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"Latar belakang: Mineral Trioxide Aggregate (MTA) masih menjadi standar emas sebagai semen bioaktif pada kedokteran gigi, tetapi waktu pengerasannya 3-4 jam. Kitosan, senyawa biopolimer yang bersifat biokompatibel, biodegradable, dan non-toksik, dapat digunakan sebagai material aditif untuk memperbaiki sifat fisik sekaligus meningkatkan sifat biologis MTA. Jenis kitosan yang dapat terlarut dalam air diharapkan dapat berinteraksi dengan MTA yang juga memiliki pelarut netral. Tujuan: Penelitian ini akan menganalisis pengaruh penambahan kitosan larut air 5% dan 10% terhadap waktu pengerasan MTA.Metode: Tiga kelompok penelitian, yaitu MTA, MTA dengan penambahan kitosan larut air 5% (MTA-CW5), dan MTA dengan penambahan kitosan larut air 10% (MTA-CW10); enam sampel penelitian tiap kelompok. Dilakukan uji waktu pengerasan akhir menggunakan jarum Vicat. Uji reliabilitas menggunakan uji Intraclass Correlation Coefficient, dan hasil penelitian dianalisis dengan uji statistic One-Way ANOVA. Hasil:  Penambahan kitosan larut air berbagai konsentrasi memengaruhi waktu pengerasan MTA. Secara bermakna, waktu pengerasan paling cepat dimiliki grup MTA-CW5. Sedangkan MTA-CW10 secara bermakna memiliki waktu pengerasan yang paling lama bila dibandingkan dengan MTA dan MTA-CW5.

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Background: Mineral Trioxide Aggregate (MTA) is still the gold standard as a bioactive material in dentistry, yet its setting time is 3-4 hours. Chitosan, a biopolymer compound that is biocompatible, biodegradable, and non-toxic, can be used as an additive material to improve the physical properties as well as to improve the biological properties of MTA. The type of chitosan that can be dissolved in water is expected to interact well with MTA which also has a neutral liquid.

Objective: To analyse the effect of adding 5% and 10% water-soluble chitosan to MTA setting time. Methods: Three groups with six samples per group: MTA, MTA with 5% water-soluble chitosan (MTA-CW5), and MTA with 10% water-soluble chitosan (MTA-CW10). The final setting time was tested using the Vicat needle. The Intraclass Correlation Coefficient was used for reliability test, and the research results were analyzed using the One-Way ANOVA.

Results: The addition of water-soluble chitosan affected the setting time of MTA. The MTA-CW5 setting time was significantly the fastest among others. Meanwhile, MTA-CW10 significantly had the longest setting time when compared to MTA and MTA-CW5."

"Latar Belakang : Enterococcus faecalis merupakan bakteri yang mampu membentuk biofilm dan banyak ditemukan pada kasus kegagalan perawatan saluran akar. Tujuan : Melihat daya antibakteri kitosan dan klorheksidin terhadap E. faecalis dalam biofilm. Metode : Deteksi dan kuantifikasi E. faecalis dalam biofilm yang hidup pasca pemaparan bahan uji, dengan real time PCR. Hasil : Terdapat perbedaan jumlah bakteri yang signifikan antara kedua kelompok bahan uji terhadap kontrol (p ≤ 0,05), tetapi tidak terdapat perbedaan bermakna antara kelompok kitosan dan klorheksidin. Kesimpulan : Daya antibakteri kitosan 2% terhadap biofilm E. faecalis sebanding dengan klorheksidin 2%.

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Background : Enterococcus faecalis has an ability to form biofilms and become a predominant bacteria that plays a major role in the etiology of persistent lesions after root canal treatment.

Aim : To analyze the efficacy of chitosan and chlorhexidine against E. faecalis in biofilms.

Methods : Detection and quantification of E. faecalis DNA that survive and live after immersing the biofilm in antibacterial solution, with real time PCR.

Result : Statistically there is significant difference of living E. faecalis between chitosan and control and between 2% chlorhexidine and control (p ≤0,05). But there is no significant different between chitosan and chlorhexidine (p>0,05).

Conclusion : Antibacterial effectivity of chitosan is equal to chlorhexidine against E. faecalis in biofilm."

