Comparative Evaluation of Efficacy of Sodium Hypochlorite and Berberine Hydrochloride as Irrigants in the Elimination of Enterococcus faecalis: An In Vitro Study

Aim: The success of endodontic treatment relies heavily on effective disinfection of the root canal system.Thus, the aim of the study is to evaluate and compare the efficacy of sodium hypochlorite (NaOCl) and berberine hydrochloride (HCl) in the elimination of Enterococcus faecalis (E.faecalis).Materials and methods: Ten single-rooted human premolars were prepared, sterilized, and inoculated with E. faecalis (ATCC 29212) for 2 weeks.Specimens were randomly divided into three groups: Group I (5.25% NaOCl), group II (berberine HCl), and group III (control).Each canal was irrigated using passive ultrasonic activation, followed by confocal laser scanning microscopy (CLSM) analysis to assess bacterial viability.Statistical analysis was performed using one-way ANOVA (p < 0.05).Results: Sodium hypochlorite demonstrated the highest bacterial reduction (mean ± SD = 1.07 ± 0.65), followed by berberine HCl (3.93 ± 0.06), both significantly outperforming the control group (28.66 ± 25.57).Confocal laser scanning microscopy confirmed extensive bacterial cell death in the NaOCl group, with partial but notable efficacy in the berberine HCl group.Conclusion: Sodium hypochlorite remains the most effective irrigant against E. faecalis.However, berberine HCl showed promising antibacterial activity and may serve as a safer, natural alternative pending further clinical evaluation.