Acta Scientific Dental Sciences (ISSN: 2581-4893)

Research Article Volume 4 Issue 11

Comparative Evaluation of the Antibacterial Activity of Cinnamon zylanicum (True Cinnamon) and Azadirachta indica (Neem) Herbal Extracts Versus Calcium Hydroxide Intracanal Medication against Enterococcus faecalis in Single Rooted Premolars Teeth: A Randomized In Vitro Study

Hisham (El-sayed Abo Elenein) El-sayed1*, Hany Samy Sadek2 and Marwa Mahmoud Bedier2

1Masters Student, Faculty of Dentistry, Cairo University, Egypt
2Associate Professor of Endodontics, Faculty of Dentistry, Cairo University, Egypt

*Corresponding Author: Hisham (El-sayed Abo Elenein) El-sayed Ban, Masters Student, Faculty of Dentistry, Cairo University, Egypt.

Received: September 09, 2020; Published: October 07, 2020



Aim of the Work: This Comparative Randomized in-vitro study was conducted to compare the antibacterial effect of two different herbal extracts: Cinnamon zylanicum (True Cinnamon) and Azadiracta Indica (Neem) versus Calcium Hydroxide (Ca (OH)2) as an intracanal medication against Enterococcus Faecalis (E. faecalis) in single-rooted premolars teeth.

Materials and Methods: Thirty nine single-rooted premolars teeth were randomly divided according to the intracanal medication used into three groups (n = 13), either True Cinnamon or Neem or Ca (OH)2.

The teeth were decoronated, infected with E. faecalis and incubated for 21 days, then Pre-operative sample (S1) was taken using size 25 sterile paper points. The root canals were prepared using ProTaper Universal rotary system till size F4, then Post-Instrumentation sample (S2) was taken using F4 sterile ProTaper paper points; this was followed by the application of the intracanal medications for 7 days, then the Post-medication sample (S3) was taken using F4 sterile paper points. The antibacterial effect was assessed using Agar Diffusion Test to count the colony forming units.

Results: Showed that there was no difference in the antibacterial effect of True Cinnamon, Neem and Ca (OH)2, however in each group there was a statistically significant difference in the antibacterial effect between the Pre-operative samples (S1), the Post-Instrumentation sample (S2) and the Post-medication sample (S3).

Conclusion: True Cinnamon, Neem and Ca (OH)2 showed similar antibacterial activity against E. faecalis, when used as intracanal medications for 7 days.

Keywords: Cinnamon zylanicum; Cinnamon; Azadiracta indica; Neem; Calcium Hydroxide; Antibacterial; Enterococcus faecalis



