of tested irrigants.
CHX, chlorhexidine; NaOCl, sodium hypochlorite; OCT, octenidine dihydrochloride.
Different lower superscript letters indicate statistically significant differences.
DISCUSSION
Irrigation of the root canal is one of the key determinants imperative for successful endodontic treatment. In the present study, antimicrobial effects of OCT against S. epidermidis was investigated and found that 0.1% OCT showed comparable antimicrobial effect with 2% CHX and 3% NaOCl. The effective concentration of OCT was determined by MIC and agar diffusion technique, and validated the antimicrobial effect by quantitative analysis of CFUs.
Evidence from literature suggested that antimicrobial efficacy of OCT was sufficient in the complex environment of the root canal system. The results of present study also indicated the same. This bispyridine derivative was first developed by Sterlig Winthrop Research Institute and its use in form of mouth rinse showed inhibition of plaque and dental caries both in humans and rats [22,23]. Enhanced antimicrobial efficacy of OCT attributed to its cation-active structure that readily binds to negatively charged bacterial cell wall and thereby affects vital functions of cell membrane that leads to cell death [24].
The agar diffusion test is a well-established technique for studying antibacterial properties. The advantage of this method is that the antimicrobial effect of medicaments can be detected by challenging the bacterial isolates with antimicrobial discs without any change in the chemical properties of the medicaments. In the present study, 3% NaOCl showed the largest zones of inhibition against S. epidermidis (p < 0.05), and all tested concentrations of OCT showed significantly larger zone of inhibition than 2% CHX (p < 0.05). Considering the discrepancies among MICs and zone of inhibition data of tested irrigants found in this experiment, it could be speculated that OCT at a lower concentration could be a potent antimicrobial irrigant against S. epidermidis.
CFU analysis revealed that 0.1% OCT significantly inhibited S. epidermidis, similar to 2% CHX and 3% NaOCl. The present antimicrobial results are in accordance with previous reports. Kapur et al. [25] demonstrated that various concentrations of OCT were effective on E. faecalis, C. albicans, and a mixture of both, compared to 5.25% NaOCl and 1% or 2% CHX. Tirali et al. [26] and Anuradha et al. [8] reported antimicrobial effect of OCT against E. faecalis, and Ghivari et al. [27] also verified antimicrobial effect of 0.1% OCT against E. faecalis, S. aureus, and C. albicans.
The dentin block model used in our experiment was modified from Haapasalo and Ørstavik [21]. Although the 3-week incubation period allowed the infection of dentinal tubules with S. epidermidis, the present ex vivo dentin infection method does not simulate deep and homogeneous penetration of bacteria into all dentinal tubules in all tested specimens. Also the tubular depth-related antimicrobial effect could not be deduced from current experimental setting. Despite its potent antimicrobial effect, in addition, OCT cannot replace NaOCl as root canal irrigant because it does not possess the ability to dissolve pulp tissue [17].
Further researches on OCT including its interactions with other irrigants, dose-effectiveness, antimicrobial efficacy against other single- or multi-species biofilms, and safety are required.
CONCLUSIONS
In this study, the antimicrobial effect of OCT against S. epidermidis was investigated in comparison to CHX and NaOCl. Within the limitations of the present study, OCT at lower concentrations effectively inhibited antimicrobial growth of S. epidermidis in compared to CHX and NaOCl, implying the possible applicability as an endodontic irrigant in terms of the antimicrobial properties that were evaluated.
-
Conflict of Interest: No potential conflict of interest relevant to this article was reported.
-
Author Contributions:
Conceptualization: Sheriff SO, Davamani F.
Data curation: Pulikkotil SJ, Suresh A.
Formal analysis: Chum JD, Lim DJZ.
Funding acquisition: Sheriff SO, Davamani F.
Investigation: Chum JD, Lim DJZ, Sheriff SO, Davamani F.
Methodology: Chum JD, Lim DJZ, Sheriff SO, Davamani F.
Project administration: Sheriff SO, Davamani F.
Resources: Sheriff SO, Davamani F.
Supervision: Sheriff SO, Pulikkotil SJ, Davamani F.
Validation: Pulikkotil SJ, Suresh A.
Writing - original draft: Chum JD, Lim DJZ, Sheriff SO, Davamani F.
Writing - review & editing: Sheriff SO, Pulikkotil SJ, Suresh A, Davamani F.
