Antimicrobial and Cytotoxic Activity of Cinnamomum zeylanicum, Calcium Hydroxide, and Triple Antibiotic Paste as Root Canal Dressing Materials

J Contemp Dent Pract. 2016 Feb 1;17(2):105-13. doi: 10.5005/jp-journals-10024-1811.


Objective: The aim of this article was (i) to define the chemical constituents of Cinnamomum zeylanicum essential oil (CEO), (ii) to compare the antimicrobial activity of CEO with triple antibiotic paste (TAP) and calcium hydroxide [Ca(OH)2] on planktonic and biofilm Enterococcus faecalis; and (iii) to compare the cytotoxicity of these medicaments on L929 fibroblasts.

Materials and methods: Gas chromatography-mass spectrometry was used to define the constituents of CEO. Zone of inhibition, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill tests were performed. Further, 108 human teeth were infected with E. faecalis and treated with the medicaments for 1, 7, and 14 days. Cytotoxicity was assessed by exposing L929 fibroblasts to the medicaments.

Results: Cinnamaldehyde was the main component of CEO. Triple antibiotic paste had the greatest zone of inhibition and the smallest MIC and MBC. Triple antibiotic paste and CEO eradicated planktonic E. faecalis after 4 and 24 hours, while Ca(OH)2 failed to achieve 100% killing after 24 hours. Cinnamomum zeylanicum essential oil and TAP eradicated biofilm E. faecalis after 7 and 14 days, but Ca(OH)2 could not eliminate E. faecalis after 14 days. Cinnamomum zeylanicum essential oil was the most biocompatible medicament.

Conclusion: Cinnamomum zeylanicum essential oil is an efficient antibacterial agent against planktonic and biofilm E. faecalis and it was cytocompatible to L929 fibroblasts. Therefore, CEO has the potential to be used as an antimicrobial agent in root canal treatment.

Keywords: 3Mix ointment.; Antimicrobial agents; Cytocompatibility; Root canal medicaments.

MeSH terms

  • Acrolein / analogs & derivatives*
  • Acrolein / pharmacology
  • Anti-Bacterial Agents / pharmacology*
  • Biofilms / drug effects*
  • Calcium Hydroxide / pharmacology*
  • Cinnamomum zeylanicum*
  • Cytotoxins / pharmacology
  • Dental Pulp Cavity / microbiology
  • Enterococcus faecalis / drug effects*
  • Fibroblasts / drug effects
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Plant Oils / pharmacology*
  • Root Canal Therapy


  • Anti-Bacterial Agents
  • Cytotoxins
  • Plant Oils
  • Acrolein
  • Calcium Hydroxide
  • cinnamaldehyde