{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:00:45Z","timestamp":1780470045356,"version":"3.54.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dent. Med."],"abstract":"\n Purpose<\/jats:title>\n \n This study aimed to evaluate the antibacterial effectiveness of three intracanal medicaments:\n Achyranthes aspera<\/jats:italic>\n and\n Trachyspermum ammi<\/jats:italic>\n based novel polyherbal gel, chlorhexidine gluconate gel, and calcium hydroxide paste, against\n Enterococcus faecalis<\/jats:italic>\n in infected root canals by means of Real-Time Polymerase Chain Reaction (qPCR) for bacterial quantification.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A triple-arm, randomized controlled trial was conducted on 45 permanent mandibular and maxillary incisor and canine teeth diagnosed with asymptomatic apical periodontitis. Participants were randomly divided into three equal groups (\n n<\/jats:italic>\n \u2009=\u200915), each receiving a different intracanal medicament. Microbiological samples were collected using sterile absorbent paper points at two time points: before instrumentation and after 7-day of intracanal medicament placement. The intracanal medicaments tested were a novel polyherbal gel, 1% (w\/w) chlorhexidine gluconate gel, and calcium hydroxide paste. Total DNA of\n Enterococcus faecalis<\/jats:italic>\n was extracted from these samples, and qPCR was performed to determine the bacterial quantification at both intervals. The primary outcome was the reduction in\n Enterococcus faecalis<\/jats:italic>\n load, indicating the antibacterial efficacy of each medicament.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All the groups showed a significant reduction in\n Enterococcus faecalis<\/jats:italic>\n counts from baseline to day 7. However, the chlorhexidine gel and calcium hydroxide paste exhibited significantly greater reductions than the polyherbal gel (\n p<\/jats:italic>\n \u2009&lt;\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n All three intracanal medicaments tested were effective in significantly reducing\n Enterococcus faecalis<\/jats:italic>\n counts. However, the chlorhexidine gel and calcium hydroxide paste demonstrated significantly greater reductions compared to the polyherbal gel. For routine endodontic practice, chlorhexidine gel and calcium hydroxide remain more reliable choices for intracanal disinfection against\n Enterococcus faecalis<\/jats:italic>\n and should be preferred in cases with high microbial load. The polyherbal gel, while antibacterial, may be better suited as an adjunct rather than a primary medicament in endodontic disinfection protocols.\n <\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n [\n https:\/\/ctri.nic.in\/Clinicaltrials\/pmaindet2.php?EncHid=NjU0MzY=<\/jats:ext-link>\n ] Clinical Trials Registry-India with registration number: [CTRI\/2022\/07\/043862].\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fdmed.2026.1820395","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:01:50Z","timestamp":1780466510000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibacterial effectiveness of novel polyherbal gel, chlorhexidine gluconate, and calcium hydroxide as intracanal medicaments in infected root canals using real-time PCR: a randomized controlled trial"],"prefix":"10.3389","volume":"7","author":[{"given":"Anil V.","family":"Ankola","sequence":"first","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinuta","family":"Hampiholi","sequence":"additional","affiliation":[{"name":"Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Surath","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manohar S.","family":"Kugaji","sequence":"additional","affiliation":[{"name":"Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Bangaramma Sajjan Campus","place":["Vijaypura, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopali M.","family":"Sankeshwari","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varkey Nadakkavukaran","family":"Santhosh","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atrey J.","family":"Pai Khot","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha","family":"Ragu","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research","place":["Belagavi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University","place":["Al-Kharj, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Almokhatieb","sequence":"additional","affiliation":[{"name":"Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University","place":["Al-Kharj, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"672887","DOI":"10.3389\/froh.2021.672887","article-title":"Microbiological