Antibacterial efficacy of nisin and calcium hydroxide with a proton pump inhibitor as an intracanal medicament

Abstract

Aim: To evaluate the antimicrobial efficacy of nisin and calcium hydroxide with and without pantoprazole against Enterococcus faecalis in comparison with chlorhexidine (CHX) 2% solution. Materials and methods: The antibacterial effect of the following experimental groups as intracanal medicaments (group I nisin, group II Ca(OH)2 powder 29% conc., group III Ca(OH)2 with pantoprazole 20 mg, group IV Ca(OH)2 with pantoprazole 40 mg, group V CHX 2% solution, and group VI saline) was evaluated using the agar diffusion test for a time period of 24 hours. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) against E. faecalis were also determined. Statistical analysis was performed using Kruskal–Wallis test and chi-square test. Results: The agar diffusion test showed zones of inhibition for groups I, II, and V. Nisin and CHX groups showed the maximum zone of inhibition compared with other experimental groups. The MIC values for the experimental groups I, II, III, and V were 0.2 mg/mL, 0.45%, 0.45% + 0.03 mg/mL, and ≤ 0.01% respectively. The MBC values were tabulated. Conclusion: The antimicrobial efficacy of nisin as an intracanal medicament was similar to CHX 2%; Ca(OH)2 with pantoprazole was not effective against E. faecalis. The MIC value of nisin is 0.2 mg/mL against E. faecalis. Clinical significance: Nisin, when used as an intracanal medicament, is effective in eliminating E. faecalis when compared with the combination of Ca(OH)2 with pantoprazole, a proton pump inhibitor (PPIs).