Anti-inflammatory potential of intracanal medicament containing oregano essential oil

Background: Successful endodontic treatment can be achieved through thoroughdebridement of the root canals from the infected or necrotic pulp tissue and microorganisms,and by achieving complete sealing of the canal space, thus stopping the persistence ofinfection and also preventing re-infection of the pulpal cavity [1]. Endodontic infections areinstigated due to gram-negative and gram-positive microorganisms and the most commonorganism responsible for the persistence of endodontic infection is Enterococcus fecalis or E.faecalis, which is known to sustain in alkaline environment and also can endure extensiveperiods without any nutrition [2]. These microorganisms cause pulpal inflammation leading toirreversible pulpitis. Intracanal medicament is “temporary placement of medicaments withgood biocompatibility into root canals for the purpose of inhibiting coronal invasion of bacteriafrom the oral cavity” [3]. There are various medical agents available which are used asintracanal medicaments in order to attain proper sterilization with calcium hydroxide being themost commonly used intra canal medicament due to its superior properties in disinfecting theroot canal system. But a drawback with this is that it is not effective against all microorganisms.Studies have reported that calcium hydroxide is not effective against Enterococcus faecalis[4]. In view of the inefficiency, possible harmful effects of synthetic medicaments, there is nowa paradigm shift to using biologic medication extracted from natural plants. Natural herbs andplants have been used since olden days in traditional medicine. Herbs with therapeutic effectsare beneficial and effective in treating various diseases [5]. Since they are obtained fromnatural products they are frequently considered to be safe and can be more easily integratedinto life-style changes than other synthetic pharmaceutical drugs. Some studies have pointedout that plant-derived essential oils may be an effective substitute to over-come microbialresistance [6]. Origanum vulgare belongs to the Lamiaceae family. Oregano is widely used asaromatics in food and alcoholic drink products. Oregano oil has been used in traditionalmedicine from decades. Oregano essential oil (OEO) is extracted from the leaves of theoregano plant (Figure 1). Oregano is known for its antibacterial and antispasmodic propertiesdue to its polyphenol content, which includes many flavones. [7]. Hence the present study wasconducted to assess the anti-inflammatory effect of the formulated novel intracanalmedicaments containing oregano essential oil (OEO).Methodology: The anti-inflammatory activity of an intracanal medicament containing oreganoessential oil at various concentrations of 3.125 percent, 6.25 percent, 12.5 percent, 25 percent,50 percent, and 100 percent was evaluated using the RAW 264.7 cell line. The sample wastreated as 100 percent, and serial two-fold dilutions were made from 100 percent to 10% usingDMEM (Dulbecco's Modified Eagle Medium) plain medium. The ability of extracts to suppressnitric oxide generation by cells was used to calculate percentage inhibition. Curcumin wasused as the standard. Results Anti-inflammatory activity of the formulation showed IC50 value of 94.34% at 50%concentration (Table 1). While standard showed IC50 value of 15.58 µg/ml.ConclusionIntra canal medicament containing OEO can be used clinically to treat infected root canals innon-vital teeth and chronic recurrent endodontic infections as it shows good anti-inflammatoryactivity.