Antifungal Effectiveness of Various Intracanal Medicaments against Candida albicans: An In Vitro Study

Abstract

Aim and objective: To evaluate the antifungal efficiency of various intracanal medicaments against Candida albicans. Materials and methods: One-hundred and forty extracted human mandibular premolar teeth were decoronated, and the biomechanical preparation was done in crown-down technique. 10 μL culture suspension of C. albicans was placed into the prepared root canal space of all the teeth. After 21 days of incubation, all the teeth were randomly divided into 7 groups with 20 teeth per each group. Group I: triple antibiotic powder (TAP) mixed with 3% chitosan solution; group II: TAP mixed with macrogol-propylene (MP) glycol; group III: chlorhexidine-guttapercha (CHX-GP); group IV: Vitapex; group V: 2% chlorhexidine gel; group VI: calcium hydroxide paste; group VII: normal saline with cotton (positive control) were used as intracanal medicaments, and the samples were incubated for 14 days. Intracanal medicaments were then completely removed using the canal brush. Dentinal chips were harvested from the walls of the root canal space in all samples using Gates-Glidden drills, were transferred into test tubes containing saline, and were serially diluted and placed in 140 Sabouraud dextrose agar plates, incubated at 37°C for 48 hours. Colony forming units (CFUs) of C. albicans were then counted using the digital colony counter. Results: One-way ANOVA test showed statistically significant difference among the seven groups, as the p value was < 0.001. Tukey's post hoc test showed intergroup comparison between group I and group V; group II and group III were statistically nonsignificant as p value was >0.05. Conclusion: 2% chlorhexidine gel and TAP mixed with 3% chitosan solution showed superior antifungal efficiency against C. albicans. Clinical significance: Chitosan solution's inherent antifungal efficiency and slow and controlled drug release make it as an effective alternate carrier in mixing it with TAP instead of mixing TAP with MP.