  1. Haapasalo M., et al. “Eradication of endodontic infection by instrumentation and irrigation solutions”. Endodontics Topics 10 (2005): 77-102.
  2. Evans M., et al. “Mechanisms involved in the resistance of enterococcus faecalis to calcium hydroxide”. International Endodontic Journal 35 (2002): 221-228.
  3. Pinheiro ET., et al. “Antimicrobial susceptibility of enterococcus faecalis isolated from canals of root filled teeth with periapical lesions”. International Endodontic Journal 37 (2004): 756-763.
  4. Kayaoglu G. “Virulence factors of Enterococcus faecalis: Relationship to Endodontic disease”. Critical Reviews in Oral Biology and Medicine 15 (2004): 308-320.
  5. Jacobson RA., et al. “Enterococcus faecalis exploits the human fibrinolytic system to drive excess collagenolysis: implications in gut healing and identification of druggable targets”. American Journal of Physiology - Gastrointestinal and Liver Physiology 11 (2019): 1-20.
  6. Bhardwaj A. “Comparative evaluation of the antimicrobial activity of natural extracts of morinda citrifolia, papain and aloe vera (all in gel formulation), 2% chlorhexidine gel and calcium hydroxide against enterococcus faecalis: An in vitro study”. Journal of Conservative Dentistry 15 (2012): 293-297.
  7. Mohammadi Z and Dummer P. “Properties and applications of calcium hydroxide in endodontics and dental traumatology”. International Endodontic Journal 44 (2011): 697-730.
  8. Chai WL., et al. “Susceptibility of enterococcus faecalis biofilm to antibiotics and calcium hydroxide”. Oral Science Journal 49 (2007): 161-166.
  9. Siqueira JF Jr and Lopes HP. “Mechanisms of antimicrobial activity of calcium hydroxide: a critical review”. International Endodontic Journal 32 (1999): 361-369.
  10. Van der Sluis LW and Wesselink PR. “The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies”. International Endodontic Journal 40 (2007): 52-57.
  11. Younos C., et al. “Analgesic and behavioral effect of Morinda Citrifolia”. Planta Medica 56 (1990): 430-434.
  12. Darout IA., et al. “Identification and Quantification of some Potentially Antimicrobial Anionic Components in Miswak Extract”. Indian Journal of Pharmacology 32 (2000): 11-14.
  13. Hammer KA., et al. “Susceptibility of oral bacteria to Melaleuca altemifoia (tea tree) oil in vitro”. Oral Microbiology and Immunology 18 (2003): 89-92.
  14. Lahijani MSS., et al. “The effect of German chamomile (Marticaria recutita L.) extract and tea tree (Melaleuca altemifolia L.) oil used as irrigants on removal of smear layer”. International Endodontic Journal 39 (2006): 190-195.
  15. Pujar M and Makandar S. “Herbal Usage in Endodontics- a Review”. International Journal of Contemporary Dental Practice 2 (2011): 34-37.
  16. Vibha H and Dhaval P. “Comparative evaluation of antimicrobial activity of neem, propolis, turmeric, liquorice and sodium hypochlorite as root canal irrigants against enterococcus faecalis”. Journal of Original Research 25 (2013): 38-45.
  17. Suresh A., et al. “Evaluation of the antibacterial efficacy of azadirachta indica, commiphora myrrha, glycyrrhiza glabra against enterococcus faecalis using real time PCR”. Open Dental Journal 10 (2016): 160-165.
  18. Siqueira JF., et al. “Bacterial reduction in infected root canals treated with 2.5% sodium hypochlorite as an irrigant and calcium hydroxide/camphorated paramonochlorophenol paste as an intracanal dressing”. Journal of Endodontics 33 (2007): 667-672.
  19. Marion JJC., et al. “Efficiency of different concentrations of sodium hypochlorite during endodontic treatment”. Dental Press Endodontics 2 (2012): 32-37.
  20. Reyhani MF., et al. “Antimicrobial efficacy of different concentration of sodium hypochlorite on the biofilm of Enterococcus faecalis at different stages of development”. Journal of Clinical and Experimental Dentistry 8 (2016): 480-484.
  21. Veerale P., et al. “Comparison of antibacterial efficacy of cinnamon extract and calcium hydroxide as intracanal medication against enterococcus faecalis”. Pharmacognosy Journal 10 (2018): 1165-1168.
  22. Abbasazadegan A., et al. “Antimicrobial and cytotoxic activity of cinnamon zylanicum, calcium hydroxide and triple antibiotic paste as root canal dressing material”. Journal of Contemporary Dental Practice (2016): 17: 105-113.
  23. Ranasinghe P., et al. “Medicinal properties of cinnamomum zeylanicum): A systematic review”. BMC Complementary Medicine and Therapies 13 (2003): 1-10.
  24. Muktishree M., et al. “Antimicrobial activity of different biological extracts as intracanal medicament against enterococcus faecalis”. Indian Endodontic Society 28 (2016): 166-170.
  25. Koona S and Budida S. “Antibacterial potential of the extracts of the leaves of azadirachta indica. Linn”. Notulae Scientia Biologicae 3 (2011): 65-69.
  26. Kunjal SM., et al. “The antimicrobial activity of Azadirachta indica, Mimusops elengi, Tinospora cardifolia, Ocimum sanctum and 2% chlorhexidine gluconate on common endodontic pathogens”. European Journal of Dentistry 8 (2014): 172-177.
  27. Atila-Pektas P and Yurdakul P. “Antimicrobial effects of root canal medications against the enterococcus faecalis and streptococcus mutans”. International Endodontic Journal 46 (2013): 413-418.
  28. Lima RK., et al. “Effectiveness of calcium hydroxide-based intracanal medications against enterococcus faecalis”. International Endodontic Journal 45 (2012): 311-316.
  29. Alireza A., et al. “A Comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against entrococcus Faecalis”. Iranian Endodontic Journal 7 (2012): 149-155.
  30. Venkatesh A., et al. “Effectiveness of calcium hydroxide plus points and chlorhexidine activ points against enterococcus faecalis by agar diffusion test”. Journal of Research Dentistry 1 (2013): 18-21.
  31. Omid D., et al. “Evaluated the atimicrobial effects of chlorohexidine gel, triple antibiotic paste, calcium hydroxide, and nanosilver against enterococcus faecalis”. Iranian Endodontic Journal 45 2014 9 (2014): 195-198.
  32. Siqueira JF Jr and Lopes HP. “Mechanisms of antimicrobial activity of calcium hydroxide: a critical review”. International Endodontic Journal 32 (1999): 361-369.
  33. Shuping GB., et al. “Reduction of intracanal bacteria using nickeltitanium rotary instrumentation and various medications”. Journal of Endodontics 26 (2000): 751-755.
  34. Ronan JR and Delgado DD. “The antimicrobial effects of calcium hydroxide, chlorhexidine and their combination against enterococcus faecalis”. Journal of Endodontics 36 (2010): 1389-1393.
  35. Valera MC., et al. “Action of chlorhexidine, zingiber officinale, and calcium hydroxide on candida albicans, enterococcus faecalis, escherichia coli, and endotoxin in the root Canals”. Journal of Contemporary Dental Practice 17 (2016): 114-118.


Citation: Hisham (El-sayed Abo Elenein) El-sayed., et al. “Comparative Evaluation of the Antibacterial Activity of Cinnamon zylanicum (True Cinnamon) and Azadirachta indica (Neem) Herbal Extracts Versus Calcium Hydroxide Intracanal Medication against Enterococcus faecalis in Single Rooted Premolars Teeth: A Randomized In Vitro Study". Acta Scientific Dental Sciences 4.11 (2020): 02-09.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor0.812

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 30, 2021.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US