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Eradication of ampicillin-resistant Enterococcus faecalis in root canal infections using tannic acid: A tooth model
Revathy Elango1, Vinothini Gunasekaran1, Palanivel Sathishkumar1
1Green Materials Laboratory, Department of Prosthodontics, Saveetha Dental College and Hospital, SIMATS, Saveetha University, Chennai, Tamil Nadu 600 077, India.
Objective:
Enterococcus faecalis is the most prevalent pathogen in the persistent root canal infections. Especially, drug-resistant E. faecalis plays a major role in the root canal treatment failure. The present study aimed to find an effective natural therapeutic drug to combat the ampicillin-resistant Enterococcus faecalis (AREF) infection in the root canal system.
Design:
The antibacterial effect of various phenolic compounds (curcumin, fisetin, hesperetin, morin, naringin, quercetin, rutin, and tannic acid) was screened against AREF, which was isolated from the infected root canals. The antibiofilm potential of tannic acid was assessed with CV staining, MTT assay, CFU counting, and CLSM analysis. The HR-SEM analysis of the tannic acid-treated AREF-infected root canals (a tooth model) was performed. Targeted interaction of tannic acid with biofilm-forming proteins such as ACE, DisA, ESP, and SrtC was investigated using Dock6. The biocompatibility of tannic acid was analysed on human RBCs and HGF cells.
Results:
Tannic acid demonstrates excellent antibacterial effect against AREF. The ZOI and MIC values of tannic acid against AREF were 19.3 ± 0.57 mm and 80 µM, respectively. The 100% deadness of AREF infection was observed in the root canals at 1xMIC (80 µM) treatment after 7 days. Tannic acid demonstrated strong binding to biofilm-forming proteins, including ACE, DisA, ESP, and SrtC. The hemocompatibility and cytocompatibility of tannic acid were observed up to 150 µM and 100 µM, respectively.
Conclusion:
The present study recommends that tannic acid may be an efficient and safe natural phytocompound for combating AREF, thereby preventing root canal treatment failure.
