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Navayath M, Ramesh SR, Kalaiselvam R, Ashok R, Rajendran MR, Balaji L. Evaluation of Nanomagnesium Oxide in Combination with Garlic Extract as an Endodontic Irrigant: An In Vitro Study. J Contemp Dent Pract 2023; 24:459-466. [PMID: 37622623 DOI: 10.5005/jp-journals-10024-3530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
AIM The aim of this in vitro study was to evaluate the effectiveness of the combination of garlic extract in combination with magnesium oxide (MgO) for use as an endodontic irrigant at various contact times. MATERIALS AND METHODS All 48 teeth were divided into 6 groups according to irrigation used after inoculation with Enterococcus faecalis and incubation. The control groups consisted of saline and sodium hypochlorite (NaOCl) used as irrigants and the test groups employed garlic extract combined with nano-magnesium oxide (nano-MgO) used as irrigant with two contact times, namely, 2 and 5 minutes, and garlic extract and nano-MgO used solely for 5 minutes each. Colony-forming units (CFUs) were counted after plating and incubation. RESULTS In NaOCl, and in both combination groups, there was a significant reduction in CFU counts. The saline group showed no decrease. Statistical analysis showed no difference in efficacy between NaOCl and the two combination groups. There was a statistical difference between the combination group and garlic/nano-MgO alone at both 2 and 5 minutes. CONCLUSIONS Under the conditions of this study, a novel irrigant, a combination of nanoparticles of MgO and garlic extract was as effective as NaOCl against E. faecalis in an in vitro model at two tested contact times. CLINICAL SIGNIFICANCE Combination of MgO nanoparticles and garlic extract achieves disinfection comparable to gold standard NaOCl without harmful caustic effects of hypochlorite.
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Affiliation(s)
- Malikka Navayath
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Seshan Rakkesh Ramesh
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9952841991, e-mail:
| | - Rajeswari Kalaiselvam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rupa Ashok
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Mathan Rajan Rajendran
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Lakshmi Balaji
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
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Susila AV, Sai S, Sharma N, Balasubramaniam A, Veronica AK, Nivedhitha S. Can natural irrigants replace sodium hypochlorite? A systematic review. Clin Oral Investig 2023; 27:1831-1849. [PMID: 36808559 DOI: 10.1007/s00784-023-04913-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 02/03/2023] [Indexed: 02/20/2023]
Abstract
CONTEXT Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored. AIMS This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite. SETTINGS AND DESIGN REGISTRATION This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence. RESULTS Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success. CONCLUSIONS The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.
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Affiliation(s)
- Anand Venkatraman Susila
- Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India.
| | - Shamini Sai
- Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India
| | - Nikita Sharma
- Department of Conservative Dentistry & Endodontics, Shree Bankey Bihari Dental College and Research Centre, Masuri, NH 24, Ghaziabad, Uttar Pradesh, India
| | - Arthi Balasubramaniam
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India
| | - Aruna Kumari Veronica
- Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India
| | - Sureshbabu Nivedhitha
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India
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Hama Gharib DS, Salman RF. Feasibility of the crude extracts of Amorphophallus paeoniifolius and Colocasia esculenta as intracanal medicaments in endodontic therapy in comparison to the 940 nm diode laser: An in vitro antimicrobial study. J Dent Sci 2023; 18:145-156. [PMID: 36643226 PMCID: PMC9831863 DOI: 10.1016/j.jds.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/26/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The elimination and debridement of intracanal bacteria are credited with long-term effectiveness in endodontic therapy. This study aimed to compare the antimicrobial efficacies of Amorphophallus paeoniifolius (Suran), Colocasia esculenta (Aravi) crude extracts as intracanal medicaments with calcium hydroxide (CH), 2% chlorhexidine (CHX) gel, and 940 nm diode laser. Materials and methods Fifty-eight intact, single-root, extracted human mandibular premolar teeth were prepared. The samples were sterilized, transferred into microcentrifuge tubes, and inoculated with E. faecalis. The samples were placed in an incubator for three weeks to allow the biofilm to grow. Then the samples were randomly divided into five experimental groups (n = 10), disinfected with Suran, Aravi crude extracts, CH, 2% CHX gel, and a 940 nm diode laser. The negative control group (n = 4) and the positive control group (n = 4). Then the samples were observed under light and scanning electron microscopy to monitor the E. faecalis biofilm. The sampling method was carried out in paper point (intracanal) and Peeso bur (intradentinal). Later the number of colony-forming units was counted and analyzed. Results Colony-forming units were significantly reduced in the 2% CHX gel in both sampling methods, while Suran showed lower colony-forming units compared to Aravi and CH. The differences between experimental groups were not statistically significant (P > 0.05) in both sampling methods. Conclusion This study showed that the application of Suran and Aravi crude extracts as intracanal medicaments leads to a significant reduction in the number of bacterial colonies compared to CH, 2% CHX gel, and 940 nm diode laser.
