Antimicrobial Effect of German chamomile Extract as Root Canal Irrigant (in vitro Study)

:- Aims: To evaluate the antimicrobial effect of German chamomile extract as a root canat irrigant in vitro, and comparing its effect with chlorhexidine 0.2Yo inigant solution. Materials and Methods: Twenty adult patients rvith age range l8+0 years attending dental school with symptomatic uniradicular teeth with necrotic'pulp diagnosed by radiograph rvith no flstula or sinus tract were chosen; l0 subjec_ts for each irrigant solution (the test and the control groups). Microbiological samples rvere obtained from the root canal at the beginning of the first appointr.nt, and then moistined paper point is placed in a screlv capped vial containing 5 ml Thioglycoiate broth for anaerobic bacteria arrd thc otlter containing Brain I leart Infusion broth for aerobic bacteria, rvfiiclr is incubated directly for l8 hours at37 "C. Turbidity test lvas used to compare antimicrobial effect of Cerman chamomile eKtract with chlorhexidine 0.2%. Rcsults: Mean reduction in bacterial count (0.36 t 0.09 for aerobic and 0.19 + 0.02 for anaerobic) for Cerman chamornilc and chlorlrcxidinc 0.2% (0.084 + 0.03 and 0.052 t 0.016 respectivcly) were

Introduction:-Inigating solutions used in endodontic treatment aid in cleaning the pulp chamber, (l) root canal, lubricate the files, flush out debris, having an antimicrobial effect and tissue d issolution properties. (2) Thg ideal irrigant should have a srrong antimicrobial action, dissolve the organic tissue but not toxic to the peri apical tissue if extruded through the apex. (i'r) Antimicrobial agent must suppress or destroy microbial grorvth, thus susceptibility of ttre .microorganisms, penetration of the antimicrobial agent to the infected site, adequate concentration of the agent, low toxicity of the host cells and lack of microbial resistance to thc agent are necessary. (s' o) Chlorhexidine gluconate (CHX) has a wide spectrum of antimicrobial activity and it is rclativcly non-toxic. Ilorvever, it has no capacity to dissolve the vital tissucs. (7) Reccntly, thcrc lras bcen an incretscd intcrcst in antimicrobial agcnts frorn nrcdicirrnl plants rvhiclr havc bccn uscd in folk mcdicinc. (8) Gcrnran charnonrilc (GC) is onc of tlrc olclcst favoritcs arnongst gardcn lrcrbs ancl its rcputltion ns a nrcdicinal plant sho',vs littlc sigrrs of abatcnrcnt, It is cspccially suitccl to tccthing childrcn ancl thosc rvho havc bccrr irr a lrislrly ctttotionll stltc ovcr a long pcriocl of tirri"^.(i) 'flrc lrcrb kills ccrtlin bactcrir nrrcl can lrc uscd as rrrotrtlr rvash fbr dcrrtaI nbsccsscs ancl torrsillitis; it is cxccllcnt irr trcating any typc of. intlarnrlation rvhcthcr irrtcrrraI o, .it"r,i.l.il'o) For the comparison of CHX 0.2% effect between aerobic and anaerobic bacteria, Table   (3) shows no significant difference, while for GC extract Table (3) shows significant difference between aerobic and anaerobic bacteria. The difference was more significant for anaerobic bacteria than for aerobic with significant difference atp < 0.05.

Discussiont-
An infusion of the florvers is taken internally as an anodyne, .^ antj-inflammatory, antiseptic, antispasmodic.t'' "r Evidence from laboratory studies shows that chamomile has antibacterial and antiviral properties. However, no animal or human studies verify its anti-infective activity; i.e., the potential antimicrobial effects as a root canal irrigant is not yet currently known. For this rcason this study was carried out.
In vltro, the antimicrobial activity of GC extract as a root canal irrigant was evaluated using brotlr nricrodilution mcthod. This method givcs nrorc bcttcr rcsults in comparison rvith disk dil'tirsion rncthod, rvhich has a low crcdibility for sarnplcs of plants that are difficult to dif'firsc in thc rncdia and also thcrc is no rclationship betrvccn diffitsion porvcr arrd antirrricrobial activity and, thcrefore, may not cxprcss its full cf lcctivc potential. (26) Accordingly, dilution nrethod is nrore suitable tharr thc agar diffirsion method to dctcrmine the susceptibility of nticroorganisms.(27) Results revealed that CHX 0.270 cause significant reduction on aerobic and anaerobic bacteria, lvith no significant difference, rvhich is much greater than GC extract. The antibacterial activity of CHX in t,ilro is not outstanding but the spectrum of activity is broad. Gram positive bacteria are more susceptible than are Gram negative bacteria; Streptococars mutans seems to be particularly sensitive. The irrigant of choice should be one that exerts its antirnicrobial activity quickly against the majority of microorganisms found iri the root canal and dentinal tubules.

Conclusion:-
The GC extract is natural product, cheep, safe and well-tolerated, showed an effective antimicrobial action in vitro when it is used as an irrigant during biomechanical instrumentation of root canal. The GC antimicrobial effect is much lower than that of CHX 0,ZYo irrigating solution.
The CC exhibit more effect on anaerobic bacteria than for aerobic lvith significant difference.