In vitro evaluation of N-acetylcysteine, calcium hydroxide, chlorhexidine digluconate and their combinations effect against five dental obligate anaerobic bacteria
4 affiliations
- 1Institute of Science and Technology, Department of Restorative Dentistry, São Paulo State University, São José dos Campos, São Paulo, Brazil.
- 2Institute of Science and Technology, Department of Restorative Dentistry, Endodontics Division, São Paulo State University, São José dos Campos, São Paulo, Brazil.
- 3School of Dentistry, Department of Oral and Maxillofacial Surgery, Prosthodontics and Traumatology, University of São Paulo, São Paulo, São Paulo, Brazil.
- 4Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São Paulo State University, São José dos Campos, São Paulo, Brazil.
Abstract
Background: This study aimed to evaluate the antibacterial action of N-acetylcysteine (NAC), calcium hydroxide Ca(OH) ₂ , chlorhexidine digluconate (CHX), and their combinations against five obligate anaerobic bacteria including Fusobacterium nucleatum, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia , and Parvimonas micra in planktonic and biofilm forms.
Methods: Eight experimental groups were evaluated in this study including saline solution (SS) (control group), Ca(OH) ₂ , CHX, NAC, NAC + Ca(OH) ₂ , NAC + CHX, Ca(OH) ₂ + CHX, and NAC + Ca(OH) ₂ + CHX. The anti-planktonic evaluation was performed by determination of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) following Clinical and Laboratory Standards Institute guidelines (CLSI M11). The antibiofilm was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and crystal violet (CV) assays. Data were analyzed statistically considering a significant level of ( α ≤ 0.05).
Results: It was found that the MIC and MBC values of the tested intracanal medications ranged from 1.95–500 mg/mL. MTT and CV assays showed significant, species-dependent antibiofilm activity. CHX was most effective against F. nucleatum ; NAC-based medications, especially combined with Ca(OH) ₂ and/or CHX, were superior against P. endodontalis, P. intermedia , and P. micra . Ca(OH) ₂ -containing groups were particularly effective against P. gingivalis . Therefore, NAC + Ca(OH) ₂ and NAC + Ca(OH) ₂ + CHX can be considered as effective combinations of intracanal medication against different obligate anaerobic bacteria.
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BibTeX
@article{carvalho2026vitro,
title = {{In vitro evaluation of N-acetylcysteine, calcium hydroxide, chlorhexidine digluconate and their combinations effect against five dental obligate anaerobic bacteria}},
author = {Lara Steffany de Carvalho and Júlia Andrade de Oliveira and Gabriel Manente Cezarino and Luiz Augusto Rodrigues Dos Santos and Gustavo Guimarães Guerrero and Mauro Felipe Rios do Nascimento and Marcia Carneiro Valera and Luciane Dias de Oliveira and Amjad Abu Hasna},
journal = {PeerJ},
year = {2026},
month = oct,
doi = {10.7717/peerj.21831},
url = {https://peerj.com/articles/21831},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - In vitro evaluation of N-acetylcysteine, calcium hydroxide, chlorhexidine digluconate and their combinations effect against five dental obligate anaerobic bacteria
AU - Lara Steffany de Carvalho
AU - Júlia Andrade de Oliveira
AU - Gabriel Manente Cezarino
AU - Luiz Augusto Rodrigues Dos Santos
AU - Gustavo Guimarães Guerrero
AU - Mauro Felipe Rios do Nascimento
AU - Marcia Carneiro Valera
AU - Luciane Dias de Oliveira
AU - Amjad Abu Hasna
PY - 2026
DA - 2026/10/22
JO - PeerJ
DO - 10.7717/peerj.21831
UR - https://peerj.com/articles/21831
AB - Background: This study aimed to evaluate the antibacterial action of N-acetylcysteine (NAC), calcium hydroxide Ca(OH) ₂ , chlorhexidine digluconate (CHX), and their combinations against five obligate anaerobic bacteria including Fusobacterium nucleatum, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia , and Parvimonas micra in planktonic and biofilm forms. Methods: Eight experimental groups were evaluated in this study including saline solution (SS) (control group), Ca(OH) ₂ , CHX, NAC, NAC + Ca(OH) ₂ , NAC + CHX, Ca(OH) ₂ + CHX, and NAC + Ca(OH) ₂ + CHX. The anti-planktonic evaluation was performed by determination of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) following Clinical and Laboratory Standards Institute guidelines (CLSI M11). The antibiofilm was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and crystal violet (CV) assays. Data were analyzed statistically considering a significant level of ( α ≤ 0.05). Results: It was found that the MIC and MBC values of the tested intracanal medications ranged from 1.95–500 mg/mL. MTT and CV assays showed significant, species-dependent antibiofilm activity. CHX was most effective against F. nucleatum ; NAC-based medications, especially combined with Ca(OH) ₂ and/or CHX, were superior against P. endodontalis, P. intermedia , and P. micra . Ca(OH) ₂ -containing groups were particularly effective against P. gingivalis . Therefore, NAC + Ca(OH) ₂ and NAC + Ca(OH) ₂ + CHX can be considered as effective combinations of intracanal medication against different obligate anaerobic bacteria.
SN - 2167-8359
ER -