- 1. Sundqvist G. Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol 1994;78:522-530.ArticlePubMed
- 2. Yoshida M, Fukushima H, Yamamoto K, Ogawa K, Toda T, Sagawa H. Correlation between clinical symptoms and microorganisms isolated from root canals of teeth with periapical pathosis. J Endod 1987;13:24-28.ArticlePubMed
- 3. Yesilsoy C, Whitaker E, Cleveland D, Phillips E, Trope M. Antimicrobial and toxic effects of established and potential root canal irrigants. J Endod 1995;21:513-515.ArticlePubMed
- 4. Ohara P, Torabinejad M, Kettering JD. Antibacterial effects of various endodontic medicaments on selected anaerobic bacteria. J Endod 1993;19:498-500.ArticlePubMed
- 5. Bufflier P, Suchett-Kaye G, Morrier JJ, Benay G, Decoret D, Bonin P, Renard F, Barsotti O. In vitro evaluation of the antibacterial effects of intracanal micro plasma system treatment. J Endod 1997;23:28-31.ArticlePubMed
- 6. Harrison JW. Irrigation of the root canal system. Dent Clin North Am 1984;28:797-808.ArticlePubMed
- 7. Paster BJ, Olsen I, Aas JA, Dewhirst FE. The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000 2006;42:80-87.ArticlePubMed
- 8. Anuradha B, Indira R, Lalitha M, Sriram T. A new irrigant against E. faecalis in root canal disinfection. Biosci Biotechnol Res Asia 2014;11:121-127.Article
- 9. Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod 2004;30:84-87.ArticlePubMed
- 10. Jeansonne MJ, White RR. A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. J Endod 1994;20:276-278.ArticlePubMed
- 11. Vahdaty A, Pitt Ford TR, Wilson RF. Efficacy of chlorhexidine in disinfecting dentinal tubules in vitro . Endod Dent Traumatol 1993;9:243-248.ArticlePubMed
- 12. Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CC, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:79-84.ArticlePubMed
- 13. Ruff ML, McClanahan SB, Babel BS. In vitro antifungal efficacy of four irrigants as a final rinse. J Endod 2006;32:331-333.ArticlePubMed
- 14. Giannelli M, Chellini F, Margheri M, Tonelli P, Tani A. Effect of chlorhexidine digluconate on different cell types: a molecular and ultrastructural investigation. Toxicol In Vitro 2008;22:308-317.ArticlePubMed
- 15. Bonacorsi C, Raddi MS, Carlos IZ. Cytotoxicity of chlorhexidine digluconate to murine macrophages and its effect on hydrogen peroxide and nitric oxide induction. Braz J Med Biol Res 2004;37:207-212.ArticlePubMed
- 16. Sedlock DM, Bailey DM. Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent. Antimicrob Agents Chemother 1985;28:786-790.ArticlePubMedPMCPDF
- 17. Slee AM, O'Connor JR. In vitro antiplaque activity of octenidine dihydrochloride (WIN 41464-2) against preformed plaques of selected oral plaque-forming microorganisms. Antimicrob Agents Chemother 1983;23:379-384.ArticlePubMedPMCPDF
- 18. Tirali RE, Bodur H, Sipahi B, Sungurtekin E. Evaluation of the antimicrobial activities of chlorhexidine gluconate, sodium hypochlorite and octenidine hydrochloride in vitro. Aust Endod J 2013;39:15-18.ArticlePubMed
- 19. Murad CF, Sassone LM, Faveri M, Hirata R Jr, Figueiredo L, Feres M. Microbial diversity in persistent root canal infections investigated by checkerboard DNA-DNA hybridization. J Endod 2014;40:899-906.ArticlePubMed
- 20. Wikipedia. Staphylococcus epidermidis [Internet]. place unknown: Wikipedia; 2016. updated 2018 Aug 5]. Available from: https://en.wikipedia.org/wiki/Staphylococcus_epidermidis.
