Antibacterial Effect of Silver Nanoparticle Gel as an Intracanal Medicament in Combination with Other Medicaments against Enterococcus faecalis: An In vitro Study

Background: Bacteria and their by-products are responsible for various pulpal and periapical infections which can be classified as biofilm-mediated infections. Recently, nanoparticles have been introduced to decrease the bacterial load in endodontic infections. Aim and Objectives: The aim of the study was to compare and evaluate the antibacterial effect of silver nanoparticles alone and combination of silver nanoparticles with calcium hydroxide and chlorhexidine against Enterococcus faecalis. Materials and Methods: A pure culture of E. faecalis was used as the test microorganism. After 24 h of incubation the bacterial colonies were isolated and suspended in 5 ml of infusion broth followed by incubation at 37 degrees C for 4 h. 0.5 McFarland of the bacterial suspension was prepared and then cultured on Mueller-Hinton agar culture medium with the help of a sterile swab. In each culture plate, five wells were created with a sterile pipette for placement of the samples. Results: Statistically significant difference in the antibacterial effect of the combination of silver nanocure gel with various medicaments was observed when compared to the effect of silver nanocure gel alone. Silver nanocure gel in combination with calcium hydroxide (Group B) was more efficacious as compared to silver nanocure gel alone (Group A) (P < 0.001). Antibacterial activity of silver nanocure gel in combination with chlorhexidine (Group C) was also significantly higher than silver nanocure gel alone (P < 0.001). Conclusion: The present study is an in vitro study, in which we concluded that the combination of all the intracanal medicaments is the best among for elimination of E. faecalis biofilm from the root canal. The above findings need to be tested in vivo also.