In Vitro Comparisons of Minimal Inhibitory Concentrations between NaOCL, CHX, MTAD and EDTA against Candida Albicans

Donika Bajrami Shabani, Agime Dragidella Teneqja

 
International Journal of Biomedicine. 2023;13(4):345-349.
DOI: 10.21103/Article13(4)_OA19
Originally published December 5, 2023

Abstract: 

The aim of this in vitro study was to evaluate the minimal inhibitory concentration (MIC) of 3% NaOCl, 2% CHX, MTAD, and EDTA against Candida albicans (C. albicans).
Methods and Results: Certified strain of C. albicans (ATCC 10231 OXOID, Hampshire, UK) was used to determine the MIC of 3% NaOCl, 2% CHX, MTAD, and EDTA in vitro. The broth dilution method was used to determine the MIC and to ensure the test was highly accurate. C. albicans and respective irrigants were gradually placed into the appropriate test tubes, starting from 1 mL to 0.06 mL of irrigant (getting halved each time). The test tubes were incubated at 37°C for 24 h. MIC was then recorded as the lowest concentration of irrigant that inhibited microbial growth, based on based on spectrophotometry. It was found the higher the value of the absorbance rate, the smaller the antifungal effectiveness of the tested substance. Our study showed that some of the tested irrigants retained an antifungal effect after dilution, which is valuable because dilution reduces toxicity. 3% NaOCl has an efficient antifungal effect against C. albicans both at full concentration and when diluted fivefold. The antifungal effect of 2% CHX for C. albicans cultures increases with its dilution. MTAD retains a good antifungal effect even when diluted fivefold.

