Antimicrobial efficacy of two commercially available herbal products with and without ultrasonic activation in primary endodontic infections: A randomized clinical trial

Effective irrigation is crucial for successful endodontic treatment. Traditional irrigants like sodium hypochlorite (NaOCl) have been widely used, but there is a growing interest in exploring natural alternatives for their potential antimicrobial properties. The study aims to compare the antimicrobial efficacy of Neem, Bitter Gourd, and NaOCl, with and without ultrasonic activation in managing primary endodontic infections. Ninety patients were randomly assigned six groups (n = 15) Group 1: NaOCl, Group 2: NaOCl with passive ultrasonic irrigation (PUI), Group 3: Neem juice, Group 4: Neem juice with PUI, Group 5: Bitter gourd juice, and Group 6: Bitter gourd juice with PUI. Bacteriological samples were collected before (S1) and after (S2) shaping, plated on brain heart infusion agar, and colony counting was done after 24 h. Shapiro–Wilk test, one-way ANOVA, post hoc Tukey analysis, and paired t-test. All the groups demonstrated a significant reduction in bacterial count. Groups with PUI (2, 4, 6) demonstrated higher mean bacterial reduction than their counterparts without PUI (1, 3, 5). Neem and Bitter gourd juices, particularly when used with PUI, demonstrated antimicrobial efficacy comparable to NaOCl with PUI.