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Antimicrobial Efficacy of Aloe vera, Lemon, Ricinus communis, and Calcium Hydroxide as Intracanal Medicament Against Enterococcus faecalis: A Confocal Microscopic Study

Introduction: The aim of this study was to evaluate the antimicrobial efficacy of different intracanal medicaments against Enterococcus faecalis using confocal microscopy. Materials and Methods: Eighty extracted single-rooted mandibular premolar teeth were used in this study, which were decoronated and instrumented with K-files following which biomechanical preparation was performed up to ProTaper F3. The teeth were inoculated with E. faecalis and incubated for 21 days. The specimens were divided into five groups according to the medicaments used: saline, calcium hydroxide, Aloe vera, Ricinus communis, and lemon extract. After 7 days of placement of intracanal medicament, the efficacy of the intracanal medicament against E. faecalis was assessed using confocal microscopy. The data were analyzed using one-way analysis of variance and the Tukey HSD (post hoc) test for multiple comparisons. Results: Calcium hydroxide showed significantly greater antimicrobial efficacy than A. vera, lemon, and R. communis (P < 0.05). Conclusion: Complete elimination of E. faecalis was not achieved in any of the experimental groups. Calcium hydroxide was more effective than the other herbal medicaments used.