Comparision of antimicrobial efficacy of triphala, withania somnifera and sodium hypochlorite against enterococcus faecalis biofilm-an invitro study

Objectives: To compare the antimicrobial efficacy of sodium hypochlorite, Triphala, Withania somnifera, combination of Triphala & Withania somnifera against Enterococcus faecalis (E faecalis) biofilm in extracted human teeth. Methods: Total of 40 human extracted teeth were collected & 10 were assigned under 4 groups (n=10 in each group). E. faecalis was cultured, inoculated in Brain Heart Infusion medium & incubated for 45days along with the teeth for biofilm formation. After incubation for 45days, teeth were subjected to irrigation. They were irrigated with sodium hypochlorite (Group I), Triphala (Group II), Withania somnifera (Group III) and Triphala + Withania somnifera (Group IV). After the irrigation, teeth were analyzed for E faecalis colony forming units. 2 teeth from each group were subjected for qualitative observation under laser scanning confocal microscopy. Results: Teeth irrigated with sodium hypochlorite showed mean E faecalis colony count of 3.6± 0.193 lakhs which is significantly less when compared to colony counts in Group II and Group III which were 4.6±.003 (P<0.001) & 3.9±0.004 (P<0.001) lakhs respectively. However, combination of Triphala+Withania somnifera group showed mean E faecalis colony count of 3.7±0.004 lakhs which was not significantly different from that of group I. All the 4 experimental groups showed marked decrease in the E faecalis colony count when compared to the initial colony count of 10 ± 0.21 lakhs. Conclusion: Sodium hypochlorite, Triphala and Withania somnifera failed to eliminate bacteria completely. But, considerable reduction in growth of E. faecalis was seen in herbal extract groups. Considering the non-toxic nature and other physiological benefits of these herbal extracts, further studies need to be carried out to consider them as an alternative for sodium hypochlorite at least in the initial stages of bacterial infection.