"Latar belakang: Semen MTA telah digunakan dalam berbagai prosedur endodontik karena memiliki sealing ability yang baik, biokompatibel, bioaktif, dan bersifat antibakteri. Namun, semen MTA memiliki beberapa kelemahan seperti waktu pengerasan yang lama, konsistensi berpasir sehingga sulit untuk dimanipulasi serta kekuatan mekanik yang relatif rendah. Polimer sintetik dan alami telah diteliti sebagai material aditif pada semen MTA dan diketahui dapat meningkatkan sifat manipulasi material. Kitosan larut air merupakan polimer alami yang memiliki keunggulan bioaktivitas, biokompatibilitas dan biodegradabilitas serta dapat larut pada pH fisiologis.Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh penambahan kitosan larut air terhadap kekuatan kompresi semen MTA. Metode: Spesimen penelitian dibagi menjadi tiga kelompok; MTA, MTA dengan penambahan kitosan larut air 5% (MTA-CW5), dan MTA dengan penambahan kitosan larut air 10% (MTA-CW10). Pengukuran kekuatan kompresi dilakukan dengan alat universal testing machine setelah diinkubasi selama empat hari pada temperatur 37°C dan kelembabab relatif 100%. Hasil: Terdapat perbedaan bermakna dari nilai rerata kekuatan kompresi ketiga kelompok perlakuan (Uji one-way ANOVA). Hasil uji Post Hoc Bonferroni menunjukkan perbedaan kekuatan kompresi yang bermakna antara kelompok MTA-CW5 dengan MTA, kelompok MTA-CW10 dengan MTA serta MTA-CW 5 dengan MTA-CW10. Kesimpulan: Penambahan kitosan larut air konsentrasi 5% dan 10% dapat meningkatan kekuatan kompresi semen MTA.

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Background: Mineral trioxide aggregates have been used in various endodontic treatments because of the sealing ability, biocompatibility, bioactivity, and antibacterial properties. However, MTA cement has several disadvantages such as long setting time, sandy consistency, and relatively low mechanical strength. Synthetic and natural polymers have been investigated as additives in MTA cement and could improve its handling characteristic. Water soluble chitosan is a natural polymer with excellent bioactivity, biocompatibility, biodegradability and soluble at physiological pH. 

Objectives: This study aimed to determine the effect of adding water-soluble chitosan to the compressive strength of MTA

Methods: The specimens were divided into three groups; MTA, MTA with the addition of 5% water soluble chitosan (MTA-CW5), and MTA with the addition of 10% water soluble chitosan (MTA-CW10). The compressive strength measurement was carried out using a universal testing machine after four days incubation at 37°C and 100% humidity.

Result: There were significant different mean values of the compressive strength between three groups (one-way ANOVA test). Post Hoc Bonferroni test showed significant differences in compressive strength between the MTA-CW5 and MTA group, the MTA-CW10 and MTA group, also the MTA-CW 5 and MTA-CW10 group.

Conclusion: The addition of 5% and 10% water-soluble chitosan could increase the compressive strength of MTA cement. "