Keywords: 
Candida albicans • minimal inhibitory concentration • MTAD • CHX • NaOCl • EDTA
References: 
  1. KAKEHASHI S, STANLEY HR, FITZGERALD RJ. THE EFFECTS OF SURGICAL EXPOSURES OF DENTAL PULPS IN GERM-FREE AND CONVENTIONAL LABORATORY RATS. Oral Surg Oral Med Oral Pathol. 1965 Sep;20:340-9. doi: 10.1016/0030-4220(65)90166-0.
  2. Sundqvist G. Ecology of the root canal flora. J Endod. 1992 Sep;18(9):427-30. doi: 10.1016/S0099-2399(06)80842-3.
  3. Möller AJ, Fabricius L, Dahlén G, Ohman AE, Heyden G. Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys. Scand J Dent Res. 1981 Dec;89(6):475-84. doi: 10.1111/j.1600-0722.1981.tb01711.x.
  4. Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? J Am Dent Assoc. 2005 Feb;136(2):187-93; quiz 231. doi: 10.14219/jada.archive.2005.0140. 
  5. Li GH, Niu LN, Zhang W, Olsen M, De-Deus G, Eid AA, Chen JH, Pashley DH, Tay FR. Ability of new obturation materials to improve the seal of the root canal system: a review. Acta Biomater. 2014 Mar;10(3):1050-1063. doi: 10.1016/j.actbio.2013.11.015. 
  6. Tong Y, Tang J. Candida albicans infection and intestinal immunity. Microbiol Res. 2017 May;198:27-35. doi: 10.1016/j.micres.2017.02.002. 
  7. Persoon IF, Crielaard W, Özok AR. Prevalence and nature of fungi in root canal infections: a systematic review and meta-analysis. Int Endod J. 2017 Nov;50(11):1055-1066. doi: 10.1111/iej.12730. 
  8. Alberti A, Corbella S, Taschieri S, Francetti L, Fakhruddin KS, Samaranayake LP. Fungal species in endodontic infections: A systematic review and meta-analysis. PLoS One. 2021 Jul 22;16(7):e0255003. doi: 10.1371/journal.pone.0255003. 
  9. Ohshima T, Ikawa S, Kitano K, Maeda N. A Proposal of Remedies for Oral Diseases Caused by Candida: A Mini Review. Front Microbiol. 2018 Jul 9;9:1522. doi: 10.3389/fmicb.2018.01522.  
  10. Siqueira JF Jr, Sen BH. Fungi in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 May;97(5):632-41. doi: 10.1016/S1079210404000046. 
  11. Waltimo TM, Haapasalo M, Zehnder M, Meyer J. Clinical aspects related to endodontic yeast infections. Endodontic Topics. 2004;9(1):66–78.
  12. Lucas VS. Association of psychotropic drugs, prevalence of denture-related stomatitis and oral candidosis. Community Dent Oral Epidemiol. 1993 Oct;21(5):313-6. doi: 10.1111/j.1600-0528.1993.tb00782.x. 
  13. Arendorf TM, Walker DM. The prevalence and intra-oral distribution of Candida albicans in man. Arch Oral Biol. 1980;25(1):1-10. doi: 10.1016/0003-9969(80)90147-8. 
  14. Dupont B, Graybill JR, Armstrong D, Laroche R, Touzé JE, Wheat LJ. Fungal infections in AIDS patients. J Med Vet Mycol. 1992;30 Suppl 1:19-28. doi: 10.1080/02681219280000731. 
  15. Slaughter RJ, Watts M, Vale JA, Grieve JR, Schep LJ. The clinical toxicology of sodium hypochlorite. Clin Toxicol (Phila). 2019 May;57(5):303-311. doi: 10.1080/15563650.2018.1543889. 
  16. Mohammadi Z, Jafarzadeh H, Shalavi S. Antimicrobial efficacy of chlorhexidine as a root canal irrigant: a literature review. J Oral Sci. 2014 Jun;56(2):99-103. doi: 10.2334/josnusd.56.99. 
  17. Singla MG, Garg A, Gupta S. MTAD in endodontics: an update review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):e70-6. doi: 10.1016/j.tripleo.2011.02.015.
  18. Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J. 2014 Mar;216(6):299-303. doi: 10.1038/sj.bdj.2014.204.
  19. Mohammadi Z, Shalavi S, Jafarzadeh H. Ethylenediaminetetraacetic acid in endodontics. Eur J Dent. 2013 Sep;7(Suppl 1):S135-S142. doi: 10.4103/1305-7456.119091. 
  20. Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001 Jan;34(1):1-10. doi: 10.1046/j.1365-2591.2001.00396.x.
  21. Fidalgo TK, Barcelos R, Portela MB, Soares RM, Gleiser R, Silva-Filho FC. Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus. Braz Oral Res. 2010 Oct-Dec;24(4):406-12. doi: 10.1590/s1806-83242010000400006. 
  22. Sen BH, Akdeniz BG, Denizci AA. The effect of ethylenediamine-tetraacetic acid on Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Nov;90(5):651-5. doi: 10.1067/moe.2000.109640.
  23. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. Sodium Hypochlorite Accident: A Systematic Review. J Endod. 2017 Jan;43(1):16-24. doi: 10.1016/j.joen.2016.09.023.
  24. Gonçalves LS, Rodrigues RC, Andrade Junior CV, Soares RG, Vettore MV. The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials. J Endod. 2016 Apr;42(4):527-32. doi: 10.1016/j.joen.2015.12.021.
  25. Abuhaimed TS, Abou Neel EA. Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin. Biomed Res Int. 2017;2017:1930360. doi: 10.1155/2017/1930360.
  26. Gomes BP, Vianna ME, Zaia AA, Almeida JF, Souza-Filho FJ, Ferraz CC. Chlorhexidine in endodontics. Braz Dent J. 2013;24(2):89-102. doi: 10.1590/0103-6440201302188.
  27. Dede M, Timpel J, Kirsch J, Hannig C, Weber MT. MTAD: Is it the right "solution"? – An overview. Dtsch Zahnärztl Z Int. 2019;1:144-150.
  28. Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J. 2001 Sep;34(6):424-8. doi: 10.1046/j.1365-2591.2001.00410.x. 
  29. Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CC, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Jan;97(1):79-84. doi: 10.1016/s1079-2104(03)00360-3. 

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Received September 30, 2023.
Accepted November 14, 2023.
©2023 International Medical Research and Development Corporation.