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Affiliation(s)
- Didar Sadiq Hama Gharib
- Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, As Sulaymaniyah, 46001, Iraq
- Corresponding author. Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, As Sulaymaniyah, 46001, Iraq.
| | - Raid Fahim Salman
- Department of Conservative Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq
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Meghana S, Nagaveni N, Poornima T. Comparison of Syzygium Aromaticum (clove) and Punica Granatum (Pomegranate) extracts with 2% chlorhexidine in dentinal tubule disinfection against faecalis by using real-time PCR: an in-vitro study. INTERNATIONAL JOURNAL OF PEDODONTIC REHABILITATION 2022. [DOI: 10.56501/intjpedorehab.v7i2.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: A vital and significant goal in treating a tooth with an apical infection is getting rid of the germs in the pulp space. Recurrent root canal infections are most frequently linked to Enterococcus faecalis and can happen even after endodontic therapy. E. faecalis can resist routine endodontic disinfectants and can also survive the nutrient-deprived conditions in the root filled tooth. So, an attempt has been made to eliminate the microorganisms using the herbal extracts which have antimicrobial properties and comparing it with the well accepted and excellent antimicrobial agent 2% chlorhexidine.
Aim: To compare Syzygium aromaticum (Clove) and Punica granatum (Pomegranate) extracts with 2% chlorhexidine in dentinal tubule disinfection with Real-time polymerase chain reaction which was used to detect E. faecalis.
Methods: Thirty-six extracted premolar teeth were selected, access cavity was prepared and cleaning and shaping was done. With the help of a rotating diamond disc bur, the middle part of the root was sliced. E. faecalis was applied to the tooth specimens and left on them for 21 days. Group 1 specimens had pomegranate extract, Group 2 contained clove extract, and Group 3 contained 2% CHX. After being watered by the corresponding groups, the specimens were incubated for 5 days. A Gates-Glidden drill was used to collect the dentinal shavings, which were then subjected to DNA isolation before being subjected to real-time PCR analysis.
Statistical analysis used: The results were statistically analyzed using one way ANOVA and Post hoc Tukey's analysis.
Results: Threshold cycle (Ct) values showed greater inhibition of bacterial load with pomegranate extracts followed by 2% chlorhexidine. Lesser reduction of bacterial load was found with clove extract.
Conclusion: Pomegranate extract, an herbal extract with therapeutic potential which can be utilised as an efficient substitute for 2% CHX for treating E. fecalis.
Keywords: Clove; Pomegranate; E. Fecalis; Real-time PCR.
