Antibacterial efficacy of aloe vera extract on resistant antimicrobial strains in endodontics
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ENDODONTOLOGY Original Research
Antibacterial efficacy of aloe vera extract on resistant
antimicrobial strains in endodontics
B. SURESHCHANDRA *
ARUN J. KUMAR **
ABSTRACT
The use of aloe vera is being promoted for a large variety of clinical conditions. The aloe vera plant has a long
history of therapeutic ability. Recently, aloe vera has gained some popularity as an active ingredient in tooth gel.
The ability of aloe vera tooth gel to successfully perform its function has been a point of contention for some
dental professionals. In this in-vitro study, the antimicrobial effect of water, alcohol, chloroform extracts of aloe
vera gel were investigated on different strains of bacteria and yeasts. The results were then evaluated.
Keywords: Aloe vera;Enterococcus faecalis;Antibacterial strains.
INTRODUCTION herbal medicine. Also researchers have shown that
Elimination of the microorganisms and the use of herbal drugs have increased instead of
prevention of reinfection within the pulp canal are synthesized drugs.
the main objectives of the pulp space therapy. Due
Aloe barbadensis Miller (Aloe Vera) belong
to the complex anatomy of the pulp space system
to the liliaceal family, of which there are about 360
and the ability of microorganisms to survive in the
species. It is a cactus like plant that grows in hot
periods of starvation, the microorganisms remain
and dry climates. Numerous studies on Aloe vera
even after thorough mechanical instrumentation
are being done to demonstrate the antiviral,
and irrigational procedures. Therefore an
antibacterial, and not to mention its other use as
antimicrobial intracanal medicament is needed to
an analgesic, anti-inflammatory, wound healing
eliminate the surviving resistant microorganisms.
properties.
In many parts of the world, there is a rich
Aloe Vera has various therapeutic uses in cases
tradition to use herbal medicine for the treatment
such as-Arthritis, Asthma, Digestive and bowel
of many infectious diseases. In developing
disorders, skin problems.(eg: eczema, psoriasis,
countries, it is estimated that about 80 percent of
acne, burns) ,Ulcers etc in general.
the population rely on traditional medicine for their
primary health care. Due to the side effects and In dentistry Aloe vera is used in cases of
the resistance that pathogenic microorganisms build Apthous ulcers, Lichen planus , Alveolar osteitis.
against the common antibiotics, much recent Enterococcus faecalis has been associated with
attention has been paid to extracts and biologically failure of pulp space therapy.It has been shown that
active compounds isolated from plants used in enterococcus faecalis may tolerate antibacterial
* Professor and Head, ** PG student, Department of Conservative Dentistry and Endodontics, A.J. Institute of Dental Sciences, Mangalore.
58ENDODONTOLOGY B. SURESHCHANDRA, ARUN J. KUMAR
effect of Calcium Hydroxide treatment.
Another resistant microorganism is Candida
Albicans, which has dentinophilic properties and
affinity to smear layer.Candida Albicans has
frequently isolated from failed cases as
Enterococcus Faecalis.Not surprisingly, Candida
Albicans can also survive in root canals after
adequate cleaning and shaping and Calcium
Hydroxide treatment.
Many people are looking towards nature for Fig 3: Mixed it well with corresponding
liquid extract media in 1:5 ratio
answers to their present health challenges. Aloe
Vera plant has a long history of therapeutic ability
and therfore has been promoted to combat large
variety of clinical conditions.
PROCEDURE
ALOE VERA EXTRACTION PROCEDURE
Fig 4: The mixed solution was placed in a crucible on a
water bath for dehydration
Fig 1: Remove pulp from the leaf
Fig 5: Precipitate of respective extract
Fig 2: Converted into a juice form
Fig 6: Dissolve it with corresponding Liquid extract media
59ENDODONTOLOGY ANTIBACTERIAL EFFICACY OF ALOE VERA EXTRACT ON RESISTANT ANTIMICROBIAL STRAINS IN ENDODONTICS
AGAR DIFFUSION TEST PROCEDURE
Fig 7: Armamentarium
Fig 12: Placed in an incubator at 37oC for 24 hours
Fig 8: Inoculation of microbial test specimen
Fig 13: Results with Candida Albicans; Zone of inhibition seen
with Chloroform extract (14mm)
Fig 9: Nipping out a hole Fig 14: Results with E. Faecalis;Chloroform extract of aloe vera
with Zone of inhibition seen(9 mm)
Fig 10: Injecting the Aloe vera and calcium hydroxide paste Fig 15: Results with E. Faecalis; Methanol extract with Zone of
Inhibition seen(12mm)
Fig 11: Placed in an anaerobic jar Fig 16:Water extract of Aloe vera
60ENDODONTOLOGY B. SURESHCHANDRA, ARUN J. KUMAR
Fig 17: Ether extract of Aloe vera Fig 18: Calcium hydroxide
Microbial Strains Test No. Water Extract Alcohol extract Chloroform extract Ether Extract Calcium hydroxide
Candida Albicans 1. - - 14mm - -
2. - - 13mm - -
3. - - 13mm - -
4. - - 15mm - -
5. - - 15mm - -
E. faecalis 1. - 14mm 9mm - -
2. - 12mm 7mm - -
3. - 10mm 10mm - -
4. - 13mm 10mm - -
5. - 11mm 9mm - -
Results of antimicrobial activity of different extracts of aloe vera and calcium hydroxide pastes
DISCUSSION against E.faecalis was 9mm. The average zone of
Agar diffusion test is generally accepted inhibition with methanol extract of aloe vera against
procedure.But has some limitations like pH of the E. faecalis was found to be 12mm. These results
substrate, incubation period, and diffusion capacity were in agreement with the studies done by Sema
of the drug having effect on activity of test materials. Agaoglu et al, and Agarry O.O et al. Results
achieved with alcohol and chloroform extracts may
However evidence also suggests agar diffusion
suggest the components of aloe vera are more
tests shows good correlation with other
soluble in those liquid extract media.
antimicrobial susceptibility tests. Natural extract of
aloe vera is always better than commercially CONCLUSION
available aloe vera products, as no preservatives Aloe vera has shown antimicrobial effect
are added in the former one which may give biased against resistant microorganisms found in pulp
results. space. The antimicrobial activity of alcohol and
chloroform extract could be due to the high
In this in-vitro study, the average zone of
solubility of active ingredients in these liquid extract
inhibition with chloroform extract of aloe vera
media. Further in-vivo studies should be carried
against Candida albicans was found to be 14mm,
out to bring this plant in use in endodontics.
61ENDODONTOLOGY ANTIBACTERIAL EFFICACY OF ALOE VERA EXTRACT ON RESISTANT ANTIMICROBIAL STRAINS IN ENDODONTICS
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