A Comparative Evaluation of Antimicrobial Efficacy of Triphala and Calcium Hydroxide as Intracanal Medicament: An In Vitro Study

BACKGROUND: The goal for placement of intracanal medicament during pulpal therapy procedures is to eradicate the bacteria and the exotoxins from the infected root canal, thereby preventing and controlling pulpal and periradicular infections. Chemo-mechanical preparation is considered an essential step in root canal disinfection; but to accomplish the total elimination of bacteria in highly complex root canal anatomy is difficult. Intracanal medicaments help eliminate bacteria by remaining in the root canal, and calcium hydroxide has been recommended as one of the most effective antimicrobial dressings during endodontic therapy. The herbal agents offer an alternative to synthetic compounds. They have been considered either non-toxic or less toxic. The rapid increase in antibiotic-resistant strains and side effects caused by synthetic drugs have prompted researchers to look for herbal alternatives. AIM AND OBJECTIVE: The in vitro study aims to evaluate and compare the antibacterial activity of triphala and calcium hydroxide against Enterococcus faecalis as an intracanal medicament MATERIALS AND METHODS: The antimicrobial efficacy of triphala and calcium hydroxide was evaluated against E. faecalis cultured and incubated for various time frames in 42 intact, caries-free, human, single-rooted teeth with straight roots and mature apices. The comparison of the number of counted colonies after each incubation time and based on the type of drug used inside the canal is evaluated using non-parametric Kruskal–Wallis test and Mann–Whitney U test, respectively. Statistical analysis was done using SPSS version 14.0. RESULTS: Efficacy of calcium hydroxide against Enterococcus faecalis was best in the first 72-hr time duration compared with triphala. Triphala showed significant antimicrobial activity against Enterococcus faecalis that was closely parallel to the calcium hydroxide group in one week. Calcium hydroxide and triphala had complete eradication of Enterococcus faecalis in a given one-month time duration.