Anti-microbial efficacy of Allium sativum extract against Enterococcus faecalis biofilm and its penetration into the root dentin: An in vitro study.

INTRODUCTION Sodium hypochlorite (NaOCl) has long been the most preferred root canal irrigant in endodontic treatment, but besides being an effective anti-microbial agent, it is highly cytotoxic. Thus, a search for an alternative herbal irrigant which would be more biocompatible but equally effective led to this study. AIM To assess the anti-microbial efficacy of garlic extract (GE) against Enterococcus faecalis biofilm and its ability to penetrate into root dentin. MATERIALS AND METHODS E. faecalis was cultured and treated with the test agents--normal saline, 5.25% of NaOCl, and the three different concentrations of GE (10%, 40%, and 70%). The experiment was done in four groups namely, 24-h Co-treatment group, 24-h biofilm treatment group, 1-week biofilm group, and 3-week biofilm group. These groups were subjected to microbial viability assay and fluorescence microscopic analysis. The most effective concentration of garlic (70%) was further tested and compared with 5.25% NaOCl for its dentin penetration property using 0.2% alizarin red under a fluorescence microscope. RESULTS The findings revealed that GE was able to disrupt as well as prevent the formation of biofilm produced by E. faecalis. All the concentrations of GE displayed considerable anti-microbial efficacy where 70% concentration was most effective and exhibited similar anti-microbial efficacy as 5.25% NaOCl. In terms of dentin penetration, no significant difference was found between GE and NaOCl. CONCLUSION The results indicate that GE has a potential to serve as an alternative herbal root canal irrigant being an effective and biocompatible anti-microbial agent with good dentinal penetration property.