"Latar Belakang: Siler biokeramik berbasis kalsium silikat diketahui memiliki biokompabilitas tinggi, mampu beradhesi dengan dinding saluran akar serta dapat menginduksi respon osteogenik, yang dikategorikan sebagai material biomimetik. Akan tetapi, siler biokeramik memiliki kekurangan pada sifat fisiknya. Kitosan larut air merupakan bentuk modifikasi kitosan yang memiliki keunggulan sebagai antioksidan, antibakteri, berperan dalam penyembuhan lesi dan regenerasi jaringan serta sebagai dapat memperbaiki sifat fisik semen. Perpaduan kedua bahan dapat menciptakan semen saluran akar biomimetik.Tujuan: Melakukan uji karakteristik, sifat fisik dan biologis terhadap novel siler hibrida biokeramik-kitosan larut air (BCC) sebagai semen biomimetik saluran akar.Metode: Novel siler hibrida BCC dimanipulasi dari semen biokeramik (BC) yang telah melalui proses ball-milling dan sintering, kemudian dicampur kitosan larut air dengan W/P 0,4. Empat variabel penelitian, yaitu semen biokeramik BC, novel siler hibrida BCC, siler biokeramik dan siler epoksi resin dilakukan uji karakterisasi (XRD, SEM/EDS), uji sifat fisik (setting time, daya alir, film thickness), serta uji biologis (sitotoksisitas dan bioaktivitas terhadap hPDLSCs).Hasil: Novel siler hibrida BCC mengandung unsur dan puncak kristalin yang serupa dengan siler biokeramik (Sure-Seal Root™), memiliki bentuk partikel yang cenderung globular dan homogen dengan jarak antarpartikel lebih rapat serta ukuran partikel deskriptif yang lebih besar dibandingkan Sure-Seal Root™ dan AH Plus® tetapi lebih kecil dibandingkan semen biokeramik BC. Hanya semen biokeramik BC dan novel siler BCC yang memiliki rasio Ca/Si/P. Novel siler BCC menunjukkan perbedaan setting time, daya alir dan film thickness yang bermakna dengan semen biokeramik BC, Sure-Seal Root™ dan AH Plus®. Keempat kelompok menunjukkan sitotoksisitas rendah terhadap hPDLSCs. Bioaktivitas novel siler BCC relatif lebih tinggi dibandingkan semua kelompok perlakuan dan kontrol.Kesimpulan: Novel siler hibrida BCC berpotensi memberikan implikasi klinis yang baik, menunjukkan sifat fisik yang mendekati standar semen saluran akar dan memiliki bioaktivitas sebagai semen biomimetik saluran akar.

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Background: Currently, bioceramic sealers with calcium silicate based have been developed and show high biocompatibility, are able to adhere to root canal dentin and can induce an osteogenic response, which can be categorized as biomimetic materials. On the other hand, water-soluble particle (WSP) chitosan, one of chitosan derivatives, has advantages as an antioxidant, antibacterial, plays a role in wound healing and tissue regeneration as well as a thickening agent. The combination of these two materials can create a biomimetic endodontic sealer.

Objective: To examine the characteristics, physical and biological properties of novel bioceramic-chitosan hybrid sealer (BCC) as biomimetic endodontic sealer.

Methods: Novel BCC sealer were manipulated from bioceramic cement (BC) which had been synthesized through a ball-milling and sintering process, then mixed with WSP chitosan with a W/P of 0,4. Four variables, namely novel BCC sealer, BC bioceramic cement, bioceramic and epoxy resin sealer were tested characterization (XRD, SEM/EDS), physical properties (setting time, flow, film thickness), and biological tests (cytotoxicity and bioactivity on hPDLSCs).

Results: Novel BCC sealer showed bioceramic elements and crystalline peaks similar to bioceramic sealer (Sure-Seal Root™), had a particle shape that tends to be globular and homogeneous with descriptive particle size larger than Sure-Seal Root™ and AH Plus® but smaller compared to BC bioceramic cement. Only BC bioceramic cements and novel BCC sealer had Ca/Si/P ratios. Novel BCC sealer showed significant differences in setting time, flow, and film thickness with BC bioceramic cements, Sure-Seal Root™ and AH Plus®. The four groups showed low cytotoxicity to hPDLSCs. The bioactivity of novel BCC sealer was relatively higher among other groups and control group.

Conclusion: Novel BCC hybrid sealer has good clinical implications, exhibit physical properties close to standard root canal cements and have bioactivity as root canal biomimetic sealer."

"Enterococcus faecalis adalah bakteri yang paling dominan pada kasus infeksi pasca perawatan endodontik. Telah diteliti aktivitas fenotipnya (kemampuan membentuk biofilm dan Gel E serta viabilitasnya terhadap NaOCL dan khlorheksidin) dan profil genotipnya. Ternyata tidak ada perbedaan aktivitas Gel E E. faecalis saluran akar dan saliva pasien pra dan pasca perawatan. Dalam membentuk biofilm, kemampuan E. faecalis saluran akar pra-perawatan lebih kuat daripada pasca-perawatan, sedangkan kemampuan E. faecalis saliva tidak berbeda. Viabilitas E. faecalis menurun jika kadar NaOCl dan khlorheksidin meningkat; 30 menit adalah waktu inkubasi efektif. Terdapat keragaman profil genotip antara E. faecalis saliva dan saluran akar, pra dan pasca perawatan.

