Antifungal effectiveness of various intracanal medicaments against Candida albicans: an ex-vivo study

BACKGROUND To investigate the antifungal activity of propolis, triple antibiotic paste (TAP), 2% chlorhexidine gel and calcium hydroxide with propylene glycol on Candida albicans-infected root canal dentinal tubules at two different depths (200 μm and 400 μm) and two time intervals (day 1 and 7). METHODS A total of 90 extracted human teeth were sectioned below the cementoenamel junction and the apical part of the root to obtain 6 mm of the middle third of the root. The root canal was enlarged to an internal diameter of 0.9 mm using Pesso Reamer size no. 2 (Mani®, UT, Japan), followed by canal irrigation and autoclaved. The specimens were infected for 21 days with C. albicans. Then, the specimens were divided into five groups prior to placement of intracanal medicaments. Group 1 (propolis), Group 2 (triple antibiotic paste), Group 3 (2% chlorhexidine Gel), Group 4 (calcium hydroxide with propylene glycol), and Group 5 (sterile saline as negative control). At the end of 1 and 7 days, dentine shavings were collected at two depths into the dentinal tubules (200 μm and 400 μm), and the total numbers of colony forming units were calculated for assessing the remaining vital viable fungal population. The values were analysed statistically using non-paramatric Kruskal-Wallis and Mann-Whitney-U tests to compare the median reduction of Candida albicans between all intracanal medicaments. Probability values of P < 0.05 were set as the reference for statistically significant results. RESULTS The reduction in number of colony forming units was statistically significant in all groups compared to the control group (sterile saline), except propolis at day 1 (400 μm depth). CONCLUSION Propolis was less effective than triple antibiotic paste, 2% chlorhexidine gel and calcium hydroxide with propylene glycol against C. albicans on day 1 at 400 μm deep inside the dentinal tubules, but equally effective after 7 days at both depths.