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Mahfouz Omer SM, Mohamed DA, Ali Abdel Latif RM. Comparative Evaluation of the Antibacterial Effect of Allium Sativum, Calcium hydroxide and Their Combination as Intracanal Medicaments in Infected Mature Anterior Teeth A Randomized Clinical Trial. Int Endod J 2022; 55:1010-1025. [DOI: 10.1111/iej.13801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/14/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shaimaa Mohamed Mahfouz Omer
- Department of Pediatric Dentistry, Preventive Dentistry and Dental Public Health, Faculty of Dentistry Suez Canal University Egypt
| | | | - Reham Mohamed Ali Abdel Latif
- Department of Pediatric Dentistry, Preventive Dentistry and Dental Public Health, Faculty of Dentistry Suez Canal University Egypt
- Department of Restorative Dental Science, Vision Colleges Jeddah Saudi Arabia
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Xu S, Liao Y, Wang Q, Liu L, Yang W. Current studies and potential future research directions on biological effects and related mechanisms of allicin. Crit Rev Food Sci Nutr 2022; 63:7722-7748. [PMID: 35293826 DOI: 10.1080/10408398.2022.2049691] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Allicin, a thiosulfonate extract from freshly minced garlic, has been reported to have various biological effects on different organs and systems of animals and human. It can reduce oxidative stress, inhibit inflammatory response, resist pathogen infection and regulate intestinal flora. In addition, dozens of studies also demonstrated allicin could reduce blood glucose level, protect cardiovascular system and nervous system, and fight against cancers. Allicin was widely used in disease prevention and health care. However, more investigations on human cohort study are needed to verify the biological or clinical effects of allicin in the future. In this review, we summarized the biological effects of allicin from previous outstanding and valuable studies and provided useful information for future studies on the health effects of allicin.
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Affiliation(s)
- Shiyin Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- China-DRIs Expert Committee on Other Dietary Ingredients, Sun Yat-sen University, Guangzhou, China
| | - Yuxiao Liao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- China-DRIs Expert Committee on Other Dietary Ingredients, Sun Yat-sen University, Guangzhou, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- China-DRIs Expert Committee on Other Dietary Ingredients, Sun Yat-sen University, Guangzhou, China
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- China-DRIs Expert Committee on Other Dietary Ingredients, Sun Yat-sen University, Guangzhou, China
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Elheeny AAH. Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12-month short-term evaluation. Clin Exp Dent Res 2019; 5:420-426. [PMID: 31452953 PMCID: PMC6704030 DOI: 10.1002/cre2.197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 11/22/2022] Open
Abstract
This study indented to assess the clinical and radiographic assessment of Allium sativum extract as an intracanal irrigant for pulpectomy of primary molars. Ninety children with 110 teeth submitted were categorized into two groups. Clinical and radiographic success rates were checked at 3, 6, and 12 months. Qui-square test at a level of significance was ˂0.05. There was no statistically significant difference (p ˂ .05) between the two groups that has not been detected clinically or radiographically. Clinical and radiographic success rates of garlic extract at 3 months were (80% and 72.7%), which declined at 6 and 12 months to be 76.4% 6 and 74.5% respectively. For NaOCl group, clinical and radiographic success rates were 87.3% and 85.5% at 3 months, 87.3% and 87.3% at 6 months and 89.1% and 87.3% at 12 months. A. sativum extract can be used efficiently as an irrigant for pulpectomy of primary molar root canals.
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Kalaiselvam R, Soundararajan K, Rajan R M, Deivanayagam K, Arumugam C, Ganesh A. Comparative Evaluation of the Anti-bacterial Efficacy of Herbal Medicaments and Synthetic Medicaments Against Enterococcus faecalis using Real-time Polymerase Chain Reaction. Cureus 2019; 11:e5228. [PMID: 31565629 PMCID: PMC6758972 DOI: 10.7759/cureus.5228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Periradicular bacterial infections are the proven cause of the failure of endodontic treatment. When the pulp canal gets infected or becomes necrotic, bacterial growth takes place in the form of biofilms and aggregates. During the endodontic procedure, bacterial colonies are disrupted, and the microbial load is reduced by biomechanical preparation, cleaning with anti-microbial solutions, and placing anti-bacterial medicaments in the root canal. These anti-microbial substances are synthetic, having a cytotoxicity effect. In recent times, herbal medicines are an alternative medicine being used increasingly as an intra-canal medicament to fight or prevent common endodontic infections. Aim The objective of this study is to compare the anti-bacterial efficacy of herbal medicaments and synthetic medicaments against Enterococcus faecalis (E. faecalis). Materials and methods This was an in-vitro study in which a total of 60 teeth specimens (n=60) were inoculated with E. faecalis for 21 days. Specimens were divided into six groups (Group 1: Piper nigrum (Piperaceae); Group 2: Piper longum (Piperaceae); Group 3: Zingiber officinale Roscoe (Zingiberaceae); Group 4: Calcium hydroxide; Group 5: 2% chlorhexidine gel (CHX); and Group 6: saline (negative control). The intra-canal medicaments were packed inside the tooth. After five days, the remaining microbial load was determined by using real-time PCR. Results The threshold cycle (Ct) values of Piper nigrum, Piper longum, dried ginger extract, 2% CHX, calcium hydroxide, and saline were found to be 21.36, 20.55, 22.14, 22.51, 23.62, and 17.81, respectively. The obtained mean bacterial load of these products was 8.64, 12.52, 7.23, 0.82, 0.14, and 149.49, respectively. Conclusion Two percent CHX showed high antibacterial activity against E. faecalis followed by calcium hydroxide, Zingiber officinale Roscoe, Piper nigrum, Piper longum, and saline.
