Efficacy of Andrographis paniculata compared to Azadirachta indica, Curcuma longa, and sodium hypochlorite when used as root canal irrigants against Candida albicans and Staphylococcus aureus: An in vitro antimicrobial study.

Andrographis paniculata (Burm. f.) Wall. ex Nees: An Updated Review of Phytochemistry, Antimicrobial Pharmacology, and Clinical Safety and Efficacy.

Abstract: Infectious disease (ID) is one of the top-most serious threats to human health globally, further aggravated by antimicrobial resistance and lack of novel immunization options. Andrographis paniculata (Burm. f.) Wall. ex Nees and its metabolites have been long used to treat IDs. Andrographolide, derived from A. paniculata, can inhibit invasive microbes virulence factors and regulate the host immunity. Controlled clinical trials revealed that A. paniculata treatment is safe and efficacious for acute respiratory tract infections like common cold and sinusitis. Hence, A. paniculata, mainly andrographolide, could be considered as an excellent candidate for antimicrobial drug development. Considering the importance, medicinal values, and significant role as antimicrobial agents, this study critically evaluated the antimicrobial therapeutic potency of A. paniculata and its metabolites, focusing on the mechanism of action in inhibiting invasive microbes and biofilm formation. A critical evaluation of the secondary metabolites with the aim of identifying pure compounds that possess antimicrobial functions has further added significant values to this study. Notwithstanding that A. paniculata is a promising source of antimicrobial agents and safe treatment for IDs, further empirical research is warranted.

Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies

Abstract: Since the time that human population comprehended the importance of general health maintenance and the burden of disease, there has been a search for healing properties in the natural environment. Herbal medicine is the use of plants with medical properties for prevention and treatment of conditions that can affect general health. Recently, a growing interest has been observed toward the use of traditional herbal medicine alongside synthetic modern drugs. Around 80% of the population, especially in developing countries relies on it for healthcare. Oral healthcare is considered a major part of general health. According to the world health organization (WHO), oral health is considered an important part of general health and quality of life. The utilization of natural medications for the management of pathologic oro-dental conditions can be a logical alternative to pharmaceutical methods due to their availability, low costs, and lower side effects. The current literature review aimed at exploration of the variety and extent of herbal products application in oral health maintenance including different fields of oral healthcare such as dental caries, periodontal maintenance, microbial infections, oral cancers, and inflammatory conditions.

A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study.

Abstract: Objectives: The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis. Methodology: Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5% NaOCl, Group B: 20% T. vulgaris, Group C: 12.5% S. persica, Group D: 10% A. nilotica, Group E: 10% C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37°C for 24 h. Bacterial zones of inhibition were recorded. Results: The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey's t-test. The highest zone of inhibition against E. faecalis was shown by 5% NaOCl, followed by 10% C. arvensis, 20% T. vulgaris and 10% A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. Conclusion: 5% NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl.

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study

Abstract: Aim: The present study aimed to individually evaluate and compare the aerobic and anaerob?ic antibacterial activity of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite (NaOCl) as root canal irrigants. Materials and Methods: Forty-eight patients were selected and randomly allocated to one of the four groups (n = 12 each) according to the irrigant to be used in each group. For each included tooth, the preirrigation and postirrigation (after irrigation with the test solution) samples were collected through sterile paper points and microbial culturing was done by swabbing on blood agar plates followed by incubation for aerobic and anaerobic bacteria. Statistical Analysis: Manual colony-forming units counting were done, and statistical analysis was performed. Analysis of variance (one-way) followed by post hoc test was performed as a parametric test to compare the difference between the groups for both aerobic and anaerobic bacteria. Results: All the groups showed a statistically significant reduction in bacteria (P Conclusion: A. sativum extract, aqueous zone, diode laser, and 3% NaOCl showed significant antibacterial activity against aerobic and anaerobic bacteria.

