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. 2025 Sep-Oct;15(5):1149-1156.
doi: 10.1016/j.jobcr.2025.07.015. Epub 2025 Jul 31.

Antibacterial efficacy of sodium dichloroisocyanurate and 2-hydroxyisocaproic acid intracanal medicaments on Enterococcus faecalis: A comparative in-vitro study

Rasmina K Nizar  1 , Anju Varughese  1 , M Remya  1 , V P Prabath Singh  1 , Gayathri Usha  1 , Gayathri Presannakumar  1
Affiliations

Antibacterial efficacy of sodium dichloroisocyanurate and 2-hydroxyisocaproic acid intracanal medicaments on Enterococcus faecalis: A comparative in-vitro study

Rasmina K Nizar et al. J Oral Biol Craniofac Res. 2025 Sep-Oct.

Abstract

Background: Optimal healing of periapical tissues by completely eradicating root canal infection is the primary goal of endodontic therapy. The use of intracanal medication enhances the antibacterial efficacy of endodontic treatment.

Aim: Comparative evaluation of antibacterial efficacy of intracanal medicaments such as sodium dichloroisocyanurate (NaDCC) and 2-hydroxyisocaproic acid (HICA) with a formulation of calcium hydroxide (Ca (OH)2) and 2 % chlorhexidine gluconate (CHX) against Enterococcus faecalis(E.faecalis).

Methodology: Fifty-two single-rooted teeth were subjected to endodontic instrumentation and inoculation with E. faecalis microbial suspension. After 14 days, the root canals of each tooth were ground with a Peeso reamer to procure the dentine chips. Colony-forming units (CFU-1) were counted after 24 h of incubation. Intracanal medicaments: NaDCC, HICA, and (Ca (OH)2) plus 2 % CHX were placed in the tooth and incubated for 14 days. The antibacterial effects of the intracanal medicaments were measured using CFU testing at three-time intervals.

Results: Inter-group analysis utilized one-way ANOVA for statistical analysis, and within-group analysis employed repeated-measures ANOVA followed by the Tukey post hoc test. NaDCC exhibited a significantly lower CFU count compared to HICA (p-value = .000) and Ca (OH)2 + 2 % CHX (p-value = .000). HICA showed a significantly lower CFU count than Ca (OH)2 + 2 % CHX (p-value = .009) after 24 h.

Conclusion: NaDCC and HICA demonstrate potent antimicrobial efficacy against E. faecalis, suggesting their potential as an alternative intracanal medicament for endodontic infection.

Keywords: 2-Hydroxyisocaproic acid; Antimicrobial effect; Calcium hydroxide; Chlorhexidine; Intracanal medicament; Sodium dichloroisocyanurate.

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Conflict of interest statement

None. The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study the flow chart of antimicrobial assessment of three Intracanal medicaments.
Fig. 2
Fig. 2
SEM images of E. faecalis biofilm formation: 2a. X500 magnification, 2b. X1,000 magnification,2c. X5,000 magnification,2d.X10,000 magnification.
Fig. 3
Fig. 3
Intragroup CFU reduction trend of the three study groups over the three time points (Mean CFU/mL x 105).
See this image and copyright information in PMC

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