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Enterococcus faecalis is strong dominance bacteria in post treatment endodontic disease. Its phenotype activity (its ability to produce biofilms and Gel E also its viability to NaOCL and chlorexidine) and its genotype profile has been observed. It turns out that there?s no difference in E. faecalis Gel E activity of root canal and saliva from pre- nor post-endodontic treated patients. In producing biofilms, the ability of E. faecalis pre-endodontic treated root canal was stronger than the postendodontic treated root canal, while the ability of E. faecalis from saliva have no difference. The viability of E. faecalis decline if the concentration of NaOCl and chlorexidine were increasing; the effective incubation time was 30 minutes. There?s various genotype profile between E. faecalis of saliva and root canal either pre- or post-endodontic treatment."

"Latar Belakang: E.faecalis isolat klinis merupakan bakteri yang menyebabkan lesi periapeks persisten. Bioceramic dan Mineral Trioxide Aggregate merupakan siler yang mempunyai sifat anti bakteri. Tujuan: Untuk menganalisis efek anti bakteri siler Bioceramic dan MTA terhadap E.faecalis isolat klinis pada waktu 2 menit segera , 4 jam initial setting , 1 dan 7 hari setelah pengadukan siler. Metode: Efek anti bakteri siler Bioceramic dan MTA diperiksa dengan direct contact test. Masing-masing siler dikontakkan langsung dengan E.faecalis isolat klinis 2 menit, 4 jam, 1 dan 7 hari setelah pengadukan siler. Suspensi ini dioleskan pada medium agar dan diinkubasi 24 jam untuk melihat koloni bakteri yang tumbuh CFU/ml. Hasil: Terdapat perbedaan bermakna antara siler Bioceramic dan MTA pada waktu 7 hari, antara siler Bioceramic pada waktu 2 dan 4 jam serta waktu 4 jam dan 7 hari setelah pengadukan siler. Kesimpulan: siler Bioceramic dan MTA mempunyai efek anti bakteri yang baik terhadap E.faecalis pada saat segera, initial setting, dan 1 hari setelah pengadukan siler, pada waktu 7 hari setelah pengadukan, siler MTA yang paling baik. Siler MTA mempunyai efek anti bakteri yang konstan sampai 7 hari Keywords : Entereococcus faecalis isolat klinis, Siler Bioceramic dan Mineral Trioxide Aggregate MTA

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Background: E.faecalis isolate clinic is a kind of bacteria that cause persistent periapical lesion. Bioceramic and Mineral Trioxide Aggregate are sealers that having antibacterial properties.

Aim: To analyze antibacterial effect of Bioceramic and MTA sealers against E.faecalis isolate clinic at 2 minutes fresh , 4 hours initial setting , 1 day and 7 day after mixed the sealers.

Methods: Antibacterial effect of Bioceramic and MTA sealers was assessed by direct test contact. Each sealer was contacted with E.faecalis isolate clinic at 2 minutes, 4 hours, 1 day and 7 days after mixed the sealers. This suspension was swab in agar medium and incubated for 24 hours. The colony in agar plates is counted with colony forming unit CFU .

Result: The significant differences was shown by Bioceramic and MTA at 7 days, between Bioceramic at 2 minutes fresh and 4 hours initial setting also at 4 hours initial setting and 7 days after mixed the sealer.

Conclusion: Both of Bioceramic and MTA sealers have a good antibacterial effect at fresh, initial setting and 1 hour after mixed the sealer but at 7 days, MTA was the greater. MTA sealer has a constant antibacterial effect until 7 days. "

