Antimicrobial efficacy of 2% chlorhexidine gel, triphala, and Azadirachta indica as intracanal medicaments against Enterococcus faecalis: A randomized clinical trial.

CONTEXT: Concerns about adverse reactions and the development of antibiotic resistance have prompted an alternative treatment strategy that utilizes traditional medicinal herbs. AIM: This randomized control trial assessed the antimicrobial efficacy of 2% chlorhexidine (CHX) gel, Triphala, and Azadirachta indica as intracanal medicaments against Enterococcus faecalis. MATERIALS AND METHODS: Forty patients with nonvital teeth and single root canals were selected (n = 10). Following the initial access opening, the first microbial samples (S1) were collected using paper points. Second microbial samples (S2) were collected following the chemo-mechanical preparation and 1 week after introducing the intracanal medicaments. Group I: 2% CHX, Group II: A. indica, Group III: Triphala, and Group IV: Calcium hydroxide (Ca(OH)(2)). S1 and S2 samples were collected, and bacterial growth was observed using the colony-forming unit (CFU) count. STATISTICAL ANALYSIS: Comparison of the difference in CFU count among four groups was performed using one-way ANOVA test (P < 0.05) followed by post hoc Tukey test. RESULTS: Reduction in CFU count postmedication S2 from S1 in each group was statistically significant. Percentage reduction in CFU count was highest in Triphala group followed by A. indica and 2% CHX group. Percentage reduction in CFU count was least in Ca(OH)(2) group. The post hoc pairwise comparison of % reduction in CFU count among four groups showed that the percent reduction was highest in Triphala group. CONCLUSION: Triphala has considerable antimicrobial efficacy against E. faecalis.