Evaluation of the efficacy of a novel antibiotic–steroid paste versus conventionally used intracanal antibiotic pastes and irrigating solutions against a 3-week-old biofilm of Enterococcus faecalis

INTRODUCTION: Intracanal medicaments have been used during endodontic regenerative procedures to eradicate endodontic pathogens. AIMS: The aim of our study was (1) to evaluate the antimicrobial efficacy of a novel antibiotic–steroid paste over the regularly used calcium hydroxide (Ca (OH)(2)), double antibiotic paste (DAP), and modified triple antibiotic paste (M-TAP) and (2) to check the antimicrobial efficacy of irrigating solutions, Chlorhexidine (CHX), and sodium hypochlorite (NaOCl) against a 3-week-old Enterococcus faecalis (E. faecalis) biofilm. MATERIALS AND METHODS: A total of 112 human extracted teeth were contaminated with E. faecalis for a period of 21 days. A novel antibiotic–steroid paste, Ca (OH) (2), DAP, M-TAP, and a placebo were placed inside the canal, sealed, and incubated in an aerobic environment at 37°C. For irrigating solutions, each prepared sample was immersed in 1 ml of sterile saline for 1 min, followed by irrigating and immersion with 1.5% NaOCl and 2% CHX for 5 min. An antimicrobial assessment was performed at the end of 2 days and 7 days, with seven teeth from each group, for each time interval. Dentin debris collected was transferred to the respective medium for culture. After 24 h, colonies were counted using classical bacterial counting technique as colony-forming units. RESULTS: Statistical analysis revealed that the novel antibiotic–steroid paste showed a statistically insignificant difference when compared to DAP, which had the highest antimicrobial properties. CONCLUSION: This novel functional paste has antimicrobial efficacy comparable with that of DAP.