"Latar Belakang: Perawatan endodontik bertujuan untuk menghilangkan infeksi mikroba yang terlibat pada sistem saluran akar. Enterococcus faecalis merupakan spesies yang terlibat dalam infeksi endodontik. E. faecalis memproduksi enzim gelatinase yang dapat membantu untuk menempel pada permukaan dentin. Propolis dikenal kaya akan bahan aktif sehingga berpotensi menjadi bahan alam untuk menunjang perawatan endodontik. Tujuan: Menetapkan efektivitas propolis 0.2%, 0.8%, dan 1.2% jika dibandingkan dengan NaOCl 5.25% serta pengaruhnya terhadap ekspresi gen gelE pada biofilm E. faecalis dan aktivitas gelatinase. Metode: Eksperimen biofilm ditumbuhkan pada 96­-well plate dan diinkubasi dalam keadaan microaerofilik selama 14, 48, dan 72 jam dan selanjutnya dilakukan uji ekspresi gen gelE dengan RT-qPCR serta uji gelatinase dilakukan pada BHI agar yang dicampurkan dengan 3mg susu skim yang dibentuk sumuran setelahnya diinkubasi selama 3, 9, dan 24 jam Hasil: Pada hasil penelitian didapatkan hasil secara kualitatif pengamatan mikroskopik adanya efektivitas propolis terhadap E. faecalis seiring dengan bertambahnya konsentrasi pada masa inkubasi 24 dan 48 jam. Dari hasil uji statistik Kruskall wallis dengan menggunakan GraphPad, ekspresi mRNA gelE dipengaruhi oleh propolis jika dibandingkan dengan kontrol negatif , hasil uji statistik didapatkan hasil yang signifikan (p < 0.05). Berdasarkan hasil dari uji gelatinase didapatkan diameter zona bening propolis 0.2%, 0.8%, dan 1.2% lebih kecil jika dibandingkan dengan kontrol negatif dan akuades secara berurutan, akan tetapi lebih besar jika dibandingkan dengan NaOCl 5.25% selaku kontrol positif. Kesimpulan: Propolis berpotensi menjadi bahan medikasi dan irigasi pada perawatan endodontik, selanjutnya perlu dilakukan penelitian lebih lanjut dengan bakteri multispesies dan konsentrasi propolis yang lebih tinggi.

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Background: Endodontic treatment aims to eliminate the microbial infection involved in the root canal system. Enterococcus faecalis is a species involved in endodontic infections. E. faecalis produces gelatinase enzymes that can help to adhere to the dentin surface. Propolis is known to be rich in active ingredients so that it has the potential to be a natural ingredient to support endodontic treatment. Objective: To determine the effectiveness of propolis 0.2%, 0.8%, and 1.2% when compared to 5.25% NaOCl and their effect on the expression of the gelE gene in E. faecalis biofilm and gelatinase activity. Methods: Biofilm were grown on a 96-well plate and incubated under microaerophilic conditions for 14, 48, and 72 hours and then tested for gelE gene expression using RT-qPCR and gelatinase test was performed on BHI agar mixed with 3mg of skim milk formed The wells were then incubated for 3, 9, and 24 hours. Results: The results obtained qualitatively microscopic observations of the effectiveness of propolis against E. faecalis along with increasing concentrations during the incubation period of 24 and 48 hours. From the results of the Kruskall Wallis statistical test using GraphPad, the expression of gelE mRNA was affected by propolis when compared to the negative control, the statistical test results obtained significant results (p < 0.05). Based on the results of the gelatinase test, the diameter of the clear zone of propolis 0.2%, 0.8%, and 1.2% was smaller than the negative control and distilled water respectively, but larger than the 5.25% NaOCl as the positive control. Conclusion: Propolis has the potential to be a medicinal and irrigation material in endodontic treatment, further research needs to be done with multispecies bacteria and higher concentrations of propolis"

"Penelitian ini dilakukan untuk menguji daya antibakteri bahan irigasi nisin 10%, klorheksidin 2%, natrium hipoklorit 2,5% terhadap pertumbuhan biofilm E. faecalis secara in vitro. Bakteri E. faecalis ATCC 29212 dibiakkan pada media agar BHI kemudian diinkubasi 24 jam pada suhu 370C. Bakteri diinokulasi pada membran filter selulosa nitrat selama 72 jam agar terbentuk biofilm. Dilakukan uji kontak langsung antara bahan uji dan biofilm selama 10 menit. Dilakukan kuantifikasi DNA bakteri yang hidup melalui penambahan PMA pada Real time PCR. Hasilnya nisin 10% mempunyai daya antibakteri terhadap biofilm E.faecalis, namun tidak sebanding dengan klorheksidin 2% dan natrium hipoklorit 2,5%.

