Comparative In Vitro Study of Antimicrobial Efficacy of Sodium Hypochlorite, Normal Saline, and Hekla Lava Tooth Powder as Root Canal Irrigants Against Enterococcus faecalis

Background: Enterococcus faecalis is a bacterium commonly associated with persistent endodontic infections. Hekla Lava has healing properties that enhance its antibacterial effects, making it a potential alternative to traditional irrigants, such as sodium hypochlorite (NaOCl). E. faecalis is particularly resilient and can form biofilms, thus complicating treatment outcomes; therefore, exploring effective irrigants is crucial for improving root canal disinfection strategies. This research aimed to assess whether Hekla Lava tooth powder (HLTP) can provide sufficient antimicrobial efficacy to support successful endodontic treatments. It evaluated the antibacterial efficacy of NaOCl, normal saline (NS), and HLTP as a root canal irrigant against E. faecalis. Methods: The in vitro study was conducted in an extracted non-carious human tooth. The treatment groups were treated with NaOCL (group A), NS (group B), and HLTP (group C) for the irrigation of the root canal for ۵ minutes and ۴۸ hours. Results: The results of the study demonstrated significant differences in the antimicrobial efficacy of the three treatment groups at both time points. HLTP showed a decrease in colony-forming units from a mean initial count of ۵۹.۳۵±۵.۸۰ after ۵ minutes to ۴۰.۴۷±۳.۸۱ after ۴۸ hours, indicating that its use was better when compared to NS. Conclusion: The findings reaffirm that the use of HLTP as an irrigant is preferable compared to NS due to its superior antimicrobial properties against E. faecalis. NS lacks substantial antimicrobial effects, making it less effective for disinfection in root canal procedures. This study highlights the potential of HLTP as a more effective alternative for improving treatment outcomes in endodontics, suggesting a shift toward herbal and natural solutions in dental care practices.