Comparative evaluation of the concentration-dependent effect of proton-pump inhibitor in association with calcium hydroxide and chlorhexidine on Enterococcus faecalis: An in vitro study.
Background
Enterococcus faecalis is the most persistent organism in the root canal which resists most of the intracanal medicaments. There is always a constant attempt to eliminate this endodontic pathogen from the root canal system.


Aim
The aim of this study was to evaluate the efficacy of the association of different concentrations of proton-pump inhibitor (PPI) (Lansoprazole) with calcium hydroxide (CH) and chlorhexidine (CHX) against E. faecalis using a broth dilution method.


Materials and Methods
E. faecalis was inoculated into brain-heart infusion broth at 37°C for 5 h. The master broth was then treated with CH (Group 1); CH + 2% CHX (Group 2); CH + PPI 6.25 μg/ml (Group 3A); CH + PPI 25 μg/ml (Group 3B); 2% CHX + PPI 6.25 μg/ml (Group 4A); 2% CHX + PPI 25 μg/ml (Group 4B); CH + 2% CHX + PPI 6.25 μg/ml (Group 5A), and CH + 2% CHX + PPI 25 μg/ml (Group 5B). The groups were spectrophotometrically analyzed at 630 nm at 24 h to determine the group with the least optical density.


Statistical Analysis
Comparison between the groups was done by the one-way analysis of variance and Kruskal-Wallis test for multiple comparisons.


Results
The mean percentage inhibition of E. faecalis by Group 5A (CH + 2% CHX + PPI 6.25 μg/ml) was the highest compared to other groups. The lowest mean value was observed in Group 3A (CH + PPI 6.25 μg/ml) indicating least efficiency.


Conclusion
There was a concentration-dependent effect of PPI on CH and CHX against E. faecalis. The maximum efficacy was found when the lower concentration of PPI was associated with CH/CHX mixture.
['Anija|R|R|', 'Kalita|Chandana|C|', 'Bhuyan|A C|AC|', 'Hussain|M D Iftikar|MDI|', 'Saikia|Anindita|A|', 'Das|Lima|L|']
proton-pump inhibitors Calcium hydroxide chlorhexidine Enterococcus faecalis root canal intracanal medicaments spectrophotometry