Abstract:

Background and Aim: The present study compared antibacterial efficacy of sodium diclofenac, sodium diclofenac + streptomycin, tri-antibiotic and calcium hydroxide on enterococcus faecalis biofilm.

Materials and Methods: In this in vitro trial, enterococcus faecalis was cultured on blood agar plate overnight. Colonies from this culture were suspended in 10 ml of normal saline solution and the resulting bacterial suspension turbidity was adjusted to McFarland standard (108 CFU/ml). E. faecalis biofilm was dispensed on 56 sterile cellulose nitrate filter disks 13mm in diameter, 0.2 micron in thickness. The disks were placed on blood agar plates and incubated anaerobically for 48 hours at 37’C. After incubation, the disks were introduced to antibacterial agents. Buffered saline was used to wash out the disks five times in order to terminate the antibacterial activity of the agents. The colony-forming units of the remaining viable bacteria on the disks were calculated. Statistical analysis was done using Kruskal-Wallis and Mann-Whitney U tests. 

Results: Tri-antibiotic and streptomycin completely removed enterococcus faecalis strains from the culture. The next highest antibacterial activity was found in modified tri-antibiotic, diclofenac in combination with streptomycin, diclofenac alone, and calcium hydroxide (mean CFU: 135.8, 160.67, 207, and 794.5 respectively p<0.004). The use of streptomycin with sodium diclofenac improved the antibacterial efficacy (p<0.004) while replacement of the sodium diclofenac with minocycline in tri-antibiotic drug significantly decreased the antibacterial activity of the agent (p<0.002). 

Conclusion: Antibacterial properties of sodium diclofenac against enterococcus faecalis biofilm were was significantly higher than calcium hydroxide. Its use may be feasible as an alternative to calcium hydroxide in root canal therapy.