Comparison of the Antimicrobial Properties of Nanoemulsions Made from Phytosphingosine and Chitosan with a Triple Antibiotic Paste Against Enterococcus faecalis in Endodontics: An in-vitro Study

Ganesh R Jadhav,1,* Priya Mittal,2,* Mohammed Abdul Kader M,3 Suheel Manzoor Baba,3 Siddharth Shinde,4 Dhanashree Dalal,5 Ahmed Abdullah Al Malwi,3 Shahabe Saquib Abullais,6 Siddharthan Selvaraj7,8 1Department of Dentistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India; 2Department of Conservative Dentistry and Endodontics, Nanded Rural Dental College & Research Centre, Nanded, Maharashtra, India; 3Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia; 4Department of Orthodontics and Dentofacial Orthopedics, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Pune, Maharashtra, India; 5Department of Pedodontics and Preventive Dentistry, Dr. D Y Patil Dental College and Hospital, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India; 6Department of Periodontics and Community Dental Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia; 7Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia; 8Department of Dental Research Cell, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to Be University), Pune, India*These authors contributed equally to this workCorrespondence: Siddharthan Selvaraj, Email [email protected]: Aerobic and facultative anaerobic bacteria are most commonly found in failed root canal cases. Among those, Enterococcus faecalis (E. faecalis) is the most resistant intracanal microbe. Hence, the antibacterial effectiveness of various intracanal medicaments (ICMs) is primarily tested against E. faecalis. To eliminate such resistant bacteria from the entire root canal system, various contemporary intracanal medicaments (ICMs) with an effective antibacterial action are evaluated. The purpose of the study is to compare the antimicrobial efficacy of intracanal medications, Phytosphingosine nano-emulsion (PHSN), Chitosan nano-emulsion (CHN), and Triple Antibiotic Paste (TAP) against E. faecalis in endodontics.Patients and Methods: Assuming the Minimum Inhibitory Concentration (MIC) of 15.93 and SD 1.53 with estimated error of 1, 80% power, and 5% alpha error, the sample size was calculated as 9. All three ICMs were prepared following the standard protocols. These ICMs were categorised into 3 groups as follows: Group I: PHSN; Group II: CHN; Group III: TAP. The antibacterial property of these ICMs was evaluated using MIC and disk diffusion methods. ANOVA and post hoc Tukey’s tests.Results: The minimum inhibitory concentration (MIC) was found to be 1 μg/mL for PHSN, 32 μg/mL for CHN, and 4.0 μL/mL for TAP against E. faecalis. PHSN showed the largest zone of inhibition (38.3 ± 1.48), followed by CHN (8.16 ± 0.966), and TAP (6.30 ± 1.71). Thus, PHSN showed significantly higher antimicrobial efficiency compared to CHN and TAP (p < 0.05). Although CHN showed a higher zone of inhibition than the TAP, the difference between them was statistically nonsignificant.Conclusion: Phytosphingosine nano-emulsion (PHSN) has maximum efficacy against E. faecalis, and it can hinder its growth with a minimum inhibitory concentration of 1μg/mL. Chitosan nano-emulsion (CHN) shows slightly more efficacy than Triple Antibiotic Paste (TAP), but without any statistical significance.Keywords: antimicrobial agent, E. faecalis, phytosphingosine, chitosan, Triple Antibiotic Paste