Comparing the Efficacy of Berberine against Sodium Hypochlorite and Chlorhexidine Cetrimide as a Chairside Disinfectant of Gutta Percha Cones

Abstract

Introduction: The primary objective in Endodontics has been to disinfect the root canal space, by both mechanical and chemical means. Clinicians rarely give a thought to the fact that contamination can happen from all sorts of instruments, materials and the by clinical setup itself. When disinfection of the root canal is been spoken, studied and researched so extensively, gutta percha cones which are the most commonly used root canal filing material for over 100 years, thanks to its malleability and biocompatibility. They may be contaminated right from the manufacturing process, packaging and use. Aim: This study intended to compare the efficacy of berberine as a more biocompatible alternative to sodium hypochlorite and chlorhexidine cetrimide as a chairside disinfectant for gutta percha cones. Materials and Methods: 180 gutta percha cones collected from freshly opened boxes were contaminated with Microbial suspensions of E. Faecalis (ATCC29212) and S. aureus (ATCC 6538) of approximately 108 CFU/mL artificially. Split into three groups with three different disinfecting agents (6% NaOCl, vista dental products, USA, berberine chloride 2 mg/ mL, Chlorhexidine 2% and cetrimide 0.2%) further subdivision was done based on exposure time (one minute, three minutes, five minutes) respectively, After disinfection in chemical agents, the cones were washed in 10 mL of detergent solution (3% Tween 80 and 5% sodium thiosulfate) for five minutes. The cones were rinsed in 10 mL of sterile distilled water, transportation to sterile test tubes containing 10 mL of thioglycollate media and incubated at 37°C for seven days, then were transferred from the 10 mL thioglycollate media to a petridish containing brain heart infusion agar, incubating for 48 hours aerobically at 37°C and the colony forming units were graded under light microscope. Results: Statistical analysis was done with Tukeys HSD test. The mean bacterial count of E. Faecalis or S. aureus was found to be significantly lesser after treating the cones with 6% sodium hypochlorite when compared with other disinfecting solutions for all time intervals tested. Berberine was found to be mildly effective against S. aureus but not effective against E. Faecalis even at the five minute stage. Conclusion: Within the limitations of the study, Sodium Hypochlorite is still the disinfectant to beat, further research is needed with berberine along with concentration modifications and duration.

Keywords

• berberine
• gutta percha disinfection
• herbal disinfectant