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Affiliation(s)
- Rajeswari Kalaiselvam
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
| | - Karthick Soundararajan
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
| | - Mathan Rajan R
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
| | - Kandaswamy Deivanayagam
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
| | - Chakravarthy Arumugam
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
| | - Arathi Ganesh
- Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, IND
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Bansal S, Tewari S, Tewari S, Sangwan P. The effect of endodontic treatment using different intracanal medicaments on periodontal attachment level in concurrent endodontic-periodontal lesions: A randomized controlled trial. J Conserv Dent 2018; 21:413-418. [PMID: 30122823 PMCID: PMC6080180 DOI: 10.4103/jcd.jcd_337_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: The aim of this study is to evaluate the effect of different intracanal medicaments used during endodontic treatment on periodontal attachment level in concurrent endodontic-periodontal lesions without communication. Materials and Methods: Seventy-five teeth with combined endodontic-periodontal lesions were randomly assigned to 3 groups: Test Group I (calcium hydroxide [Ca(OH)2]), Test Group II (2% chlorhexidine + Ca(OH)2), and control group (no intracanal medicament). Root canal treatment (RCT) was performed using standard methodology. Teeth of test groups were medicated with respective medicaments for 10 days before obturation. Scaling and root planning was done 1 month after completion of RCT in all the groups. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline, 1, 3, and 6 months. Radiographic parameters, including periapical index (PAI) score and alveolar bone level, were measured at baseline and 6 months. Statistical Analysis: Data were analyzed using Friedman test, Kruskal–Wallis, and Wilcoxon signed-rank test. Results: Significant improvement in PD, CAL, %BOP, and PAI score (P < 0.05) was found in all the three groups from baseline to 6 months. However, there was no significant intergroup difference. No significant difference was observed from baseline to 6 months in marginal bone level within the three groups. Conclusion: Endodontic treatment before periodontal therapy results in attachment gain. Intracanal medicaments may not affect the healing of concurrent endodontic-periodontal lesions without communication.
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Affiliation(s)
- Shweta Bansal
- Senior Consultant Endodontist, HS Dental Institute Private Limited, Gurgaon, Haryana, India
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shikha Tewari
- Department of Periodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Pankaj Sangwan
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
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Prabhakaran P, Mariswamy AB. 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. J Conserv Dent 2018; 21:401-407. [PMID: 30122821 PMCID: PMC6080175 DOI: 10.4103/jcd.jcd_373_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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.
