Comparative Evaluation of Smear Layer Removal in Apical Third Using Four Different Irrigants With Ultrasonic Agitation: An In Vitro Scanning Electron Microscopy (SEM) Analysis

Murugesan, Kalaiarasi; Vishwanath, Sankar; Kadandale, Sadasiva; Thanikachalam, Yashini; Parthasarathy, Revathy; Ilango, Sangita

doi:10.7759/cureus.23142

Cited by 4 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its biocompatibility with human tissues has also been observed (Mohammed and Selivany, 2021;Kebede et al, 2021). The study also found that chamomile was more effective than NaOCl alone in removing smear layers than NaOCl + EDTA (Murugesan et al, 2022). The research findings indicate that Tea Tree Oil (TTO) could serve as a viable root canal irrigant for young patients, exhibiting antimicrobial properties similar to Chlorhexidine (CHX).…”

Section: Discussionmentioning

confidence: 69%

Comparative Evaluation of Antimicrobial Efficacy of German Chamomile Extract, Tea Tree Oil and Chlorhexidine as Root Canal Irrigants against E-faecalis and Streptococcus Mutans – An In Vitro Study

2023

IJAB

View full text Add to dashboard Cite

Article HistoryBackground: In endodontic therapy, root canal irrigants are utilized to enhance mechanical debridement. However, conventional irrigants have certain drawbacks, such as being incapable of removing the smear layer, causing tissue irritation, toxicity, and unpleasant taste, especially in children. Therefore, there is a growing necessity to explore natural alternatives, such as herbal irrigants. This study sought to evaluate the antimicrobial effectiveness of German chamomile, tea tree oil (TTO), and chlorhexidine (CHX) as root canal irrigants against E. faecalis and Streptococcus mutans. Method: Fifteen test samples of German chamomile extract, tea tree oil, and chlorhexidine were taken. Indicator strains were grown in Brain Heart Infusion (BHI) agar at 37ºC for 24 hr. In preparation for the experiment, a 15 ml base layer of BHI agar was mixed with 300µl of each inoculum and placed in individual sterilized petri plates. Once the culture medium had solidified, four wells were created on each plate and subsequently filled with the designated testing materials. This methodology was employed to ensure methodological rigor and accuracy in the experimental process. In preparation for the experiment, a 15 ml base layer of BHI agar was mixed with 300µl of each inoculum and placed in individual sterilized petri plates. Once the culture medium had solidified, four wells were created on each plate and subsequently filled with the designated testing materials. This methodology was employed to ensure methodological rigor and accuracy in the experimental process. The plates were kept for 2 hours at room temperature for the diffusion of the material and then incubated at 37ºC for 48 hours. Antibacterial tests were repeated 5 times for homogeneity of the results. Results: The comparison of antimicrobial efficacy of chlorhexidine 2%, tea tree oil, and German chamomile showed a significant difference whereas the comparison between chlorhexidine 2% and tea tree oil was statistically insignificant. Conclusion: The effective reduction in the microbial count by all three test irrigants was observed to be significant. The antimicrobial efficacy of tea tree oil was found to be better than 2% chlorhexidine and German chamomile extract.

show abstract

Section: Discussionmentioning

confidence: 69%

Comparative Evaluation of Antimicrobial Efficacy of German Chamomile Extract, Tea Tree Oil and Chlorhexidine as Root Canal Irrigants against E-faecalis and Streptococcus Mutans – An In Vitro Study

2023

IJAB

View full text Add to dashboard Cite

show abstract

“…Twenty‐four reports investigated either the detrimental effects (20) or the regenerative potential (4) of EOW on oral hard and soft tissues (Table 3, Table S1). Most (16) were in vitro studies assessing potential endodontic applications 80,99,129–142 . Others examined dentine microhardness (human 134,136,137,143 ; bovine 144 ), dentine surface roughness (human 137 ), dentine structure (bovine 145 ), pulp/apical papilla cytotoxicity (human 67,146 ) and pulp dissolution capability (bovine 86,147,148 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most (16) were in vitro studies assessing potential endodontic applications. 80,99,[129][130][131][132][133][134][135][136][137][138][139][140][141][142] Others examined dentine microhardness (human 134,136,137,143 ; bovine 144 ), dentine surface roughness (human 137 ), dentine structure (bovine 145 ), pulp/apical papilla cytotoxicity (human 67,146 ) and pulp dissolution capability (bovine 86,147,148 ).…”