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The aim of this study was to evaluate antibacterial efficacy of 10% nisin, 2% chlorhexidine, 2.5% sodium hypochlorite against E.faecalis biofilm in vitro. Petri dishes containing BHI agar were seeded with E. faecalis ATCC 29212, incubated overnight at 370C. Celullose nitrate filter membrane was inoculated with E.faecalis for 72 hours to grown a biofilm. Direct contact test was performed between the test solutions and biofilm for 10 minutes. DNA quantification was performed using Real time PCR with PMA additive to count the lived cell. It was concluded that 10% nisin possessed antibacterial effect against E.faecalis biofilm, but not comparable with 2% chlorhexidine and 2.5% sodium hypochlorite."

"Latar Belakang: E. faecalis dan C. albicans adalah mikroorganisme di saluran akar yang mampu bertahan hidup meski sudah dilakukan perawatan saluran akar. Penggunaan larutan irigasi sintetik saat perawatan saluran akar efektif dalam mengeliminasi mikroorganisme di saluran akar namun terbukti toksik terdapat sel punca mesenkim di periapikal. Cuka apel mengandung zat aktif seperti asam organik, flavonoid, fenol, tanin yang bersifat antimikroba dan menghambat pertumbuhan mikroba, namun terbukti tidak toksik bagi sel punca. Tujuan penelitian ini adalah untuk membandingkan efek antimikroba larutan cuka apel berbagai konsentrasi terhadap biofilm E. faecalis dan C. albicans. Metode: Dilakukan paparan larutan cuka apel 0,63%, 1,25%, dan 2,5%, serta kontrol positif NaOCl 2,5% dan kontrol negatif pada biofilm E. faecalis dan C. albicans. Kemudian dilakukan evaluasi efek antimikroba dengan uji hitung koloni dan nilai viabilitas dengan metode MTT Assay. Hasil: Terdapat perbedaan bermakna jumlah koloni dan nilai viabilitas biofilm E. faecalis (p<0,05) dan biofilm C. albicans (p<0,05) antara seluruh konsentrasi larutan cuka apel, kontrol positif, dan kontrol negatif, dengan efek antimikroba larutan cuka apel tertinggi pada konsentrasi 2,5% dan terendah pada konsentrasi 0,63%. Kesimpulan: Larutan cuka apel 2,5% memiliki kemampuan antimikroba dengan nilai viabilitas dan jumlah koloni hampir sebanding dengan kontrol positif NaOCl 2,5%, sehingga larutan cuka apel dapat dipertimbangkan untuk dijadikan alternatif larutan irigasi saluran akar.

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Background: E. faecalis and C. albicans are microorganisms in root canals that are able to survive even after root canal treatment. The use of synthetic irrigation solutions during root canal treatment is effective in eliminating microorganisms in the root canal but has been shown to be toxic to periapical mesenchymal stem cells. Apple vinegar contains active substances such as organic acids, flavonoids, phenols, tannins which are antimicrobial and inhibit microbial growth, but have been proven not to be toxic to stem cells. The aim of this study was to compare the antimicrobial effects of apple vinegar solutions of various concentrations on E. faecalis and C. albicans biofilms. Method: Exposure to 0.63%, 1.25% and 2.5% apple vinegar solutions, as well as 2.5% NaOCl positive control and negative control on E. faecalis and C. albicans biofilms were carried out. Then the antimicrobial effect was evaluated using the colony count test and viability value using the MTT Assay method. Result: There were significant differences in the number of colonies and viability values of E. faecalis biofilm (p<0.05) and C. albicans biofilm (p<0.05) between all concentrations of apple vinegar solution, positive control and negative control, with the antimicrobial effect of the apple vinegar solution were highest at a concentration of 2.5% and lowest at a concentration of 0.63%. Conclusion: The 2.5% apple vinegar solution has antimicrobial ability with viability values and colony numbers almost comparable to the 2.5% NaOCl as positive control, so 2,5% apple vinegar solution can be considered as an alternative root canal irrigation solution."