aspects of root canal infections and disinfection strategies: an update review on the current knowledge and challenges","volume":"2","author":"Wong","year":"2021","journal-title":"Front Oral Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/0103-6440202305577","article-title":"Irrigants and irrigation activation systems in endodontics","volume":"34","author":"Gomes","year":"2023","journal-title":"Braz Dent J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1038\/s41368-024-00280-5","article-title":"Expert consensus on irrigation and intracanal medication in root canal therapy","volume":"16","author":"Zou","year":"2024","journal-title":"Int J Oral Sci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2433","DOI":"10.1016\/j.jds.2024.07.020","article-title":"Eradicating Enterococcus faecalis in root canal system: an update","volume":"19","author":"Nasiri","year":"2024","journal-title":"J Dent Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"116654","DOI":"10.1016\/j.diagmicrobio.2024.116654","article-title":"Detection of Enterococcus faecalis and the red complex bacteria analyzed by the checkerboard technique for DNA-DNA hybridization in endodontic infections: a systematic review and meta-analysis","volume":"111","author":"Alarc\u00f3n-S\u00e1nchez","year":"2025","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2475947","DOI":"10.1080\/20002297.2025.2475947","article-title":"Novel approaches on root canal disinfection methods against E. faecalis","volume":"17","author":"Wu","year":"2025","journal-title":"J Oral Microbiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2422","DOI":"10.3390\/ijms25042422","article-title":"From the friend to the foe\u2014enterococcus faecalis diverse impact on the human immune system","volume":"25","author":"Daca","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B8","first-page":"770","article-title":"2% Chlorhexidine in root canal treatment: a review","volume":"3","author":"Thakur","year":"2020","journal-title":"J Curr Med Res Opin"},{"key":"B9","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.sdj.2017.06.001","article-title":"Disinfection of dentinal tubules with 2% chlorhexidine gel, calcium hydroxide and herbal intracanal medicaments against Enterococcus faecalis: an in-vitro study","volume":"38","author":"Vasudeva","year":"2017","journal-title":"Singapore Dent J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"376","DOI":"10.4103\/endo.endo_11_24","article-title":"Effect of calcium hydroxide and calcium hydroxide nanoparticles used as intracanal drugs after manual and ultrasonic removal on the bond strength of a new sealer with a pozzolan base (endoseal mineral trioxide aggregate)","volume":"36","author":"Reyhani","year":"2024","journal-title":"Endodontology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1111\/iej.14074","article-title":"Impact of root canal disinfection on the bacteriome present in primary endodontic infection: a next generation sequencing study","volume":"57","author":"Alquria","year":"2024","journal-title":"Int Endod J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1479953","DOI":"10.3389\/fdmed.2024.1479953","article-title":"Antibiofilm efficacy of plant extracts as root canal irrigants in endodontics: a systematic literature review","volume":"5","author":"Diouchi","year":"2024","journal-title":"Front Dent Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"101046","DOI":"10.1016\/j.jaim.2024.101046","article-title":"Antibacterial and cytotoxicity properties of a polyherbal mouthwash containing Achyranthes aspera and Trachyspermum ammi against selected periodontal pathogens","volume":"15","author":"Kumar","year":"2024","journal-title":"J Ayurveda Integr Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"401","DOI":"10.13005\/bbra\/3371","article-title":"Preliminary phytochemical, isolation, characterization, antioxidant, and antimicrobial activity assessments of Achyranthes Aspera L","volume":"22","author":"Shukla","year":"2025","journal-title":"Biosci Biotechnol Res Asia"},{"key":"B15","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1016\/j.jobcr.2024.06.006","article-title":"Clinical and microbial evaluation of mouthwash containing Achyranthes aspera and Trachyspermum ammi: a randomized controlled non-inferiority trial","volume":"14","author":"Kumar","year":"2024","journal-title":"J