Section: Effects Of Eow On Oral Hard and Soft Tissuesmentioning

confidence: 99%

“…Increased contact times and/or concentration decreased dentine microhardness, increased dentine surface roughness and increased the toxicity towards human cell lines for all EOWs, but especially for acidic EOW. 80,136,137,143,146 Smear layer removal with various EOWs was similar or better than with other test irrigants [NaOCl, EDTA, H 2 O 2 , BioPure MTAD (mixture of 3% tetracycline, 4.25% citric acid and 0.5% Tween 80 det ergent)], 99,[129][130][131][132][133][134][135][136][137][138][139]141,142 although acidic EOW reportedly caused erosion, obliterated dentinal tubular margins and widened tubular orifices. 136,137 Increasing the contact time with acidic EOW reduced the microhardness of coronal and radicular dentine.…”

Section: Effects Of Eow On Dentine Smear Layer Removal (Cleaning Effi...mentioning

confidence: 99%

See 1 more Smart Citation

Electrolysed oxidising water as a multi‐purpose biocide in dental healthcare—A scoping review

Krishnan,

Tompkins,

Lyons

et al. 2023

Gerodontology

View full text Add to dashboard Cite

ObjectivesThe objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps.BackgroundEOW is an emerging, “green,” and cost‐effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people.Materials and MethodsThe review follows the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full‐text, original reports published in English‐language peer‐reviewed journals.ResultsThe search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at ‘point‐of‐use’ (POU; 72%), bottled (‘ready‐to‐use’, RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage‐related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost‐effectiveness of POU EOW.ConclusionsNeutral‐pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti‐Candida biofilm efficacy and mechanism of action against yeasts, long‐term effects on denture materials and cost‐effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection‐control requirements relating to older people.

show abstract

“…Multiple investigative studies that utilized scanning electron microscopy (SEM) have shown the efficacy of sodium hypochlorite (NaOCl) irrigation in debris removal [ 4 ]. However, one should note that there is a significant disadvantage associated with NaOCl: its potential cytotoxic effects when inadvertently injected into peri-radicular tissue.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Different Root Canal Irrigating Solutions in Removing Smear Layer: A Scanning Electron Microscopic Study

Nanda,

Singh,

Kamble

et al. 2023

Cureus

View full text Add to dashboard Cite

Background The aim of the present investigation was to evaluate and compare the efficacy of frequently used chemical agents in terms of their capacity to eliminate the smear layer after instrumentation, as observed via scanning electron microscopy (SEM). Materials and methods Sixty extracted single-rooted mandibular premolar teeth, each with roots 15 mm in length, were used in this study. The teeth were divided into one control group and four study groups, each containing 12 teeth. In Control Group 0, teeth were irrigated with 3 ml of saline only. In Group 1, teeth were irrigated initially with 3% sodium hypochlorite (NaOCl) and then given a final rinse with 3 ml of 17% ethylenediaminetetraacetic acid (EDTA) for one minute. In Group 2, teeth were irrigated with 3% NaOCl and given a final rinse with 3 ml of a mixture of tetracycline, acid, and detergent (MTAD, BIOPURE) for one minute. In Group 3, teeth were irrigated with saline and given a final rinse with 3 ml of 17% EDTA for one minute. In Group 4, teeth were irrigated with saline and given a final rinse with 3 ml of MTAD for one minute. One-half of each tooth was chosen and prepared for scanning electron microscopic (SEM) examination at the cervical, middle, and apical thirds. These were observed at magnifications of up to 1,000 times to check for the presence or absence of a smear layer. The data were analyzed using the Kruskal-Wallis test and post-hoc Dunn's test. Results All of the root canal irrigation protocols exhibited superior efficacy compared to the control group in the elimination of the smear layer. Group 2 (3% NaOCl with MTAD) showed the lowest mean scores, compared to all the groups, followed by Group 1 (3% NaOCl with 17% EDTA). MTAD was more effective than EDTA. The smear layer was effectively removed from the apical third, followed by the middle and coronal thirds of the root. Conclusion Initial irrigation with 3% NaOCl and one-minute final irrigation with 3 ml MTAD was the most effective root irrigant, and particularly indicated in teeth with infection of the apical third.

show abstract

Comparative Evaluation of Smear Layer Removal in Apical Third Using Four Different Irrigants With Ultrasonic Agitation: An In Vitro Scanning Electron Microscopy (SEM) Analysis

Cited by 4 publications

References 24 publications

Comparative Evaluation of Antimicrobial Efficacy of German Chamomile Extract, Tea Tree Oil and Chlorhexidine as Root Canal Irrigants against E-faecalis and Streptococcus Mutans – An In Vitro Study

Comparative Evaluation of Antimicrobial Efficacy of German Chamomile Extract, Tea Tree Oil and Chlorhexidine as Root Canal Irrigants against E-faecalis and Streptococcus Mutans – An In Vitro Study

Electrolysed oxidising water as a multi‐purpose biocide in dental healthcare—A scoping review

Efficacy of Different Root Canal Irrigating Solutions in Removing Smear Layer: A Scanning Electron Microscopic Study

Contact Info

Product

Resources

About