- 21. Haapasalo M, Ørstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 1987;66:1375-1379.ArticlePubMedPDF
- 22. Patters MR, Anerud K, Trummel CL, Kornman KS, Nalbandian J, Robertson PB. Inhibition of plaque formation in humans by octenidine mouthrinse. J Periodontal Res 1983;18:212-219.ArticlePubMed
- 23. Shern RJ, Monell-Torrens E, Kingman A. Effect of two recently developed antiseptics on dental plaque and caries in rats. Caries Res 1985;19:458-465.ArticlePubMed
- 24. Hübner NO, Siebert J, Kramer A. Octenidine dihydrochloride, a modern antiseptic for skin, mucous membranes and wounds. Skin Pharmacol Physiol 2010;23:244-258.ArticlePubMedPDF
- 25. Kapur I, Aggarwal A, Makkar S, Pasricha S. Comparative evaluation of octenidine hydrochloride and chlorhexidine as antibacterial root canal irrigant. Indian J Oral Sci 2015;6:10-13.Article
- 26. Tirali RE, Turan Y, Akal N, Karahan ZC. In vitro antimicrobial activity of several concentrations of NaOCl and Octenisept in elimination of endodontic pathogens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e117-e120.Article
- 27. Ghivari SB, Bhattacharya H, Bhat KG, Pujar MA. Antimicrobial activity of root canal irrigants against biofilm forming pathogens: an in vitro study. J Conserv Dent 2017;20:147-151.ArticlePubMedPMC
REFERENCES
Tables & Figures
REFERENCES
Citations
Citations to this article as recorded by 
- Peptidoglycan Recognition Protein-S as a Dual-Action Antimicrobial and Immunomodulatory Agent Against Staphylococcus aureus
Priya Verma, Priyanka Swaroop, Surabhi Pandit, Ved Prakash, Surender Kumar Sharawat, T. P. Singh, Sujata Sharma, Pradeep Sharma
Probiotics and Antimicrobial Proteins.2026; 18(4): 5660. CrossRef - Effect of final irrigation protocols on the bond strength and dentinal tubule penetration of root canal sealers: an ex vivo laboratory study
Sevinc Askerbeyli Örs, Gülgün Atay Yılmaz, Nihan Şengül, Ahmet Keleş, Selen Küçükkaya Eren
BMC Oral Health.2026;[Epub] CrossRef - WITHDRAWN: Substantivity of different antiseptic oral gels. An In vitro study
Nirit Tagger Green, Roni Kolerman, Carlos Nemcovsky, Shlomo Matalon, Dan Gaukhman, Liat Chaushu
Heliyon.2025; : e42654. CrossRef - Antimicrobial and anti-biofilm activity of crustacean-derived chitosan against Salmonella Typhimurium, Staphylococcus aureus and Listeria monocytogenes
Sivainesh Devi Remesh, Pratheep Sandrasaigaran, Santhaniswarman Remesh, Veeradasan Perumal, Joshua Yap Lip Vun, Sivasangkary Gandhi, Hanan Hasan
Food Bioscience.2025; : 106697. CrossRef - Glycerol-Enhanced Gum Karaya Hydrogel Films with a Sandwich-like Structure Enriched with Octenidine for Antibacterial Action against Multidrug-Resistant Bacteria
Eva Černá, Vilém Neděla, Eva Tihlařiková, Jana Brtníková, Zdenka Fohlerová, Břetislav Lipový, Lukáš Vacek, Filip Růžička, Jana Matulová, Lucy Vojtová
ACS Omega.2025; 10(27): 29530. CrossRef - Effect of Mouth Rinsing and Antiseptic Solutions on Periodontitis Bacteria in an In Vitro Oral Human Biofilm Model
Jan Tinson Strenge, Ralf Smeets, Maria Geffken, Thomas Beikler, Ewa Klara Stuermer
Dentistry Journal.2025; 13(7): 324. CrossRef - In Vitro Investigation of the Effects of Octenidine Dihydrochloride on Nasal Septum Squamous Carcinoma Cells
Ihsan Hakki Ciftci, Asuman Deveci Ozkan, Gulay Erman, Elmas Pinar Kahraman Kilbas, Mehmet Koroglu
Biomedicines.2025; 13(11): 2668. CrossRef - In Vitro Evaluation of Antimicrobial Effects of Endodontic Irrigants Containing Disodium Edetate and Chlorhexidine Gluconate, Octenidine Dihydrochloride, and Benzalkonium Bromide Against Intracanal Enterococcus faecalis
Anna Siemińska, Katarzyna Kot, Ewa Marek, Agnieszka Chamarczuk, Magdalena Kaczała, Joanna Rasławska-Socha, Laurentia Schuster, Till Dammaschke, Liliana Szyszka-Sommerfeld, Mariusz Lipski
Journal of Clinical Medicine.2025; 14(19): 7100. CrossRef - Evaluation of postoperative pain in endodontic retreatment with apical periodontitis using ozonated 2% chlorhexidine and 0.1% octenidine application: A randomized clinical trial