Oral Biol Craniofacial Res"},{"key":"B16","first-page":"37","article-title":"Antibacterial activity of Achyranthes aspera extract against oral pathogens\u2013an in vitro study","volume":"21","author":"Lakshmi","year":"2020","journal-title":"Plant Cell Biotechnol Mol Biol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"101","DOI":"10.30476\/dentjods.2024.100380.2218","article-title":"Evaluation of antibacterial and cytotoxic potency of polyherbal gel formulation containing Achyranthes Aspera and Trachyspermum Ammi as intracanal medicament: an in vitro study","volume":"26","author":"Kumar","year":"2025","journal-title":"J Dent"},{"key":"B18","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1111\/iej.13087","article-title":"Preferred reporting items for RAndomized trials in endodontics (PRIRATE) guidelines: a development protocol","volume":"52","author":"Nagendrababu","year":"2019","journal-title":"Int Endod J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"411","DOI":"10.4103\/JCD.JCD_169_19","article-title":"Herbal medicaments in endodontics\u2013current guidelines for in vivo studies in India","volume":"22","author":"Kishan","year":"2019","journal-title":"J Conserv Dent Endod"},{"key":"B20","doi-asserted-by":"publisher","first-page":"4392","DOI":"10.1038\/s41598-025-86277-4","article-title":"Investigating root and canal morphology of anterior and premolar teeth using CBCT with a novel coding classification system in Saudi subpopulation","volume":"15","author":"Mustafa","year":"2025","journal-title":"Sci Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"97","DOI":"10.5577\/intdentres.2022.vol12.no2.8","article-title":"Indexes for periapical health evaluation: a review","volume":"12","author":"Rajasekhar","year":"2022","journal-title":"Int Dent Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.sdentj.2019.03.003","article-title":"An in vivo comparative evaluation of antimicrobial efficacy of chitosan, chlorhexidine gluconate gel and their combination as an intracanal medicament against Enterococcus faecalis in failed endodontic cases using real time polymerase chain reaction (qPCR)","volume":"31","author":"Savitha","year":"2019","journal-title":"Saudi Dent J"},{"key":"B23","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4020-6241-4","volume-title":"Principles and Technical Aspects of PCR Amplification","author":"van Pelt-Verkuil","year":"2008"},{"key":"B24","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/j.tripleo.2006.08.020","article-title":"Primer sensitivity: can it influence the results in Enterococcus faecalis prevalence studies?","volume":"103","author":"Nandakumar","year":"2007","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1111\/iej.13277","article-title":"Antibacterial effectiveness of calcium hydroxide alone or in combination with ibuprofen and ciprofloxacin in teeth with asymptomatic apical periodontitis: a randomized controlled clinical study","volume":"53","author":"Karata\u015f","year":"2020","journal-title":"Int Endod J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1433313","DOI":"10.3389\/fcimb.2024.1433313","article-title":"Strategies and mechanisms targeting Enterococcus faecalis biofilms associated with endodontic infections: a comprehensive review","volume":"14","author":"Yang","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"517","DOI":"10.3390\/microorganisms9030517","article-title":"Bacteriophages to control multi-drug resistant Enterococcus faecalis infection of dental root canals","volume":"9","author":"El-Telbany","year":"2021","journal-title":"Microorganisms"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.4103\/JCDE.JCDE_385_24","article-title":"Quantitative analysis of antibacterial efficacy of herbal irrigants against endodontic microflora\u2013A clinical study","volume":"27","author":"Das","year":"2024","journal-title":"J Conserv Dent Endod"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/S1517-83822009000100001","article-title":"Principles and applications of polymerase chain reaction in medical diagnostic fields: a review","volume":"40","author":"Valones","year":"2009","journal-title":"Braz J Microbiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.joen.2009.10.022","article-title":"Identification of Bacteria enduring endodontic treatment procedures by a combined reverse transcriptase\u2013polymerase chain reaction and reverse-capture checkerboard approach","volume":"36","author":"R\u00f4\u00e7as","year":"2010","journal-title":"J