Analysis of the effectiveness of different intracanal medications against Enterococcus faecalis: an exploratory study

Abstract

The persistence of microorganisms in the root canal system is the primary cause of endodontic treatment failure, with Enterococcus faecalis being one of the most prevalent pathogens in persistent infections because of its ability to colonize dentinal tubules and withstand adverse conditions. It aims to evaluate the antimicrobial effectiveness of three intracanal medications, calcium hydroxide (Ca(OH)₂) paste, 2% chlorhexidine (CHX) gel, and blue®m gel, against E. faecalis using the agar diffusion method. To this end, E. faecalis (ATCC29212) was cultivated on Mueller-Hinton agar plates. Four equidistant wells were created per plate and filled with the test substances, with saline solution as a negative control. Inhibition halos were measured at 24, 48, and 72 hours. In this way, it is observed that 2% CHX produced the largest inhibition halos (mean 26.17 mm), followed by Ca(OH)₂ (mean 19.67 mm). At the same time, blue®m gel and saline showed no inhibitory effect at any time point, and there was no statistically significant variation in the active substances across the experimental periods (p > 0.05). These findings indicate that 2% CHX gel and Ca(OH)₂ paste are effective against E. faecalis, with CHX demonstrating superior antimicrobial activity, whereas blue®m gel showed no efficacy under the tested conditions.