Antimicrobial efficacy of herbal products in secondary endodontic infections: in vivo study

Abstract Aim To clinically compare the efficacy of two herbal products (propolis and garlic) with 2% chlorhexidine (CHX) used as irrigants and intracanal medications in secondary endodontic infection cases. Patients and methods Thirty patients with single-canal teeth diagnosed with failure in endodontic treatment were selected for this study, and randomly assigned into three groups according to the type of irrigating solution and intracanal medications used. Group 1 (2% CHX irrigation solution and CHX gel intracanal medication), group 2 (30% propolis irrigation and propolis gel intracanal medication), group 3 (30% garlic irrigation and garlic gel intracanal medication). The first microbial sample (S1) was collected after the removal of the primary filling material. A ProTaper Universal rotary system was used for reinstrumentation up to F4 or F5 depending on the canal size. The second microbial sample (S2) was collected after chemomechanical preparation using different irrigant solutions. Intracanal medication was administered as previously mentioned. Finally, the third microbial sample (S3) was collected after the removal of intracanal medication. The three samples were cultured then the growing colonies were counted and recorded as colony forming units. Results The results showed statistical nonsignificant differences between the percentages of bacterial reduction among samples within and between groups. The highest mean bacterial reduction was observed in patients with CHX, however there were no statistically significant differences compared with the other groups. Conclusion CHX was the best intracanal medication, the most suggested irrigant was propolis and the CHX group was considered the best group in this study. Irrigation and intracanal medication can reduce microbial counts, especially in secondary infection cases.