Comparative antimicrobial efficacy of N-acetylcysteine and calcium hydroxide against Enterococcus faecalis: an in vitro study.

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Title: Comparative antimicrobial efficacy of N-acetylcysteine and calcium hydroxide against Enterococcus faecalis: an in vitro study.
Alternate Title: Eficácia antimicrobiana comparativa da N-acetilcisteína e do hidróxido de cálcio contra Enterococcus faecalis: estudo in vitro.
Authors: ROSALES ESPINOSA, Elba Cristina1, AGUIRRE BALSECA, Mauricio1, FREITAS, Karina Maria Salvatore2 kmsf@uol.com.br, CARRILLO, Karol Jazmín1
Source: Dental Press Endodontics. May-Aug2025, Vol. 15 Issue 2, p94-114. 42p.
Subjects: CALCIUM hydroxide, ENTEROCOCCUS faecalis, ACETYLCYSTEINE, DRUG efficacy, IN vitro studies, BACTERIAL growth, MICROBIOLOGICAL techniques, TREATMENT effectiveness
Abstract (English): OBJECTIVE: To evaluate and compare the antimicrobial effectiveness and speed of action of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] against Enterococcus faecalis over 24, 48, 72, and 96 hours using in vitro microbiological analysis. MATERIAL AND METHODS: Standardized cultures of E. faecalis (ATCC 29212) were exposed to NAC (200 mg/mL) and Ca(OH)2 for different incubation periods. The control group consisted of bacterial cultures with no medicament. Colony-forming units (CFU/mL) were quantified through serial dilutions and agar plating. Statistical analysis was performed using Wilcoxon and Kruskal-Wallis tests (p < 0.05). RESULTS: Calcium hydroxide eliminated all bacterial growth within 24 hours, maintaining complete inhibition through 96 hours. NAC demonstrated a progressive antimicrobial effect: CFU counts reduced from 45,000,000 at 24h to 80,000 at 48h, with complete inhibition achieved at 72h and sustained at 96h. Statistically significant differences were observed between groups at each time point after 24 hours (p < 0.05). CONCLUSION: Both medicaments were effective against E. faecalis by 96 hours, but calcium hydroxide exhibited faster and more consistent antimicrobial activity. The null hypothesis was rejected. NAC, although slower, proved to be a viable alternative intracanal medicament and warrants further study--particularly in combination with calcium hydroxide to potentially enhance overall efficacy. [ABSTRACT FROM AUTHOR]
Abstract (Portuguese): OBJETIVO: Avaliar e comparar a efetividade antimicrobiana e a velocidade de ação da N-acetilcisteína (NAC) e do hidróxido de cálcio [Ca(OH)₂] contra Enterococcus faecalis ao longo de 24, 48, 72 e 96 horas, por meio de análise microbiológica in vitro. MATERIAL E MÉTODOS: Culturas padronizadas de E. faecalis (ATCC 29212) foram expostas à NAC (200 mg/mL) e ao Ca(OH)₂ por diferentes períodos de incubação. O grupo controle consistiu em culturas bacterianas sem medicação. As unidades formadoras de colônia (UFC/mL) foram quantificadas por meio de diluições seriadas e plaqueamento em ágar. A análise estatística foi realizada utilizando os testes de Wilcoxon e Kruskal-Wallis (p < 0,05). RESULTADOS: O hidróxido de cálcio eliminou todo o crescimento bacteriano em 24 horas, mantendo a inibição completa até 96 horas. A NAC demonstrou um efeito antimicrobiano progressivo: a contagem de UFC reduziu de 45.000.000 em 24h para 80.000 em 48h, atingindo inibição completa em 72h e mantida em 96h. Diferenças estatisticamente significativas foram observadas entre os grupos em cada ponto de tempo após 24 horas (p < 0,05). CONCLUSÃO: Ambos os medicamentos foram eficazes contra E. faecalis em 96 horas, porém o hidróxido de cálcio apresentou ação antimicrobiana mais rápida e consistente. A hipótese nula foi rejeitada. Embora mais lento, a NAC demonstrou ser uma alternativa viável como medicação intracanal e merece estudos adicionais -- especialmente em associação ao hidróxido de cálcio, visando potencializar a eficácia global. [ABSTRACT FROM AUTHOR]
Copyright of Dental Press Endodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Comparative antimicrobial efficacy of N-acetylcysteine and calcium hydroxide against Enterococcus faecalis: an in vitro study.
