Comparison of the Antimicrobial Properties of Nanoemulsions Made from Phytosphingosine and Chitosan with a Triple Antibiotic Paste Against Enterococcus faecalis in Endodontics: An in-vitro Study.

PURPOSE: Aerobic and facultative anaerobic bacteria are most commonly found in failed root canal cases. Among those, Enterococcus faecalis (E. faecalis) is the most resistant intracanal microbe. Hence, the antibacterial effectiveness of various intracanal medicaments (ICMs) is primarily tested against E. faecalis. To eliminate such resistant bacteria from the entire root canal system, various contemporary intracanal medicaments (ICMs) with an effective antibacterial action are evaluated. The purpose of the study is to compare the antimicrobial efficacy of intracanal medications, Phytosphingosine nano-emulsion (PHSN), Chitosan nano-emulsion (CHN), and Triple Antibiotic Paste (TAP) against E. faecalis in endodontics.

PATIENTS AND

METHODS

Assuming the Minimum Inhibitory Concentration (MIC) of 15.93 and SD 1.53 with estimated error of 1, 80% power, and 5% alpha error, the sample size was calculated as 9. All three ICMs were prepared following the standard protocols. These ICMs were categorised into 3 groups as follows: Group I: PHSN; Group II: CHN; Group III: TAP. The antibacterial property of these ICMs was evaluated using MIC and disk diffusion methods. ANOVA and post hoc Tukey's tests.

RESULTS

The minimum inhibitory concentration (MIC) was found to be 1 μg/mL for PHSN, 32 μg/mL for CHN, and 4.0 μL/mL for TAP against E. faecalis. PHSN showed the largest zone of inhibition (38.3 ± 1.48), followed by CHN (8.16 ± 0.966), and TAP (6.30 ± 1.71). Thus, PHSN showed significantly higher antimicrobial efficiency compared to CHN and TAP (p < 0.05). Although CHN showed a higher zone of inhibition than the TAP, the difference between them was statistically nonsignificant.

CONCLUSION

Phytosphingosine nano-emulsion (PHSN) has maximum efficacy against E. faecalis, and it can hinder its growth with a minimum inhibitory concentration of 1μg/mL. Chitosan nano-emulsion (CHN) shows slightly more efficacy than Triple Antibiotic Paste (TAP), but without any statistical significance.