Endod"},{"key":"B31","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/iej.13677","article-title":". Present status and future directions: microbiology of endodontic infections","volume":"55","author":"Siqueira","year":"2022","journal-title":"Int Endod J"},{"key":"B32","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/j.1365-2591.2012.02093.x","article-title":"Antimicrobial effectiveness of intracanal medicaments on E nterococcus faecalis: chlorhexidine versus octenidine","volume":"46","author":"De Lucena","year":"2013","journal-title":"Int Endod J"},{"key":"B33","doi-asserted-by":"publisher","first-page":"233","DOI":"10.17796\/jcpd.30.3.r773j6l674lw0268","article-title":"Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study","volume":"30","author":"\u00d6n\u00e7ag\u00a8","year":"2006","journal-title":"J Clin Pediatr Dent"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1111\/iej.13801","article-title":"Comparative evaluation of the antibacterial effect of Allium sativum, calcium hydroxide and their combination as intracanal medicaments in infected mature anterior teeth: a randomized clinical trial","volume":"55","author":"Mahfouz Omer","year":"2022","journal-title":"Int Endod J"},{"key":"B35","doi-asserted-by":"publisher","first-page":"415","DOI":"10.4103\/jcd.jcd_208_22","article-title":"Comparative evaluation of antimicrobial efficacy of mushroom, Aloe vera, and Curcuma longa with calcium hydroxide as an intracanal medicament against Enterococcus faecalis: an: in vitro: study","volume":"25","author":"Patil","year":"2022","journal-title":"J Conserv Dent Endod"},{"key":"B36","doi-asserted-by":"publisher","first-page":"223","DOI":"10.4103\/endo.endo_225_21","article-title":"Effect of calcium hydroxide on fracture resistance and microhardness of dentin in human teeth: a systematic review","volume":"34","author":"Sethi","year":"2022","journal-title":"Endodontology"},{"key":"B37","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/ptr.1070","article-title":"Effect of alcohol extract of Achyranthes aspera linn. on acute and subacute inflammation","volume":"17","author":"Vetrichelvan","year":"2003","journal-title":"Phytother Res"},{"key":"B38","doi-asserted-by":"publisher","first-page":"695","DOI":"10.9734\/EJMP\/2014\/8786","article-title":"Antioxidant and antibacterial activities of leaf extract of Achyranthes aspera linn.(prickly chaff flower)","volume":"4","author":"Pandey","year":"2014","journal-title":"Eur J Med Plants"},{"key":"B39","doi-asserted-by":"publisher","first-page":"15645","DOI":"10.1038\/s41598-022-19594-7","article-title":"Thymol screening, phenolic contents, antioxidant and antibacterial activities of Iranian populations of Trachyspermum ammi (L.) sprague (Apiaceae)","volume":"12","author":"Modareskia","year":"2022","journal-title":"Sci Rep"},{"key":"B40","doi-asserted-by":"publisher","first-page":"3422","DOI":"10.3390\/ijms12063422","article-title":"Flavonoid analyses and antimicrobial activity of various parts of Phaleria macrocarpa (scheff.) boerl fruit","volume":"12","author":"Hendra","year":"2011","journal-title":"Int J Mol Sci"},{"key":"B41","doi-asserted-by":"publisher","first-page":"6669607","DOI":"10.1155\/2020\/6669607","article-title":"Antimicrobial efficacy of intracanal medicaments against E. Faecalis bacteria in infected primary molars by using real-time PCR: a randomized clinical trial","volume":"2020","author":"Ghahramani","year":"2020","journal-title":"Int J Dent"},{"key":"B42","doi-asserted-by":"publisher","first-page":"191","DOI":"10.4103\/ccd.ccd_195_18","article-title":"Comparative evaluation of triple antibiotic paste, propolis with moxifloxacin, and calcium hydroxide as intracanal medicaments against Streptococcus spp. and Enterococcus faecalis in type II diabetes Mellitus patients: a randomized clinical trial","volume":"10","author":"Tirukkolluru","year":"2019","journal-title":"Contemp Clin Dent"}],"container-title":["Frontiers in Dental Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1820395\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:01:52Z","timestamp":1780466512000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1820395\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":42,"alternative-id":["10.3389\/fdmed.2026.1820395"],"URL":"https:\/\/doi.org\/10.3389\/fdmed.2026.1820395","relation":{},"ISSN":["2673-4915"],"issn-type":[{"value":"2673-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]},"article-number":"1820395"}}