7/7/2015 Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness in decontaminating gutta percha cones

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J Conserv Dent. 2012 Jul­Sep; 15(3): 246–248.doi: 10.4103/0972­0707.97949

PMCID: PMC3410334

Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness indecontaminating gutta percha conesPrakash P Athiban, Bikash Jyoti Borthakur, S Ganesan, and B Swathika

Department of Conservative dentistry and Endodontics, Mahatma Gandhi Post Gradute Institute of Dental Sciences, (Govt.of Puducherry Institution),Puducherry, IndiaAddress for correspondence: Dr. Prakash P Athiban, Department of Conservative dentistry and Endodontics, Mahatma Gandhi Post Gradute Instituteof Dental Sciences, (Govt. of Puducherry Institution), Indira Nagar, Gorimedu, Puducherry – 605 006, India E­mail: prakash4bds@gmail.com

Received 2012 Jan 26; Revised 2012 Mar 10; Accepted 2012 Mar 13.

Copyright : © Journal of Conservative Dentistry

This is an open­access article distributed under the terms of the Creative Commons Attribution­Noncommercial­Share Alike 3.0 Unported, which permitsunrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Aim:

The aim of this study was to evaluate the antimicrobial efficacy of Aloe vera and to determine its effectiveness indecontaminating gutta percha cones.

Materials and Methods:

A concentrated extract of Aloe vera was used to check for the antimicrobial efficacy using the agar well diffusionmethod. Presence of zones’ of diffusion was identified against three common GP contaminants namely, E.coli,E.faecalis and Staph. aureus. New GP Cones, freshly taken out of the packet were then decontaminated for1minute using Aloe vera gel and then placed in thioglycolate broth to check for the presence of turbidity.

Results:

The zones of inhibition on the agar plate were measured as 24mm,21mm and 24mm respectively. The brothremained clear even after 48 hours of incubation.

Conclusion:

We conclude that Aloe vera is indeed effective as a GP decontaminant and it holds a promising future as a mediumfor storage of GP cones.

Keywords: Aloe vera, decontamination, gutta percha cones

INTRODUCTION

The primary objective of endodontic therapy is to maintain an aseptic chain right from the access opening to thepermanent coronal restoration of the tooth. Eliminating or decreasing the number of micro­organisms is ofconsiderable importance for endodontic success. Gutta percha (GP) is a dried coagulated extract of plants of

7/7/2015 Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness in decontaminating gutta percha cones

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palaquiam of the blanco genus of sapotaceae family, and was introduced to dentistry in 1847 by Edwin Truman.[1,2] It still continues to maintain its position as an important dental material and has emerged as the prime rootcanal filling material. The SS White Company began marketing GP points for dental use in 1887. GP suppliedcommercially is not usually sterilized or decontaminated before obturation. Also, it cannot be sterilized by moist ordry heat as this carries a risk of physical deformation. However, chair side decontamination prior to obturationcannot be ignored. Many chemicals such as, hydrogen peroxide, chlorhexidine, ethyl alcohol, polyvinyl pyrolidoneiodine, quartenary ammonium compounds have been tried for GP decontamination. Recently, the use of electronbeam sterilization has also been tried. However, none of these methods have been proven as fully effective. Therecommended method for decontamination of GP points consists of treating the cones using a 1% Sodiumhypochlorite for 1 minute (Milton's solution), or 0.5% Sodium hypochlorite for 5 minutes (Dakin's solution).[3]Here, the risk of Sodium hypochlorite causing crystal deposition within the canals which can impede the obturationcannot be ignored. The purpose of this study was to evaluate the effectiveness of a herbal alternative, Aloe vera gelfor rapid decontamination of gutta percha cones.

Aloe barbadensis Mill, is a short succulent herb resembling a cactus, with green dagger shaped fleshy, spiny andmarginated leaves, filled with a clear viscous gel. Aloe vera has potent antibacterial, antifungal, and antiviralproperties.[4,5] The antimicrobial effects of Aloe vera have been attributed to the plant's natural anthraquinoneswhich have demonstrated in vitro inhibition of Mycobacterium tuberculosis and Bacillus subtilis. Aloe juice hasbeen found to be bacteriostatic against Staphylococcus aureus, Streptococcus pyogenes and also Salmonellaparatyphi.[6,7] In an in vitro disc diffusion study by Suleyman et al Streptococcus faecalis and Candida albicanswere cultured to contain 10 ­10 CFU mL/1 levels of organism. A 100% Aloe vera juice obtained from the coldpressed leaves of the plant were used and the results obtained showed significant zones of inhibition of 20mm and30mm against both these organisms[8]. Aloe vera is also known to be virucidal, especially against herpes virus.

MATERIALS AND METHODS

Test organisms

Reference strains of three most common GP contaminants, Eschericia coli, Enterococcus faecalis andStaphylococcus aureus were obtained from the Department of Microbiology, JIPMER, Puducherry.