Irrigation in Endodontics

Abstract: SUMMARY Irrigation has a key role in successful endodontic treatment. Although hypochlorite isthe most important irrigating solution, no single irrigant can accomplish all the tasksrequired by irrigation. Detailed understanding of the mode of action of varioussolutions is important for optimal irrigation. New developments such as CFD andmechanical devices will help to advance safe and effective irrigation. ACKNOWLEDGMENTS The authors would like to thank Ingrid Ellis for her editorial assistance in the finalpreparation of this manuscript. REFERENCES 1. Peters OA, Scho¨nenberger K, Laib A. Effects of four Ni-Ti preparation techniqueson root canal geometry assessed by micro computed tomography. Int Endod J2001;34:221–30.2. Hu¨lsmann M, Hahn W. Complications during root canal irrigation: literature reviewand case reports [review]. Int Endod J 2000;33:186–93.3. Mcdonnell G, Russell D. Antiseptics and disinfectants: activity, action, and resis-tance. Clin Microbiol Rev 1999;12:147–79.4. Barrette WC Jr, Hannum DM, Wheeler WD, et al. General mechanism for thebacterial toxicity of hypochlorous acid: abolition of ATP production. Biochemistry1989;28:9172–8.5. McKenna SM, Davies KJA. The inhibition of bacterial growth by hypochlorousacid. Biochem J 1988;254:685–92.6. Zehnder M, Kosicki D, Luder H, et al. Tissue-dissolving capacity and antibacterialeffect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med OralPathol Oral Radiol Endod 2002;94:756–62.7. Gomes BP, Ferraz CC, Vianna ME, et al. In vitro antimicrobial activity of severalconcentrations of sodium hypochlorite and chlorhexidine gluconate in the elimi-nation of Enterococcus faecalis. Int Endod J 2001;34:424–8.8. Radcliffe CE, Potouridou L, Qureshi R, et al. Antimicrobial activity of varyingconcentrations of sodium hypochlorite on the endodontic microorganisms Actino-myces israelii, A. naeslundii, Candida albicans and Enterococcus faecalis. IntEndod J 2004;37:438–46.9. Vianna ME, Gomes BP, Berber VB, et al. In vitro evaluation of the antimicrobialactivity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral PatholOral Radiol Endod 2004;97:79–84.10. Waltimo TM, Orstavik D, Siren EK, et al. In vitro susceptibility of Candida albicansto four disinfectants and their combinations. Int Endod J 1999;32:421–9.

Diversity of Endodontic Microbiota Revisited

Abstract: Although fungi, archaea, and viruses contribute to the microbial diversity in endodontic infections, bacteria are the most common micro-organisms occurring in these infections. Datasets from culture and molecular studies, integrated here for the first time, showed that over 460 unique bacterial taxa belonging to 100 genera and 9 phyla have been identified in different types of endodontic infections. The phyla with the highest species richness were Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Diversity varies significantly according to the type of infection. Overall, more taxa have been disclosed by molecular studies than by culture. Many cultivable and as-yet-uncultivated phylotypes have emerged as candidate pathogens based on detection in several studies and/or high prevalence. Now that a comprehensive inventory of the endodontic microbial taxa has been established, future research should focus on the association with different disease conditions, functional roles in the community, and susceptibility to antimicrobial treatment procedures.

Irrigation in endodontics.

Abstract: Irrigation is a key part of successful root canal treatment. It has several important functions, which may vary according to the irrigant used: it reduces friction between the instrument and dentine, improves the cutting effectiveness of the files, dissolves tissue, cools the file and tooth, and furthermore, it has a washing effect and an antimicrobial/antibiofilm effect. Irrigation is also the only way to impact those areas of the root canal wall not touched by mechanical instrumentation. Sodium hypochlorite is the main irrigating solution used to dissolve organic matter and kill microbes effectively. High concentration sodium hypochlorite (NaOCl) has a better effect than 1 and 2% solutions. Ethylenediaminetetraacetic acid (EDTA) is needed as a final rinse to remove the smear layer. Sterile water or saline may be used between these two main irrigants, however, they must not be the only solutions used. The apical root canal imposes a special challenge to irrigation as the balance between safety and effectiveness is particularly important in this area. Different means of delivery are used for root canal irrigation, from traditional syringe-needle delivery to various machine-driven systems, including automatic pumps and sonic or ultrasonic energy.

Andrographis paniculata in the treatment of upper respiratory tract infections: A systematic review of safety and efficacy

Abstract: Acute respiratory infections represent a significant cause of over-prescription of antibiotics and are one of the major reasons for absence from work. The leaves of Andrographis paniculata (Burm. f.) Wall ex Nees (Acanthaceae) are used as a medicinal herb in the treatment of infectious diseases. Systematic literature searches were conducted in six computerised databases and the reference lists of all papers located were checked for further relevant publications. Information was also requested from manufacturers, the spontaneous reporting schemes of the World Health Organisation and national drug safety bodies. No language restrictions were imposed. Seven double-blind, controlled trials (n = 896) met the inclusion criteria for evaluation of efficacy. All trials scored at least three, out of a maximum of five, for methodological quality on the Jadad scale. Collectively, the data suggest that A. paniculata is superior to placebo in alleviating the subjective symptoms of uncomplicated upper respiratory tract infection. There is also preliminary evidence of a preventative effect. Adverse events reported following administration of A. paniculata were generally mild and infrequent. There were few spontaneous reports of adverse events. A. paniculata may be a safe and efficacious treatment for the relief of symptoms of uncomplicated upper respiratory tract infection; more research is warranted.

Antimicrobial activity of Andrographis paniculata.

Abstract: The antimicrobial activity of aqueous extract, andrographolides and arabinogalactan proteins from Andrographis paniculata were evaluated. The aqueous extract showed significant antimicrobial activity, which may be due to the combined effect of the isolated arabinogalactan proteins and andrographolides.