Antibacterial Efficacy of Octenisept, Alexidine, Chlorhexidine, and Sodium Hypochlorite against Enterococcus faecalis Biofilms

Introduction: The purpose of this study was to evaluate the antibacterial effectiveness of Octenisept (OCT; Schülke & Mayr GmBH, Norderstedt, Germany), 1% alexidine (ALX) (Santa Cruz Biotechnology, Inc, Santa Cruz, CA), and 2% chlorhexidine (CHX) against Enterococcus faecalis biofilm using confocal laser scanning microscopy.

Methods: Root dentin discs were prepared from extracted human teeth, sterilized, and inoculated with E. faecalis strain (ATCC 29212) to establish 3-week-old biofilm model. Infected dentin discs were exposed to OCT (n = 20), 1% ALX (n = 20), and 2% CHX (n = 20) for 10 minutes. Dentin discs (n = 15) exposed to 5.25% sodium hypochlorite (NaOCl) were used as a positive control, whereas specimens exposed to saline (n = 15) were used as a negative control. After exposure, the dentin discs were stained with fluorescent LIVE/DEAD BacLight dye (Invitrogen Molecular Probes, Eugene, OR) and analyzed with confocal laser scanning microscopy to determine the proportion of dead cells in the biofilm. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests (P < .05).

Results: The highest proportion of dead cells was found in the 5.25% NaOCl group (94.14%; range, 92.30%-98.20%) compared with the experimental groups (P < .05). A significantly greater proportion of dead cells was found in the OCT group (74.14%; range, 70.03%-78.96%) compared with the 1% ALX and 2% CHX groups (P < .05). The proportion of dead cells was 43.89% (range, 24.86%-55.63%) and 42.78% (range, 25.45%-55.06%) in the 1% ALX and 2% CHX groups, respectively, with no statistical significant difference between the 2 groups (P > .05).

Conclusions: NaOCl had significantly greater antimicrobial activity against E. faecalis biofilms compared with OCT, CHX, and ALX. OCT was more effective than CHX and ALX.