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