Preparation of the extract

The leaves of the plant were washed with distilled water, cut opened, and fresh pulp was collected. The gel wasdried in an oven at 80°C for 48 hours and then powdered. An ethanol extract was obtained by dissolving 20 gramsof the powder in 200 ml of ethanol. The contents were then filtered through Whatmann filter paper no1, and thefiltrate was evaporated for dryness.

Antimicrobial activity of Aloe vera

The antibacterial activity of the extract was tested using Agar well diffusion technique. The reference strains werecultured overnight in thioglycolate broth, and the culture was streaked on a plate of blood agar. Three wells of 5mm × 5 mm measure were made with the help of a template on the surface of the agar plate. About 0.1 ml of theextract was delivered into the well using a micropipette. The other two wells were filled with 5.25% of sodiumhypochlorite and 0.9% normal saline as positive and negative controls, respectively. They were then incubated at37°C for 24 hours, and closely monitored for the development of clear zones around the extracts. The antibacterialactivity was assessed by the diameter of the inhibition zone. A clear zone of inhibition was obtained against all thethree organisms.

Gutta Percha decontamination

A new pack of Dia­ProT (Diadent Europe.B.V,Almere, Netherlands) F2 Size Protaper gutta percha points

8 9

plus

7/7/2015 Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness in decontaminating gutta percha cones

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were used for the procedure. The pack was opened under sterile conditions and four points were taken out using asterile tweezer. The points were then placed inside the freshly prepared thioglycolate broth, and incubated for 24hours. Simultaneously, four new GP cones were removed, and decontaminated for one minute in 90% Aloe veragel. The cones were then removed from the gel, and cleaned free of the gel using a sterile gauze, and thenincubated in thioglycolate broth for 24 hours. Both the tubes were then closely monitored for the development ofturbidity.

RESULTS

The antimicrobial efficacy was assessed by the presence of zones of inhibition. Escherichia coli, Enterococcusfaecalis, Staphylococcus aureus showed 24 mm, 21 mm and 24 mm inhibition zones respectively, which wasalmost equivalent to 5.25% Sodium hypochlorite used as the control [Table 1]. The decontaminating efficacy wasthen assessed by the occurrence of turbidity in the thioglycolate broth. The GP cones which were notdecontaminated and directly placed in the broth developed turbidity. The cones decontaminated with Aloe vera andthen placed in the broth remained clear even after 24 hours, indicating the absence of the microbial contaminants.

Table 1Zones of inhibition in millimeters(mm) obtained against the test organisms

DISCUSSION

The importance of GP decontamination to prevent any bacterial contamination of the root canal during theobturation procedure is now widely recognized in endodontic practice. Thus, it is imperative to employ a rapid,reliable, inexpensive and effective decontaminant. Glutaraldehyde has been effectively used as a chemosterilizer ora high level disinfectant. Aqueous solutions of 2% glutaraldehyde have a broad spectrum of action and thuseffective against most of the micro­organisms, and has been used effectively for decontaminating endodontic filesprior to sterilization in a glass bead sterilizer However, Boucher found that Bacillus subtilis spores are resistant totreatment with Glutaraldehyde.[9–11] 70% concentrated Ethanol is widely used in dentistry. However, studiesindicate that it provides an intermediate level of disinfection, and the surface requiring decontamination requires tobe submerged atleast for 10 minutes.[12] 2% Chlorhexidine kills bacteria by disruption of the cell membranes andby inducing precipitation of the cytoplasm. It has however been reported by Sequeira et al. that it is ineffective evenafter 10 minutes of surface exposure and requires much longer durations of contact.[13–15]

Sodium hypochlorite has a strong antibacterial and sporicidal effect, and acts by a mechanism involving theliberation of active chlorine, (a powerful oxidizing agent) which in turn inactivates the bacterial enzymes. Sodiumhypochlorite 5.25% has been found to be effective in decontaminating GP cones. However, it is imperative thatafter disinfection, the GP cone should be rinsed in ethyl alcohol to remove crystallized sodium hypochlorite beforeobturation as the crystals may impair the hermetic seal. Aloe vera has been used from time immemorial for thetreatment of a multitude of ailments ranging from peptic ulcers to its use in cosmetics. It has a well­establishedantimicrobial activity ascribed to compounds that are now specifically identified as p­coumaric acid, ascorbic acid,pyrocatechol and cinnamic acid.[15] Another major advantage is that Aloe vera gel has been found to be effectivein decontaminating GP cones within one minute. To substantiate these results, further in depth studies incorporatingmore isolates from clinical samples are required.

CONCLUSION

Within the limits of this study, it can be concluded that Aloe vera gel can be used effectively for decontaminatingGP cones within a short duration, and holds a promising future as a medium for storage of GP points.

Footnotes

7/7/2015 Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness in decontaminating gutta percha cones

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410334/ 4/4

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Source of Support: Nil

Conflict of Interest: None declared.

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