Antimicrobial Activity of Calcium Hydroxide Synthesized from Indonesian Limestone against Enterococcus faecalis

Abstract:

Recurrent endodontic infections of treated teeth are mainly linked to microbial persistency in the root canal system. Enterococcus faecalis is a bacterium that is often identified in these recurrent infections. Calcium hydroxide (Ca(OH)₂) is a widely used root canal medicament and is now being developed to be produced from natural materials. Ca(OH)₂, which is synthesized from natural limestone from Palimanan, Indonesia, has a structure similar to Ca(OH)_2, which is often used as a root canal medicament. The purpose of this study was to determine the antimicrobial property of Ca(OH)₂ paste synthesized from natural limestone compared to conventional Ca(OH)₂ paste. This study is an in vitro experimental study consists of 3 groups (n=24, namely, conventional Ca(OH)₂ paste, limestone synthesized Ca(OH)₂ paste, and saline as the negative control, for 2 intervals of time and evaluated by Total Plate Counting (TPC) method. Samples were mandibular first premolar root canal prepared by root canal preparation and contaminated with E. faecalis (ATCC 29212). The infected root canals of each group were treated by the medicaments, and samples from the root canals were taken on day 7 (n=4) and 14 (n=4). Results showed that both Ca(OH)₂ groups had antimicrobial activities against E. faecalis. The limestone Ca(OH)₂ paste group had the least amount of bacterial colonies on the 7^th day compared to other groups. In contrast, on the 14^th day, the conventional Ca(OH)₂ paste had the least bacterial colonies. It can be concluded that the Ca(OH)₂ paste synthesized from natural limestone has an antimicrobial effect on E. faecalis, the antimicrobial effect was higher on the 7^th day but decreases on the 14^th day, whereas the conventional Ca(OH)₂ had a higher antimicrobial effect on day 14 compared to day 7. Further studies are expected to improve the long-term antimicrobial effectiveness and sustainability of the natural limestone synthesized Ca(OH)₂ paste.

• Periodical: Materials Science Forum (Volume 1044)
• Pages: 171-177
• DOI: https://doi.org/10.4028/www.scientific.net/MSF.1044.171
• Online since: August 2021
• Authors: Myrna Nurlatifah Zakaria, Ida Rodiyah Siti Halimah, Atia Nurul Sidiqa, Ira Artilia, Arief Cahyanto*
• Keywords: Antimicrobial, Calcium Hydroxide, Enterococcus faecalis, Limestone, Root Canal Medicament

References

[1] Qureshi, E. Soujanya, Nandakumar, Pratapkumar, Sambashivarao, Recent advances in pulp capping materials: An overview, J. Clin. Diagn. Res. 8 (2014) 316-321.

[2] T.J. Hilton, Key to success with pulp capping: a review of the literature, Oper. Dent. 34 (2009) 615–625.

[3] Z. Mohammadi, P.M.H. Dummer, Properties and applications of calcium hydroxide in endodontics and dental traumatology, Int. Endod. J. 44 (2011) 697–730.

DOI: 10.1111/j.1365-2591.2011.01886.x

[4] E. Sahara, R.A. Farah, M.Z. Zakaria. Calcium hydroxide as intracanal medicament in pulp necrosis with periapical lesion: a case report. Key. Eng. Mater. 829 (2019) 226–231.

DOI: 10.4028/www.scientific.net/kem.829.226

[5] M.N. Zakaria, Save the pulp is the essential issues on pulp capping treatment. J. Dentomaxillofac. Sci. 1 (2016) 301-305.

DOI: 10.22208/jdmfs.1.2.2016.294-298

[6] M.N. Zakaria, T. Takeshita, Y. Shibata, et al., Microbial community in persistent apical periodontitis: a 16S rRNA gene clone library analysis, Int. Endod. J. 48 (2015) 717-728.

DOI: 10.1111/iej.12361

[7] A.A. Hasna, R.D. Khoury, C.C. Toia, G.B. Gonçalves, F.B. de Andrade, C.A.T. Carvalho, C.H.R Camargo, M.C. Valera, In vitro evaluation of the antimicrobial effect of N-acetylcysteine and photodynamic therapy on root canals infected with Enterococcus faecalis, Iran. Endod. J. 15 (2020) 236-45.

[8] R.K.P. Lima, J.M. Guerreiro-Tanomaru, N.B. Faria-Junior, M. Tanomaru-Filho, Effectiveness of calcium hydroxide-based intracanal medicaments against Enterococcus faecalis, Iran Endod J. 45 (2012) 311-316.

DOI: 10.1111/j.1365-2591.2011.01976.x

[9] Z. Mohammadi, L. Giardino, F. Palazzi, S. Sousan, Buffering effect of hydroxyapatite and dentin powder on the antibacterial activity of sodium hypochlorite, Int. J. Clin. Dent. 6 (2013) 237-241.

[10] Z.M Vahid, A. Hasani, G. Jabbari, Comparison of the penetration depth of conventional and nano-particle calcium hydroxide into dentinal tubules. Int. Endod. J. 13 (2017) 366-370.

[11] J.M.V.M. de Lucena, E.M. Decker, C. Walter, L.S. Boeira, C. Lost, R. Weiger, Antimicrobial effectiveness of intracanal medicaments on Enterococcus faecalis: chlorhexidine versus octenidine, Iran Endod J. 46 (2013) 53-61.

DOI: 10.1111/j.1365-2591.2012.02093.x

[12] M.N. Zakaria, A.N. Sidiqa, I. Artilia, A. Cahyanto, Synthesis and characterization of calcium hydroxide from indonesian limestone as endodontic intracanal medicament, Key. Eng. Mater. 782 (2018) 268-272.

DOI: 10.4028/www.scientific.net/kem.782.268

[13] A.N. Sidiqa, M.N. Zakaria, I. Artilia, Z.Y. Dewi, A. Cahyanto, Evaluation of calcium ion release in calcium hydroxide prototype as intracanal medicament, J. Dentomaxillofac, Sci. 5 (2020) 86-89.

DOI: 10.15562/jdmfs.v0i0.1017

[14] B.A. Pektas, P. Yurdakul, D. Glmez, O. Gorduysus, Antimicrobial effects of root canal medicaments against Enterococcus faecalis and Streptococcus mutans, Iran Endod J. 46 (2013) 413-418.

DOI: 10.1111/iej.12004

[15] M. Evans, J.K. Davies, G. Sundqvist, D. Figdor, Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxine, Iran Endod J. 35 (2002) 221-228.

DOI: 10.1046/j.1365-2591.2002.00504.x

[16] P. Chivatxaranukul, S.G. Dashper, H.H. Messer, Dentinal tubule invasion and adherence by Enterococcus faecalis, Iran Endod J. 41 (2008) 873-882.

DOI: 10.1111/j.1365-2591.2008.01445.x

[17] C.P. McHugh, P. Zhang, S. Michalek, P.D. Eleazer, Ph required to kill Enterococcus faecalis in vitro, J. Endod. 30 (2004) 218-219.

DOI: 10.1097/00004770-200404000-00008

[18] E.K. Siren, E. Kerosuo, E. Lavonius, J.H. Meurman, Ca(OH)2 application modes : in vitro alkalinity and clinical effect on bacteria, Int. Endod J. 47 (2014) 628-638.

DOI: 10.1111/iej.12199

[19] O. Dianat, S. Saedi, M. Kazem, M. Alam, Antimicrobial activity of nanoparticle calcium hydroxide against Enterococcus faecalis: an in vitro study, Iran Endod J. 10 (2015) 39-43.