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Affiliation(s)
- Pranitha Prabhakaran
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Annapoorna Ballagere Mariswamy
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Tasanarong P, Dechatiwongse Na Ayudhya T, Techanitiswad T, Koontongkaew S. Reduction of viable bacteria in dentinal tubules treated with a novel medicament (Z-Mix). J Dent Sci 2016; 11:419-426. [PMID: 30895007 PMCID: PMC6395269 DOI: 10.1016/j.jds.2016.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 06/12/2016] [Indexed: 11/25/2022] Open
Abstract
Background/purpose The 3Mix-MP formulation (a mixture of metronidazole, ciprofloxacin, and minocycline; macrogol and propylene glycol) has been used to kill residual bacteria in dentin caries. This study aimed to investigate the dentin disinfection and cytotoxicity of a novel zinc oxide (ZnO) based medicament, Z-Mix. Materials and methods Z-Mix was prepared as a prefilled syringe of materials containing mainly ZnO, incorporated with amoxicillin, ciprofloxacin, and metronidazole (1 g% of each antibiotic). Drug penetration was measured at 24 hours and 72 hours. Streptococcus mutans, Lactobacillus acidophilus, or Enterococcus faecalis were inoculated into dentinal tubules for 30 days and were then subjected to Z-Mix or 0.2% chlorhexidine (CHX) for 48 hours. Viable bacteria in the dentin were determined using fluorescence staining. Their cytotoxicity against human dental pulp cells was assessed using an MTT assay. Results Z-Mix obviously diffused into dentinal tubules and the root apex, compared to the 3Mix-MP (P < 0.05). Fluorescence staining demonstrated a reduction of viable bacteria at 100 μm and 500 μm below infected cavities after treatment with Z-mix or CHX for 48 hours. Live and dead bacteria ratios indicated that Z-Mix exhibited markedly antimicrobial effects on inoculated bacteria in dentin samples (P < 0.05). There was no significant difference in the antimicrobial property between Z-Mix and CHX (P > 0.05). An acceptable level of cytotoxicity was observed in Z-Mix and its ingredients. Conclusion Z-Mix, a soft shapeable paste containing a mixture of three antibiotics, is successfully. It can penetrate to the root apex and exhibits antimicrobial properties.
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Affiliation(s)
- Parinda Tasanarong
- Faculty of Dentistry, Thammasat University, Rangsit Campus, Pathum Thani, Thailand
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12
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Venkateshbabu N, Anand S, Abarajithan M, Sheriff SO, Jacob PS, Sonia N. Natural Therapeutic Options in Endodontics - A Review. Open Dent J 2016; 10:214-26. [PMID: 27386007 PMCID: PMC4911752 DOI: 10.2174/1874210601610010214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 01/10/2016] [Accepted: 01/28/2016] [Indexed: 11/22/2022] Open
Abstract
Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer.
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Affiliation(s)
| | - Suresh Anand
- Department of Conservative Dentistry and Endodontics, Penang International Dental College, Penang, Malaysia
| | | | - Sultan O Sheriff
- Department of Restorative Dentistry, International Medical University, Kuala lumpur, Malaysia
| | - Pulikkotil S Jacob
- Department of Restorative Dentistry, International Medical University, Kuala lumpur, Malaysia
| | - Nath Sonia
- Department of Periodontology, Vananchal Dental College, Garhwa, India
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Zhongpeng Y, Ling Z. [Advance in herbal medicine applied to intracanal antisepsis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2014; 32:621-4. [PMID: 25665435 PMCID: PMC7030715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 06/18/2014] [Indexed: 11/14/2023]
Abstract
Intracanal antisepsis acts as one of the fundamental steps in root canal therapy. Intracanal medication is very common among the multitudinous root canal disinfection methods so far. However, as the most frequently-used intracanal medication, calcium hydroxide exists some problems, such as insufficient antimicrobial power and antibiogram. Thus exploring new root canal disinfectant is necessary. Herbal medicine is gaining favor for its wide varieties, broad efficacy and affordable prices. The current researches revealed that many kinds of herbs or compound herbal preparations possess good ability of antimicrobial and other properties that superior to those of traditional root canal disinfectants. However, herbal medicine itself and the studies have shortcomings. This paper will provide a review of various herbal alternatives that are being studied of late years.
