ANTIBACTERIAL EFFECTIVENESS OF LERAK FRUIT ETHANOL EXTRACT ( Sapindus rarak DC) AND 2% CHLORHEXIDINE IN Enterococcus faecalis (EFEKTIVITAS ANTIBAKTERI EKSTRAK ETANOL

The failure of a root canal treatment can be caused by the facultative anaerobic bacteria Enterococcus faecalis , which should be eliminated throughout root canal irrigation. Chlorhexidine 2% is a popular antibacterial liquid used in root canal irrigation. Natural substances can also be used to make antibacterial irrigation liquids. One natural substance with antibacterial properties is lerak fruit extract ( Sapindus rarak DC), containing 28 per cent of saponins, alkaloid compounds, polyphenols, antioxidant chemicals


JHDS 2021
| 189 rarak DC) as a treatment group, and aquadest as a negative control.Each group was repeated ten times on Muller Hinton Agar (MHA) media which was applied using a paper disc.Then the diameter of the inhibition zone was calculated using a caliper.The results in this study, 25% lerak (Sapindus rarak DC) fruit extract had an average inhibition zone diameter of 11.775 mm, and an average inhibition zone diameter of 2% chlorhexidine was 19.745 mm.The difference in the diameter of the inhibition zone was significantly different in all groups.Conclusion ethanol extract of lerak fruit (Sapindus rarak DC) 25% can inhibit the growth of E. faecalis and can be used as an alternative to other antimicrobial agents as disinfection of root canal irrigation.The presentation of the effects of data processing is then displayed in tabular form.

RESULT
The effectiveness test of 25% lerak fruit ethanol extract (Sapindus rarak DC) against E. faecalis compared to 2% Chlorhexidine can be seen in Figure 1.Based on Table 1, it was identified that the   2).

DISCUSSION
The study used the agar diffusion method to determine the diameter of the clear zone (inhibition zone) formed around the paper disc from the 25% ethanol extract of lerak fruit (Sapindus rarak DC) against E. faecalis compared to 2% Chlorhexidine.
Table 2 shows a significant difference between 25% lerak fruit ethanol extract Kata kunci: antibacteri; buah lerak, khlorheksidinINTRODUCTIONRoot canal therapy is a procedure used to remove bacteria from the root canal wall that might cause infection and tissue growth.The removal of germs from the root canal system is critical to the effectiveness of root canal therapy.1,2Root canal therapy is divided into three stages: biomechanical preparation, disinfection, and root canal obturation.Endodontic treatment relies on biomechanical preparation to remove microorganisms found in root canals.Proper irrigation might have an impact on the root canal cleansing potential.The optimal irrigation solution must have the ability to destroy microorganisms, dissolve necrotic tissue, be lubricating, remove the smear layer, and not irritate good tissue. 2,3Facultative bacteria, particularly Enterococcus faecalis, are commonly responsible for root canal treatment failure.Infections caused by these bacteria have a frequency of 24-77%.E. faecalis resistance factor may survive in nutritional deficiencies and at alkaline pH.E. faecalis can also compete with other bacteria for dentinal tubule invasion. 4The smear layer can also infiltrate into the dentinal tubules in the same circumstances, causing microorganisms to be coated by the smear layer and making E. faecalis challenging to remove. 5The failure of the root canal treatment can be avoided by using the proper irrigation solutions.Chlorhexidine 2% is one of the suitable irrigation fluids shown to be more efficient against E. faecalis. 6Chlorhexidine 2% is effective against E. faecalis in root canals and dentinal tubules.Irrigation with 2% chlorhexidine solution for 2 minutes removed microorganisms in the dentinal tubules up to 100 m.Chlorhexidine 2% has low cytotoxicity, broad-spectrum antibacterial, and is also water-soluble.The irrigation can damage the integrity of the cell membrane so that it can precipitate JHDS 2021 | 191 cytoplasmic fluid.Its antibacterial effect attracts cation molecules from 2% chlorhexidine with anion molecules from the bacterial cell membrane.The disadvantage Chlorhexidine 2% is less effective against gram-negative bacteria and cannot dissolve necrotic tissue or remove the smear layer.Therefore 2% Chlorhexidine cannot be used as a sole irrigation solution in root canal treatment. 6,3Lerak fruit (Sapindus rarak DC) is one of the alternative natural ingredients that can be developed as root canal irrigation.The active compounds contained in lerak fruit (Sapindus rarak DC) are 28% saponins, alkaloid compounds, polyphenols, antioxidant compounds, and flavonoids, as well as tannins. 7-9Ethanol extract of lerak fruit (Sapindus rarak DC) can be used for alternative irrigation.The root canal has low surface tension.The benefit of low surface tension is that the liquid can wet the entire surface of the root canal wall.Research on the effect of various preparations of lerak extract (Sapindus rarak DC) found that lerak fruit (Sapindus rarak DC) can lift the smear layer.At the same time, 2% Chlorhexidine cannot remove the smear layer. 8,3Innovation of ethanol extract of lerak fruit (Sapindus rarak DC) as a root canal irrigant is known to have antibacterial and antifungal effects.In the study of E. faecalis, ethanol extract of lerak fruit (Sapindus rarak DC) had an antibacterial effect with a minimal bactericidal concentration of 25%. 9 No study has compared the natural antibacterial ingredients of the ethanolic extract of lerak fruit (Sapindus rarak DC) 25% compared with 2% chlorhexidine against E. faecalis.The purpose of this study was to explain the differences in the antibacterial effectiveness of the 25% ethanol extract of lerak fruit (Sapindus rarak DC) against E. faecalis compared to 2% chlorhexidine.METHOD The study was conducted in vitro with agar diffusion method on E. faecalis bacterial plates.The bacteria were identified as E. faecalis after being reidentified.A total of 9 samples of bacterial plates were divided into three groups, namely ethanol extract of lerak fruit (Sapindus rarak DC) 25% (group 1), 2% chlorhexidine (group 2), and distilled water as a control.The 25% ethanolic extract of lerak fruit (Sapindus rarak DC) was obtained from the Laboratory of the Research Institute for Spices and Medicinal Plants (Balittro) by weighing the extract using an analytical balance of as much as 1.25 grams and then dissolved in 5 ml of distilled water.Anova then tested the results JHDS 2021 | 192 obtained if the data were normally distributed, and the Post Hoc test continued.

