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113 Effectivity Antibacterial Zinc Oxide Eugenol with Zinc Oxide Propolis for Endodontic Treatment in Primary Teeth

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113 Effectivity Antibacterial Zinc Oxide Eugenol with Zinc Oxide Propolis for Endodontic Treatment in Primary Teeth Rahman/Christiono 113 EFFECTIVITY ANTIBACTERIAL ZINC OXIDE EUGENOL WITH ZINC OXIDE PROPOLIS FOR ENDODONTIC TREATMENT IN PRIMARY TEETH Erwid Fatchur Rahman* ,Sandy Christiono** Keywords: ABSTRACT Zinc oxide, Eugenol, Propolis, Background: Enterococcus faecalis is generally found on the failure of root canal Enterococcus treatments. Zinc oxide propolis is believed to have an antibacterial effect on that faecalis. bacteria. This research aimed to compare bacteriostatic effect of zinc oxide eugenol (ZOE) and zinc oxide propolis (ZOP) as the sealer materials of root canal. Method: This was an experimental research with post-test only control group design with two different groups (ZOE and ZOP). Culture of Enterococcus faecalis bacteria was smeared on Blood Agar Plate media with six times replication per group and kept inside incubator for 24 hours. The result was obtained from the inhibition zone formed around the pasta. Result: The average result of ZOE and ZOP was 27.7 mm and 13.45 mm respectively. Normality test using Shapiro-Wilks showed that data was normal (p>0.05). Then, the data was analysed using Independent Samples T-test. The result showed that there was different inhibition zone between ZOE group and ZOP group (p<0.05). Conclusion: Based on the result, it can be concluded that ZOP has lower antibacterial effectiveness of the Enterococcus faecalis than ZOE. INTRODUCTION disinfection and obturation of root canal. The successful of endodontic treatment requires Elimination microorganism from infected proper preparation and obturation the root ca- root canals are major focus in the root canal nal, especially on the apical third. A number of treatment mainly primary teeth, presence of 60 % of treatment failures caused by poor of bacteria play an important role in the patho- obturation in the root canal.3 genesis of pulp and success of endodontic Since 1930, zinc oxide eugenol has been treatment.1 the bacteria can survive in the root the material of choice. But it lacks in slow re- canals is Enterococcus class of anaerobic bac- sorption, periapical tissue irritation, necrosis of teria and Enterococcus one of part infection of bone and cementum and changes the path of endodontic treatment. Enterococcus facealis is eruption of permanent teeth.4 Zinc oxide euge- resistant bacteria in root canal and can survive nol is also cytotoxic to the cell and connective long periods without additional nutrient. 1,2 En- tissue. This is caused by release of eugenol terococcus faecalis is most often cause of the because of hydrolysis on the surface of the ce- infection at the root canal treatment. Retreat- ment.5 It is necessary to develop an antimicro- ment usually fail because of failure to clean or bial material that does not irritate the periapical kill the bacteria on the initial treatment.2 tissues and cause inflammation. Endodontic treatment is one of type to Propolis contains at least 38 types of fla- maintain teeth in order to continue the function. vonoids, among others: galagin, kaemfenol, Stage of endodontic treatment are preparation, quercentin, pinocembrin, pinostrobin, and pi- *Department of Bedah mulut dan Maksilofasial, Faculty of Dentistry, Sultan Agung Islamic University, Semarang - Indonesia, **Department of Pediatric Dentistry, Faculty of Dentistry, Sultan Agung Islamic University, Semarang - Indonesia Korespondensi: [email protected] ODONTO Dental Journal. Volume 6. Nomor 2. Desember 2019 EFFECTIVITY ANTIBACTERIAL ZINC OXIDE EUGENOL WITH ZINC OXIDE 114 PROPOLIS FOR ENDODONTIC TREATMENT IN PRIMARY TEETH nobasksin. Propolis has been known to have ed with distilled water up to 10ml, this solution the ability as an antimicrobial, anti-inflammato- were added to zinc oxide powder to make zinc ry, anaesthetic, systolic, and cariostatic. Flavo- oxide propolis. For medium used Blood Plate, noids can inhibit the growth of microorganisms Brain Heart Infusion (HIB), 0.9% NaCl solution, because it can form complexes with proteins sterile distilled water, alcohol 70%. Equipment through hydrogen bonding. Polyphenols and used in this study are: measuring pipette, light phenol works as an antibacterial by dena- methylated, Ose sterile, Test tube, test tube turation protein and cell membrane plasma racks, Propipet, cup dishes, autoclave, incuba- damage.6 A scientific study found that propo- tor, sliding caliper, cotton sterile, pinset, ruler, lis inhibited the activity of some Streptococcus glass Beaker, cement spatula, glass slab. bacteria cause dental caries.7 Another study Petri dishes, test tubes, sterilised by dry compared the antimicrobial of propolis, sodium heating. Heating is carried out at a tempera- hypochlorite and saline as irrigation materials ture of 160o C - 180o C for 1.5-2 hours. Tools intracanal. Bacterial samples take immediately which cannot be dry-heated such as pipettes