Comparison of Antimicrobial Effect of Berberine as an Endodontic Irrigant with that of Other Common Root Canal Irrigants on Three Microorganisms Involved in Persistent Endodontic Infections

Background and Aim: The present study investigated the antimicrobial effect of Berberine as an endodontic irrigant on the microorganisms involved in persistent endodontic infections. In this experimental in vitro trial, organisms Enterococcus Faecalis, Staphylococcus Aureus, and Staphylococcus Epidermidis were assessed in a multi-species biofilm tooth model. Methods: Seventy-five single-rooted anterior teeth were collected and standardized to a length of 10mm. The teeth were randomly assigned into 5 groups. The teeth were then autoclaved to confirm being sterile. Afterwards, a biofilm consisting of the three selected bacteria was inoculated into the teeth and they were incubated for 21 days. Results: The comparison of the amount of reduction in viable bacterial counts after irrigation by different solutions among the groups was done by Kruskal-wallis test while the changes of viable bacterial counts before and after irrigation with each solution was done by Wilocoxon Signed Ranks test. No significant difference existed among the studied irrigation solutions regarding the mean reduction of total viable bacterial counts, neither did it exist regarding the viable staphylococcus aureus, staphylococcus epidermidis or Enterococcus faecalis counts after irrigation. MIC of berberine against staphylococcus aureus, staphylococcus epidermidis and Enterococcus faecalis species were 0.5ug/ml, 0.03ug/ml and 1ug/ml, respectively. These values were found to be 0.39ug/ml, 0.09ug/ml and 0.78ug/ml for NaOCl and 0.04ug/ml, 0.04ug/ml and 0.09ug/ml for chlorhexidine, respectively. Conclusion: it is concluded that Berberine can be used as a natural alternative instead of conventional root canal irrigants. However, more studies are required in order to confirm that characteristics of this substance are appropriate from other aspects.