The Antifungal Effect of Endocyn Against Candida albicans Biofilm

Introduction: Endocyn, a super-oxidized water-based irrigation solution, has been reported to be non-toxic against mammalian cells, yet highly efficacious against bacteria; however, its effect against fungi and fungal biofilms remain unknown. This study evaluated the antifungal efficacy of Endocyn compared to sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods: An in vitro biofilm system was used to assess the antifungal efficacy of Endocyn, NaOCl, and CHX based irrigants against Candida albicans biofilm at 1, 5, 10, 15, 30, and 45 min using the XTT metabolic assay. PBS served as the control. Additionally, the irrigants were tested in extracted teeth inoculated with C. albicans with antifungal efficacy monitored quantitatively by microbiological plate count and qualitatively by confocal microscopy using Live/Dead staining. XTT data was analyzed by two-way analysis of variance (ANOVA) and Bonferroni post-test and CFU data analyzed using a one-way ANOVA and Kruskall-Wallis posttest. Results: XTT results revealed that Endocyn demonstrated similar antifungal activity as NaOCl or CHX at the 10 min exposure interval (p < 0.05) but was less effective at 1 min. For the ex vivo tooth model, while no irrigants completely eliminated fungal burden, NaOCl and CHX showed better antifungal activity than Endocyn (P < 0.05). Staining patterns assessed by confocal microscopy confirmed these results. Conclusion: Endocyn demonstrated similar inbibition of C. albicans biofilms as NaOCl and CHX in vitro. However, Endocyn was not as effective as NaOCl and CHX at reducing fungal burden in an ex vivo endodontic infection model.