post-opening of the root canal. These results and media, sterilised using by autoclave at a indicate that propolis has antimicrobial activi- temperature of 120oC at 2 atm for 20 minutes. ty similar to sodium hypochlorite.8 The results The tools to be used must be awaited prior of another study entitled “Effect of Propolis on to reach room temperature and dry. Pasta is Human fibroblasts from the pulp and periodon- made by manipulating the test of zinc oxide eu- tal ligaments” showed that propolis with anti- genol with 4:1 ratio of powder and liquid on the bacterial, antifungal, antiviral, and its ability to glass slab with a spatula cement, zinc oxide enhance immune response, it is also possible as well as propolis. Then making the bacteria to use as a replacement appropriate for end- Enterococcus faecalis suspension by bacterial odontic intracanal because of lower cytotox- culture was taken 1-2 ose Enterococcus faeca- icity.9 The purpose of this study was to deter- lis aged 18-24 hours. Enter into a tube contain- mine the antibacterial effectivity between zinc ing liquid medium Brain Hearth Infusion (HIB), oxide eugenol with zinc oxide propolis as the and then incubated at 37o for 24 hours then endodontic treatment in the primary teeth in suspended in 0.9% NaCl solution according to inhibiting the growth of bacteria Enterococcus standard sensitivity Mc Farland III containing 9 faecalis in vitro. x 108 bacteria/ml2 germs. Core test performed by a sterile cotton stick MATERIALS AND METHODS is inserted into the bacterial suspension En- terococcus faecalis that has been made, cot- The type of this research was experimen- ton stick was taken and razed to the Blood To tal. The study design was post-test only con- Plate. Incubation at 37o C for 24 hours. Zinc trol group design. Samples were taken by the oxide propolis, zinc oxide eugenol and sterile bacterium Enterococcus faecalis sensitivity Mc distilled water that has been placed on the sur- Farland standard. The materials used are zinc face of the media made Blood To Plate. Then oxide eugenol and zinc oxide propolis, zinc put in petri dishes were incubated at a tem- oxide is made from zinc oxide powder manip- perature incubator to 37o C for 24 hours. Af- ulated with liquid. Propolis powder 2g is dilut- ter incubation, the Petridish was observed the ODONTO Dental Journal. Volume 6. Nomor 2. Desember 2019 Rahman/Christiono 115 barrier zone formed around the paper discs. If Inhibition zone showed the antibacterial ef- the barrier zone is formed, take the measure- fectiveness of zinc oxide eugenol and zinc ox- ment zone diameter size of the barriers by ide propolis against Enterococcus faecalis. In using sliding calliper. Resistance zone is mea- both groups the mean inhibition zone formed sured from edge to edge past the paper discs. on the zinc oxide and zinc oxide eugenol prop- Experiments carried out one time and the rep- olis is 27.7 mm and 13.45 mm. lication six times. The analysis showed that all groups had p values> 0.05 so that the data was distribut- RESULTS ed normally. After knowing the distribution of normal data, the homogeneity was tested. It The research was done by in vitro tests on showed that the zinc oxide eugenol antibacte- bacterial growth media. Antibacterial effective- rial stronger than zinc oxide propolis (27.7333> ness is shown by the formation of inhibition 13.4500). zones around the pasta test. The results anti- The test results showed that homogenity bacterial test of the effectiveness of zinc oxide of 0.066 (p> 0.05) the data variance homo- eugenol and zinc oxide propolis in inhibiting geneous. Therefore, because the data are the growth of Enterococcus faecalis in vitro are normally distributed and homogeneous, para- presented in table 1. metric test requirements are met. Sig results Table 1.The results of the diameter of inhibition zone cause by zinc oxide eugenol and zinc oxide propolis on the growth of Enterococcus faecalis. Tabel 2. Normality test ODONTO Dental Journal. Volume 6. Nomor 2. Desember 2019 EFFECTIVITY ANTIBACTERIAL ZINC OXIDE EUGENOL WITH ZINC OXIDE 116 PROPOLIS FOR ENDODONTIC TREATMENT IN PRIMARY TEETH Tabel 3. T Test Independent Samples showed a mean value of 0.000 and 0.000 p bond such as bond nonkovalen ionic, hydro- <0.05 then there is a significant difference in phobic, hydrogen. This form is called the tertia- the data. ry structure of proteins; are easily distracted by some chemical or physical agents, causing the DISCUSSION protein to be not working. While the cell mem- brane works as a selective barrier, allowing The result of independent statistical T-test, some of the solute to pass through and hold the mean inhibition zone diameter zinc oxide other substances. Substances that are assem- produced by propolis has a value p <0.05. bled on the cell surface can alter the physical This suggests that the resistance provided by and chemical properties of the membrane, the the zinc oxide propolis statistically significant. membrane prevents the normal functioning However, effectiveness is still weaker than zinc so that it will kill or inhibit the cell.11 Research oxide eugenol.
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