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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]
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Database: MedicLatina
Description
Abstract: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]
ISSN:21783713
DOI:10.14436/2358-2545.15.2.094-114.oar