Antibacterial and Anti-biofilm Activity of AH Plus with Chlorhexidine and Cetrimide

• Published in: Journal of endodontics Vol. 40; no. 7; pp. 977 - 981
• Main Authors: Bailón-Sánchez, M. Estela, DDS, Baca, Pilar, DDS, MD, PhD, Ruiz-Linares, Matilde, DDS, PhD, Ferrer-Luque, Carmen María, DDS, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2014
• Subjects: AH Plus; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacology; Anti-Infective Agents, Local - administration & dosage; Anti-Infective Agents, Local - pharmacology; Bacterial Load - drug effects; biofilm; Biofilms - drug effects; cetrimide; Cetrimonium Compounds - administration & dosage; Cetrimonium Compounds - pharmacology; chlorhexidine; Chlorhexidine - administration & dosage; Chlorhexidine - pharmacology; Dentistry; direct contact test; Dose-Response Relationship, Drug; Drug Combinations; Endocrinology & Metabolism; Enterococcus faecalis; Enterococcus faecalis - drug effects; Epoxy Resins - pharmacology; Humans; Humidity; Materials Testing; Nephelometry and Turbidimetry - methods; Root Canal Filling Materials - pharmacology; Temperature; Time Factors; Enterococcus faecalis; AH Plus; direct contact test; chlorhexidine; cetrimide; biofilm
• DOI: 10.1016/j.joen.2013.11.020
• ISSN: 0099-2399

Abstract Introduction The use of root canal filling materials with antibacterial activity can be considered beneficial to reduce the remaining microorganisms in the root canal system, where Enterococcus faecalis is often found, and prevent recurrent infection. The aim of this study was to evaluate the antimicrobial activity and capacity for inhibiting E. faecalis biofilm formation of AH Plus, alone and mixed with chlorhexidine (CHX), cetrimide (CTR), and combinations of the two. Methods AH Plus alone and mixed with 1% and 2% CHX, 0.1%–0.5% CTR, and combinations of both were tested to assess antimicrobial activity by a modified direct contact test and determine inhibition of E. faecalis biofilm formation at 24 hours. The results were expressed as log10 viable counts. Eradication and inhibition of biofilm formation were understood as no bacterial growth or log10 reduction = 5 with respect to the control (AH Plus alone). Results AH Plus + CHX showed a low antimicrobial activity with respect to the control (at 2%, log10 reduction = 1.30). None of the tested concentrations achieved eradication or inhibition of biofilm. AH Plus + CTR showed a direct relationship of concentration-antimicrobial effect, reaching a log10 reduction of 2.92 at 0.5% and inhibition of biofilm formation at 0.2%. With the combination CHX + CTR, lower concentrations were needed for the same effect, and eradication and inhibition of biofilm were achieved. Conclusions The addition of CHX, CTR, or some combination of both to AH Plus confers it with bactericidal and anti-biofilm activity against E. faecalis.