A comparative evaluation of Morinda citrifolia, green tea polyphenols, and Triphala with 5% sodium hypochlorite as an endodontic irrigant against Enterococcus faecalis: An in vitro study

Abstract

Background: Endodontic infections require effective removal of microorganisms from the root
canal system for long‑term prognosis. Sodium hypochlorite (NaOCl) is the most effective irrigant
currently, but potential complications due to its toxicity warrant search for newer alternatives. In
this study, the antimicrobial efficacy of Morinda citrifolia (MC), green tea polyphenols and Triphala
was compared with 5% NaOCl against Enterococcus faecalis.
Materials and Methods: In this in vitro study sixty extracted human premolar teeth were infected
with E. faecalis, a Group D Streptococci for 48 h. At the end of 48 h, the vital bacterial population
was assessed by counting the number of colony‑forming units (CFUs) on blood agar plate. Samples
were divided into five groups; Group I (distilled water), Group II (NaOCl), Group III (MC),
Group IV (Triphala), and Group V (green tea polyphenols). The samples were irrigated with individual
test agents and CFUs were recorded. Kruskal–Wallis test was performed as the parametric test
to compare different groups. Student’s t‑test was used to compare mean values between groups
before and after treatment with test agents (P < 0.001).
Results: NaOCl was the most effective irrigant the elimination of E. faecalis reinforcing its role as
the best irrigant available currently and a gold standard for comparison of the experimental groups.
Its antibacterial effect was comparable to Triphala. Among the experimental groups, MC showed
the minimum antibacterial effect.
Conclusion: The use of herbal alternatives as a root canal irrigant might prove to be advantageous
considering the several undesirable characteristics of NaOCl.
Key Words: Enterococcus faecalis, green tea, Morinda citrifolia, sodium hypochlorite, Triphala