Nidhi Sinha, Geeta Asthana, Girish Parmar, Akshayraj Langaliya, Jinali Shah, Bijay Singh
Journal of Conservative Dentistry and Endodontics.2024; 27(6): 654. CrossRef - Research on NiTi instruments combined with ultrasonic irrigation and multiantibiotic paste in root canal therapy of periapical inflammation in deciduous teeth
Zongxia Zhu, Guangli Fu
Experimental and Therapeutic Medicine.2024;[Epub] CrossRef - Comparative evaluation of antimicrobial efficacy of 0.1% octenidine dihydrochloride, superoxidized solution, ozonated water, 0.1% silver nanoparticle solution, and Q mix™ 2 in 1 in root canals infected with Enterococcus faecalis
Mahenaz Salam Inamdar, Dayanand G. Chole, Shrinivas S. Bakle, Preeti B. Vaprani, Neha P. Gandhi, Nikhil R. Hatte
Journal of Conservative Dentistry and Endodontics.2024; 27(10): 1059. CrossRef - Causal relationship, shared genes between rheumatoid arthritis and pulp and periapical disease: evidence from GWAS and transcriptome data
Huili Wu, Lijuan Wang, Chenjie Qiu
Frontiers in Immunology.2024;[Epub] CrossRef - The effect of octenidine dihydrochloride on the antibacterial activity of a formulated resin composite: an in vitro study
Mahitab Mansour, Tarek Salah, Haidy N. Salem
Bulletin of the National Research Centre.2024;[Epub] CrossRef - Association between pulp and periapical disease with type 2 diabetes: A bidirectional Mendelian randomization
Yuqiang Wang, Jiakang Zhu, Ying Tang, Cui Huang
International Endodontic Journal.2024; 57(5): 566. CrossRef - New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry
Stefania-Irina Dumitrel, Anamaria Matichescu, Stefania Dinu, Roxana Buzatu, Ramona Popovici, Dorin Dinu, Dana Bratu
Molecules.2024; 29(16): 3802. CrossRef - Formulation and Characterization of a Novel Palm-Oil-Based α-Mangostin Nano-Emulsion (PO-AMNE) as an Antimicrobial Endodontic Irrigant: An In Vitro Study
Omer Sheriff Sultan, Haresh Kumar A/L Kantilal, Khoo Suan Phaik, Hira Choudhury, Fabian Davamani
Processes.2023; 11(3): 798. CrossRef - Comparative Evaluation of Antimicrobial Efficacy of Herbal Formulations of Septilin and Triphala with Conventional 2% Chlorhexidine on Root Canal and Oral Commensal Bacteria using Kirby Bauer Method
Shadab Ahmed, Kamil Shahnawaz, Tapan Kumar Mandal, Mamnoon Ghafir, Shiva Shankar Gummaluri, Gaurav Vishal
Contemporary Clinical Dentistry.2022; 13(4): 383. CrossRef - A comparative assessment of pomegranate extract, sodium hypochlorite, chlorhexidine, Myrrh (Commiphora molmol), tulsi extract against Enterococcus faecalis, Fusobacterium nucleatum and Staphylococci epidermidis
Mallwika Sisodiya, Shadab Ahmed, Ranjan Sengupta, Priyanka, Ankit Kumar Saha, Gourav Verma
Journal of Oral and Maxillofacial Pathology.2021; 25(2): 369. CrossRef - Effects of Octenidine on the Formation and Disruption of Dental Biofilms: An Exploratory In Situ Study in Healthy Subjects
B. Reda, J. Dudek, M. Martínez-Hernández, M. Hannig
Journal of Dental Research.2021; 100(9): 950. CrossRef - Does Cavity Disinfectant Affect Sealing Ability of Universal Self-etch Adhesive?
S Lata, Prasanti Kumari Pradhan, Gaurav Patri, Subhasmita Bhol, Kanhu C Sahoo, Khushboo Ghosh
The Journal of Contemporary Dental Practice.2021; 22(3): 273. CrossRef - Effect of duration and dilution on antimicrobial efficacy of octenidine hydrochloride as an intracanal medicament with chitosan carrier against Enterococcus faecalis – A modified direct contact test
VinayaSusan Varghese, Nirmal Kurian
Journal of Conservative Dentistry.2020; 23(5): 463. CrossRef
ePub Link
Cite
XML Download
Figure 1 Measurements of the inhibition zones of the irrigants (mm).CHX, chlorhexidine; NaOCl, sodium hypochlorite; OCT, octenidine dihydrochloride.Different lower superscript letters indicate statistically significant differences.
Figure 2 Colony-forming unit (CFU) values of tested irrigants.CHX, chlorhexidine; NaOCl, sodium hypochlorite; OCT, octenidine dihydrochloride.Different lower superscript letters indicate statistically significant differences.