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  Data: Efic&#225;cia antimicrobiana comparativa da N-acetilciste&#237;na e do hidr&#243;xido de c&#225;lcio contra Enterococcus faecalis: estudo in vitro.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22ROSALES+ESPINOSA%2C+Elba+Cristina%22&quot;&gt;ROSALES ESPINOSA, Elba Cristina&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22AGUIRRE+BALSECA%2C+Mauricio%22&quot;&gt;AGUIRRE BALSECA, Mauricio&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22FREITAS%2C+Karina+Maria+Salvatore%22&quot;&gt;FREITAS, Karina Maria Salvatore&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;i&gt; kmsf@uol.com.br&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22CARRILLO%2C+Karol+Jazm&#237;n%22&quot;&gt;CARRILLO, Karol Jazm&#237;n&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Dental+Press+Endodontics%22&quot;&gt;Dental Press Endodontics&lt;/searchLink&gt;. May-Aug2025, Vol. 15 Issue 2, p94-114. 42p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CALCIUM+hydroxide%22&quot;&gt;CALCIUM hydroxide&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22ENTEROCOCCUS+faecalis%22&quot;&gt;ENTEROCOCCUS faecalis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22ACETYLCYSTEINE%22&quot;&gt;ACETYLCYSTEINE&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22DRUG+efficacy%22&quot;&gt;DRUG efficacy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22IN+vitro+studies%22&quot;&gt;IN vitro studies&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22BACTERIAL+growth%22&quot;&gt;BACTERIAL growth&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22MICROBIOLOGICAL+techniques%22&quot;&gt;MICROBIOLOGICAL techniques&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22TREATMENT+effectiveness%22&quot;&gt;TREATMENT effectiveness&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: OBJECTIVE: To evaluate and compare the antimicrobial effectiveness and speed of action of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] against Enterococcus faecalis over 24, 48, 72, and 96 hours using in vitro microbiological analysis. MATERIAL AND METHODS: Standardized cultures of E. faecalis (ATCC 29212) were exposed to NAC (200 mg/mL) and Ca(OH)2 for different incubation periods. The control group consisted of bacterial cultures with no medicament. Colony-forming units (CFU/mL) were quantified through serial dilutions and agar plating. Statistical analysis was performed using Wilcoxon and Kruskal-Wallis tests (p &lt; 0.05). RESULTS: Calcium hydroxide eliminated all bacterial growth within 24 hours, maintaining complete inhibition through 96 hours. NAC demonstrated a progressive antimicrobial effect: CFU counts reduced from 45,000,000 at 24h to 80,000 at 48h, with complete inhibition achieved at 72h and sustained at 96h. Statistically significant differences were observed between groups at each time point after 24 hours (p &lt; 0.05). CONCLUSION: Both medicaments were effective against E. faecalis by 96 hours, but calcium hydroxide exhibited faster and more consistent antimicrobial activity. The null hypothesis was rejected. NAC, although slower, proved to be a viable alternative intracanal medicament and warrants further study--particularly in combination with calcium hydroxide to potentially enhance overall efficacy. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Portuguese)
  Group: Ab
  Data: OBJETIVO: Avaliar e comparar a efetividade antimicrobiana e a velocidade de a&#231;&#227;o da N-acetilciste&#237;na (NAC) e do hidr&#243;xido de c&#225;lcio [Ca(OH)₂] contra Enterococcus faecalis ao longo de 24, 48, 72 e 96 horas, por meio de an&#225;lise microbiol&#243;gica in vitro. MATERIAL E M&#201;TODOS: Culturas padronizadas de E. faecalis (ATCC 29212) foram expostas &#224; NAC (200 mg/mL) e ao Ca(OH)₂ por diferentes per&#237;odos de incuba&#231;&#227;o. O grupo controle consistiu em culturas bacterianas sem medica&#231;&#227;o. As unidades formadoras de col&#244;nia (UFC/mL) foram quantificadas por meio de dilui&#231;&#245;es seriadas e plaqueamento em &#225;gar. A an&#225;lise estat&#237;stica foi realizada utilizando os testes de Wilcoxon e Kruskal-Wallis (p &lt; 0,05). RESULTADOS: O hidr&#243;xido de c&#225;lcio eliminou todo o crescimento bacteriano em 24 horas, mantendo a inibi&#231;&#227;o completa at&#233; 96 horas. A NAC demonstrou um efeito antimicrobiano progressivo: a contagem de UFC reduziu de 45.000.000 em 24h para 80.000 em 48h, atingindo inibi&#231;&#227;o completa em 72h e mantida em 96h. Diferen&#231;as estatisticamente significativas foram observadas entre os grupos em cada ponto de tempo ap&#243;s 24 horas (p &lt; 0,05). CONCLUS&#195;O: Ambos os medicamentos foram eficazes contra E. faecalis em 96 horas, por&#233;m o hidr&#243;xido de c&#225;lcio apresentou a&#231;&#227;o antimicrobiana mais r&#225;pida e consistente. A hip&#243;tese nula foi rejeitada. Embora mais lento, a NAC demonstrou ser uma alternativa vi&#225;vel como medica&#231;&#227;o intracanal e merece estudos adicionais -- especialmente em associa&#231;&#227;o ao hidr&#243;xido de c&#225;lcio, visando potencializar a efic&#225;cia global. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Dental Press Endodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.14436/2358-2545.15.2.094-114.oar
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      – Code: eng
        Text: English
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        PageCount: 42
        StartPage: 94
    Subjects:
      – SubjectFull: CALCIUM hydroxide
        Type: general
      – SubjectFull: ENTEROCOCCUS faecalis
        Type: general
      – SubjectFull: ACETYLCYSTEINE
        Type: general
      – SubjectFull: DRUG efficacy
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      – SubjectFull: IN vitro studies
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      – SubjectFull: BACTERIAL growth
        Type: general
      – SubjectFull: MICROBIOLOGICAL techniques
        Type: general
      – SubjectFull: TREATMENT effectiveness
        Type: general
    Titles:
      – TitleFull: Comparative antimicrobial efficacy of N-acetylcysteine and calcium hydroxide against Enterococcus faecalis: an in vitro study.
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            NameFull: ROSALES ESPINOSA, Elba Cristina
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            NameFull: FREITAS, Karina Maria Salvatore
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              M: 05
              Text: May-Aug2025
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              Y: 2025
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