Hamadan University of Medical Sciences Avicenna Journal of Dental Research 2423-7582 17 3 2025 09 29 Comparative In Vitro Study of Antimicrobial Efficacy of Sodium Hypochlorite, Normal Saline, and Hekla Lava Tooth Powder as Root Canal Irrigants Against Enterococcus faecalis 154 159 10.34172/ajdr.2187 EN Banu Jothi A https://orcid.org/0009-0000-0515-391X Rajmohan M https://orcid.org/0000-0002-3695-5074 Savithri S Prabu D Lubna Fathima Sindhu R Dinesh Dhamodhar Indira Nehru Hari Priya R Journal Article 10.34172/ajdr.2187 2024 12 04 2025 03 16 Background: Enterococcus faecalis is a bacterium commonly associated with persistent endodontic infections. Hekla Lava has healing properties that enhance its antibacterial effects, making it a potential alternative to traditional irrigants, such as sodium hypochlorite (NaOCl). E. faecalis is particularly resilient and can form biofilms, thus complicating treatment outcomes; therefore, exploring effective irrigants is crucial for improving root canal disinfection strategies. This research aimed to assess whether Hekla Lava tooth powder (HLTP) can provide sufficient antimicrobial efficacy to support successful endodontic treatments. It evaluated the antibacterial efficacy of NaOCl, normal saline (NS), and HLTP as a root canal irrigant against E. faecalis. Methods: The in vitro study was conducted in an extracted non-carious human tooth. The treatment groups were treated with NaOCL (group A), NS (group B), and HLTP (group C) for the irrigation of the root canal for 5 minutes and 48 hours. Results: The results of the study demonstrated significant differences in the antimicrobial efficacy of the three treatment groups at both time points. HLTP showed a decrease in colony-forming units from a mean initial count of 59.35±5.80 after 5 minutes to 40.47±3.81 after 48 hours, indicating that its use was better when compared to NS. Conclusion: The findings reaffirm that the use of HLTP as an irrigant is preferable compared to NS due to its superior antimicrobial properties against E. faecalis. NS lacks substantial antimicrobial effects, making it less effective for disinfection in root canal procedures. This study highlights the potential of HLTP as a more effective alternative for improving treatment outcomes in endodontics, suggesting a shift toward herbal and natural solutions in dental care practices.