Comparative Evaluation of Neem, Aloevera, Chlorhexidine and Calcium Hydroxide as an Intracanal Medicament against E. faecalis-An in vitro Study

Introduction: Microorganisms play a fundamental role in the aetiology of pulp and periapical diseases. Their control and elimination are important during endodontic treatment. Intracanal medicaments help in reducing the bacteria remaining after root canal preparation and can provide a favourable environment for periapical tissue repair. Aim: To determine the antimicrobial activity of neem extract, aloevera and calcium hydroxide in comparison with 2% Chlorhexidine on Enterococcus faecalis (E. faecalis) infected root canal dentin at two different depths (200 mu m and 400 mu m) and at three intervals of time (day 1, 3 and 5). Materials and Methods: A total of 90 extracted single rooted human premolar teeth were selected for the study and infected for 21 days with E. faecalis. Samples were divided into five groups: Group I (2% chlorhexidine); Group II (neem); Group III (calcium hydroxide); Group IV (aloevera); and Group V (saline). The remaining vital bacterial population was assessed at the end of 1, 3 and 5 days. Gates glidden drills were used to obtain dentin shavings at two depths (200 mu m and 400 mu m) and the total number of Colony Forming Units (CFUs) were determined following culture. The data were statistically analysed using ANOVA and Scheffe's multiple comparison test (p<0.05). Results: Chlorhexidine produced better antimicrobial efficacy followed by neem and calcium hydroxide. Aloevera showed the least antimicrobial activity. There was statistical significant difference between the experimental groups, neem showing highest antimicrobial activity and aloevera the least at 200 mu m and 400 mu m depth. Conclusion: Among the natural intracanal medicaments, neem consistently showed good inhibition up to five days, with aloevera showing minimal antimicrobial activity.