Antibacterial Activity of Buah Merah (Pandanus conoideus Lam.) Against Bacterial Oral Pathogen of Streptococcus sanguinis ATCC10556, Streptococcus mutans ATCC 25175, and Enterococcus faecalis ATCC 29212: An in Vitro Study

Background: Caries and periodontitis are dental diseases caused by bacteria of S. sanguinis, S. mutans, and E. faecalis with three main etiological factors of the host, substrate, and time. Objective: This study proposed to investigate the antibacterial effects of Buah Merah (Pandanus conoideus Lam.) against oral bacteria of E. faecalis, S. mutans, and S. sanguinis. Materials and Methods: The Buah Merah was extracted with different solvents to yield n-hexane, ethyl acetate, methanol, and H2O extracts. The concentrations of single and mixture extracts were adjusted for antibacterial assay against bacteria of E. faecalis, S. mutans, and S. sanguinis strains through agar well diffusion assay with chlorhexidine, fosfomycin, and quercetin used as positive controls. Results: The ethyl acetate extract showed highest antibacterial activity against three oral bacterial of E. faecalis, S. mutans, and S. sanguinis with inhibition zones values of 9.3, 12.3, and 17.9 mm at 40%, respectively, together with their MIC and MBC values of 1250 & 2500, 0.312 & 0.625, and 0.312 & 0.625 ppm, respectively. For the formulation of extracts, combinations samples test gave various effects to different bacteria, with the best activity showed by methanol-ethyl acetate (M-Ea) extracts against S. mutans with an inhibition zone of 16.25 mm at 40 ppm. The strong and synergistic effect of methanol extract against S. mutans was supported by inhibition zones of the formulation of methanol extract-fosfomycin which showed an inhibition zone of 25.9 mm at 10 ppm. Conclusion: The extracts of Buah Merah demonstrated antibacterial activity against oral bacteria of E. faecalis, S. mutans, and S. sanguinis and gave important information for further in vivo clinical studies to determine the exact dosages and its effectiveness in practical application. These results prove the antimicrobial effects of Buah Merah extracts as alternative natural drugs with synergistic effects of active constituents.