Figure 1 .
Figure 1.The effectiveness test of 25% ethanol extract of lerak fruit (Sapindus rarak DC) against E. faecalis compared to (B) Chlorhexidine 2% and (C) Aquades as a negative control.

Table 1
25% ethanol extract of lerak fruit (Sapindus rarak DC) affects inhibiting the growth of E. faecalis bacteria.Still, the 2% Chlorhexidine inhibition diameter is greater than that of the 25% ethanol extract of lerak fruit (Sapindus rarak DC).Diameter of inhibition of 25% lerak fruit (Sapindus rarak DC) ethanol extract against Enterococcus faecalis compared to 2% chlorhexidine The ethanolic extract of lerak fruit (Sapindus rarak DC) 25% affected inhibiting the growth of E. faecalis bacteria.Still, the diameter of the diffusion zone of chlorhexidine 2% was greater than 25% extract of lerak fruit (Sapindus rarak DC).
the average diameter of inhibition formed by 25% lerak fruit ethanol extract (Sapindus rarak DC) is 11.775 mm.At the same time, the average diameter of the inhibition created by 2% Chlorhexidine is 19.745 mm.The mechanism of 2% chlorhexidine eliminates E. faecalis is by damaging the cell membrane integrity to precipitate cytoplasmic fluid.The antibacterial effect works by attracting cation molecules from 2% chlorhexidine with anion molecules from the bacterial cell membrane.Meanwhile, the mechanism of lerak extract (Sapindus rarak DC) eradicates E. faecalis by saponins, alkaloid compounds, polyphenols, antioxidant compounds, and flavonoid groups, as well as tannins.Inhibition of bacterial growth occurs due to the reaction of a chemical compound in lerak fruit as an antibacterial.Flavonoid compounds are one of the chemical compounds that are bacteriostatic.Its mechanism of action is by denaturing bacterial cell proteins and damaging the cytoplasmic membrane.Other compounds contained in Lerak fruit, such as saponins can also damage the cytoplasmic membrane.Cytoplasmic membrane Damage can cause the permeability of the cell membrane to decrease so that the transport of substances into and out of the cell becomes uncontrolled. 10Alkaloids have the ability to an antibacterial.The alkaloids mechanism is by interfering with the peptidoglycan constituent components in bacterial cells so that the cell wall layer is not fully formed.It is suspected that the alkaloids work first to damage the cell wall, and then the flavonoids work to damage the bacterial cell membrane.Tannins are thought to shrink cell walls.Damage to the cell wall will inhibit the growth of bacterial cells, and eventually, the bacteria will die.In general, the work of a chemical as an antibacterial agent can result in changes that damage the inhibition of the growth of these bacterial cells. 11,12

Table 2 .
Diffusion zone of E. faecalis