A scanning electron microscope evaluation of efficacy of sodium hypochlorite and Allium sativum in smear layer removal in root canals with the use of modified evacuation system: An ex vivo study

Abstract

Context:Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant. Although it fulfills most of the requisites of an ideal irrigant, it has certain drawbacks, chiefly severe soft-tissue damage. Allium sativum (garlic extract) is a proven antimicrobial agent that has the ability to dissolve inorganic tissue with minimal toxicity. However, its ability to remove smear layer (SL) is not known. Conventional hand-held syringe irrigation is ineffective in removing canal debris. The use of newer irrigation systems is limited owing to their high cost. Modified evacuation system (MES) may prove to be an effective yet economical alternative.Aims:This study aims to evaluate the SL removing capacity of garlic extract as an alternative to 5% NaOCl and the use of modified evacuation system for removal of irrigant along with debris from root canals.Settings and Design:Sixty-eight single-rooted mandibular premolars were divided into 8 Groups: Two control Groups A and B (4 samples each) and six experimental Groups C to H (10 samples each). Garlic extract was prepared at a concentration of 64 mg/ml. MES was set up using 21-gauge flat-end needle fixed onto chair side high-volume evacuation system.Subjects and Methods:Control groups were irrigated with normal saline, Groups C and D with 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA), Groups E and F with garlic extract and 17% EDTA and Groups G and H with plain garlic extract. MES was used in Groups B, D, F, and H. Scanning electron microscope analysis was done to view SL at coronal, middle, and apical thirds.Statistical Analysis Used:Chi-square test.Results:Groups A and B showed least scores. At coronal and middle thirds, Group D shows better results, followed by Groups F and H. Apically, Group F showed better results. Groups C and H, and E and G showed similar results. All groups with MES showed better results.Conclusions:A. sativum has an SL removal capacity. MES is effective in debris removal.

Garlic (Allium sativum L.) Bioactives and Its Role in Alleviating Oral Pathologies

“…In recent ex vivo study the efficacy of sodium hypochlorite (NaOCl) and garlic in smear layer removal in root canals is examined. They observed the elimination of irrigant as well as debris from root canals in 68 single-rooted mandibular premolars treated with 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) with GE (64 mg/mL) prepared by garlic cloves in 70% ( v / v ) ethanol [ 105 ].…”

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study

“…The extract exhibits a wide range of inhibitory effect on the growth of various bacteria due to the presence of thiosulfinates which include diallyl sulfide, diallyl disulfide, and allyl methyl sulfide, which disrupt the cell membrane of the bacteria and block their enzymatic pathways. [ 12 13 15 16 ] The results of the current study showed statistically significant activity against both aerobic and anaerobic bacterial growth ( P < 0.01). Up to the available data, the use of AS extract in endodontic treatment is limited.…”

Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12‐month short‐term evaluation

“…Using a sterile mortar and pestle, cloves were homogenized aseptically and filtered through a double layer paper. The fully concentrated and extracted was diluted to the concentration of 25% with distilled water (Eswar, Venkateshbabu, Rajeswari, & Kandaswamy, 2013;Prabhakaran & Mariswamy, 2018).…”

“…The complex nature of the deciduous root canal system facilitates the spread of pathogenic microbes through lateral and accessory canals, dentinal tubules, apical ramifications, and the possibility of harming the tooth germ of permanent successor, and subsequently, these barriers make total removal of necrotic tissue by instrumentation alone impossible (Camp, 2008;Pazelli et al, 2003;Pozos-Guillen, Garcia-Flores, Esparza-Villalpando, & Garrocho-Rangel, 2016;Vianna et al, 2004). Therefore, irrigation is a replenishing step to mechanical instrumentation during root canal preparation to create a disinfectant atmosphere inside the root canal (Prabhakaran & Mariswamy, 2018). Another critical function of intracanal irrigation is elimination of the smear layer that raises dentin permeability and allows permeation of intracanal medication (Pashley, Michelich, & Kehl, 1981;Teixeira, Felippe, & Felippe, 2005;Zehnder, 2006).…”