Antibacterial efficacy of calcium hydroxide, polyantibiotic paste, and Laccifer lacca combinations: An in vitro study

Abstract Background: Persistent Enterococcus faecalis infections compromise root canal therapy, with conventional medicaments like calcium hydroxide showing limited efficacy due to bacterial resistance. Novel combinations may improve disinfection outcomes. Objective: To compare the antibacterial efficacy of calcium hydroxide with Laccifer lacca , calcium hydroxide alone, and a polyantibiotic paste (Neosporin-H) against E. faecalis . Methods: Twenty-eight extracted mandibular premolars were prepared and inoculated with E. faecalis for 21 days. Specimens were divided into four groups: calcium hydroxide, calcium hydroxide + Laccifer lacca (6:4 ratio), Neosporin-H, and untreated controls. After 7 days of medicament placement, dentin scrapings were cultured to assess colony-forming units (CFUs). Statistical analysis was performed using one-way ANOVA. Results: CFUs were highest in controls (318.00), reduced with calcium hydroxide (204.57), and further lowered by Neosporin-H (143.00). The calcium hydroxide + Laccifer lacca group showed the greatest reduction (7.71 CFUs; F = 49.64, P = 0.0001). Conclusion: Laccifer lacca significantly enhances calcium hydroxide’s antibacterial activity, offering a promising alternative intracanal medicament for resistant E. faecalis infections.