Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study

Abstract Background Enterococcus faecalis (E. faecalis) is the most frequently retrieved microorganism from teeth with failed endodontic treatment. Sodium hypochlorite (NaOCl) irrigant still poses some drawbacks, such as its cytotoxic effect and reduced effectiveness when applied at lower concentrat...

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Main Authors: Mai Sayed Hanafy, Noha Mohamed Kamal, Hebatallah Atef Fathallah
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06212-x
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author Mai Sayed Hanafy
Noha Mohamed Kamal
Hebatallah Atef Fathallah
author_facet Mai Sayed Hanafy
Noha Mohamed Kamal
Hebatallah Atef Fathallah
author_sort Mai Sayed Hanafy
collection DOAJ
description Abstract Background Enterococcus faecalis (E. faecalis) is the most frequently retrieved microorganism from teeth with failed endodontic treatment. Sodium hypochlorite (NaOCl) irrigant still poses some drawbacks, such as its cytotoxic effect and reduced effectiveness when applied at lower concentrations. Root canal disinfection by probiotics may yield positive outcomes due to their proven antibacterial and anti-inflammatory abilities. This research was intended to assess the antibacterial efficacy of a probiotic irrigant after ultrasonic activation against E. faecalis in a tooth model. Methods Teeth specimens were infected with E. faecalis biofilm and then randomly divided into five groups according to the final flush irrigation protocol used; PRO for probiotic irrigant, PRO + for activated probiotic irrigant, NaOCl for NaOCl irrigant, NaOCl + for activated NaOCl irrigant, and saline for saline irrigation. Activation of the irrigant was done for 1 min using an Ultra X ultrasonic tip. By counting the colony-forming units per milliliter, the antibacterial activity was quantitatively evaluated for each group pre- and post-irrigation application; then, the bacterial load reduction percentages were calculated accordingly. The one-way ANOVA was conducted to compare the mean values of all variables, followed by the post-hoc Tukey test to make group comparisons with a significance level set at p < 0.05. Results All experimental groups exerted antibacterial activity against E. faecalis with a reduction in the mean CFUs/mL values and an increase in the mean bacterial load reduction percentages. The lowest mean post-irrigation CFUs/mL values were observed in the NaOCl + group, followed by NaOCl, PRO + , PRO, and saline groups respectively. Statistically significant differences were observed among all groups, except for the NaOCl and PRO + groups which did not exhibit any statistically significant difference. Conclusion Ultrasonically activated probiotic irrigant revealed an antibacterial effect similar to the conventional NaOCl and can be effectively used to fight against E. faecalis biofilm.
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spelling doaj-art-383eabcec3fb4642aef39e9a1399c33a2025-08-20T03:22:03ZengBMCBMC Oral Health1472-68312025-05-0125111010.1186/s12903-025-06212-xAntibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro studyMai Sayed Hanafy0Noha Mohamed Kamal1Hebatallah Atef Fathallah2Endodontic Department, Faculty of Dentistry, Suez UniversityBotany Department, Faculty of Women for Arts, Science, and Education, Ain Shams UniversityEndodontic Department, Faculty of Oral and Dental Medicine, Nahda University in Beni SuefAbstract Background Enterococcus faecalis (E. faecalis) is the most frequently retrieved microorganism from teeth with failed endodontic treatment. Sodium hypochlorite (NaOCl) irrigant still poses some drawbacks, such as its cytotoxic effect and reduced effectiveness when applied at lower concentrations. Root canal disinfection by probiotics may yield positive outcomes due to their proven antibacterial and anti-inflammatory abilities. This research was intended to assess the antibacterial efficacy of a probiotic irrigant after ultrasonic activation against E. faecalis in a tooth model. Methods Teeth specimens were infected with E. faecalis biofilm and then randomly divided into five groups according to the final flush irrigation protocol used; PRO for probiotic irrigant, PRO + for activated probiotic irrigant, NaOCl for NaOCl irrigant, NaOCl + for activated NaOCl irrigant, and saline for saline irrigation. Activation of the irrigant was done for 1 min using an Ultra X ultrasonic tip. By counting the colony-forming units per milliliter, the antibacterial activity was quantitatively evaluated for each group pre- and post-irrigation application; then, the bacterial load reduction percentages were calculated accordingly. The one-way ANOVA was conducted to compare the mean values of all variables, followed by the post-hoc Tukey test to make group comparisons with a significance level set at p < 0.05. Results All experimental groups exerted antibacterial activity against E. faecalis with a reduction in the mean CFUs/mL values and an increase in the mean bacterial load reduction percentages. The lowest mean post-irrigation CFUs/mL values were observed in the NaOCl + group, followed by NaOCl, PRO + , PRO, and saline groups respectively. Statistically significant differences were observed among all groups, except for the NaOCl and PRO + groups which did not exhibit any statistically significant difference. Conclusion Ultrasonically activated probiotic irrigant revealed an antibacterial effect similar to the conventional NaOCl and can be effectively used to fight against E. faecalis biofilm.https://doi.org/10.1186/s12903-025-06212-xProbioticsLactobacillus plantarumEnterococcus faecalis biofilmUltrasonic-activated irrigationAntibacterial activity
spellingShingle Mai Sayed Hanafy
Noha Mohamed Kamal
Hebatallah Atef Fathallah
Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
BMC Oral Health
Probiotics
Lactobacillus plantarum
Enterococcus faecalis biofilm
Ultrasonic-activated irrigation
Antibacterial activity
title Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
title_full Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
title_fullStr Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
title_full_unstemmed Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
title_short Antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against Enterococcus faecalis biofilm: an in-vitro study
title_sort antibacterial efficacy of ultrasonically activated probiotic endodontic irrigant against enterococcus faecalis biofilm an in vitro study
topic Probiotics
Lactobacillus plantarum
Enterococcus faecalis biofilm
Ultrasonic-activated irrigation
Antibacterial activity
url https://doi.org/10.1186/s12903-025-06212-x
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AT nohamohamedkamal antibacterialefficacyofultrasonicallyactivatedprobioticendodonticirrigantagainstenterococcusfaecalisbiofilmaninvitrostudy
AT hebatallahateffathallah antibacterialefficacyofultrasonicallyactivatedprobioticendodonticirrigantagainstenterococcusfaecalisbiofilmaninvitrostudy