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Zhongpeng Y, Ling Z. [Advance in herbal medicine applied to intracanal antisepsis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2014; 32:621-624. [PMID: 25665435 PMCID: PMC7030715 DOI: 10.7518/hxkq.2014.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 06/18/2014] [Indexed: 06/04/2023]
Abstract
Intracanal antisepsis acts as one of the fundamental steps in root canal therapy. Intracanal medication is very common among the multitudinous root canal disinfection methods so far. However, as the most frequently-used intracanal medication, calcium hydroxide exists some problems, such as insufficient antimicrobial power and antibiogram. Thus exploring new root canal disinfectant is necessary. Herbal medicine is gaining favor for its wide varieties, broad efficacy and affordable prices. The current researches revealed that many kinds of herbs or compound herbal preparations possess good ability of antimicrobial and other properties that superior to those of traditional root canal disinfectants. However, herbal medicine itself and the studies have shortcomings. This paper will provide a review of various herbal alternatives that are being studied of late years.
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Yin X, Zhang J, Li X, Liu D, Feng C, Liang R, Zhuang K, Cai C, Xue X, Jing F, Wang X, Wang J, Liu X, Ma H. DADS suppresses human esophageal xenograft tumors through RAF/MEK/ERK and mitochondria-dependent pathways. Int J Mol Sci 2014; 15:12422-41. [PMID: 25026173 PMCID: PMC4139851 DOI: 10.3390/ijms150712422] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 06/22/2014] [Accepted: 07/07/2014] [Indexed: 11/16/2022] Open
Abstract
Diallyl disulfide (DADS) is a natural organosulfur compound isolated from garlic. DADS has various biological properties, including anticancer, antiangiogenic, and antioxidant effects. However, the anticancer mechanisms of DADS in human esophageal carcinoma have not been elucidated, especially in vivo. In this study, MTT assay showed that DADS significantly reduced cell viability in human esophageal carcinoma ECA109 cells, but was relatively less toxic in normal liver cells. The pro-apoptotic effect of DADS on ECA109 cells was detected by Annexin V-FITC/propidium iodide (PI) staining. Flow cytometry analysis showed that DADS promoted apoptosis in a dose-dependent manner and the apoptosis rate could be decreased by caspase-3 inhibitor Ac-DEVD-CHO. Xenograft study in nude mice showed that DADS treatment inhibited the growth of ECA109 tumor in both 20 and 40 mg/kg DADS groups without obvious side effects. DADS inhibited ECA109 tumor proliferation by down-regulating proliferation cell nuclear antigen (PCNA). DADS induced apoptosis by activating a mitochondria-dependent pathway with the executor of caspase-3, increasing p53 level and Bax/Bcl-2 ratio, and downregulating the RAF/MEK/ERK pathway in ECA109 xenograft tumosr. Based on studies in cell culture and animal models, the findings here indicate that DADS is an effective and safe anti-cancer agent for esophageal carcinoma.
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Affiliation(s)
- Xiaoran Yin
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Jun Zhang
- Department of Digestion, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Xiaoning Li
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Dong Liu
- Department of Digestion, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Cheng Feng
- Department of Digestion, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Rongrui Liang
- Department of Oncology, the First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, China.
| | - Kun Zhuang
- Department of Digestion, Xi'an Central Hospital, Xi'an 710003, China.
| | - Chenlei Cai
- Department of Digestion, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Xinghuan Xue
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Fuchun Jing
- Department of Digestive Diseases, Baoji People's Hospital, Baoji 721000, China.
| | - Xijing Wang
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Jun Wang
- Department of Gastroenterology, Xi'an Hospital of Traditional Chinese Medicine, Xi'an 710001, China.
| | - Xinlian Liu
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
| | - Hongbing Ma
- Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
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Pai S, Vivekananda Pai AR, Thomas MS, Bhat V. Effect of calcium hydroxide and triple antibiotic paste as intracanal medicaments on the incidence of inter-appointment flare-up in diabetic patients: An in vivo study. J Conserv Dent 2014; 17:208-11. [PMID: 24944440 PMCID: PMC4056388 DOI: 10.4103/0972-0707.131776] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/12/2014] [Accepted: 02/14/2014] [Indexed: 11/22/2022] Open
Abstract
Aim: To evaluate and compare the effect of antibacterial intracanal medicaments on inter-appointment flare-up in diabetic patients. Materials and Methods: Fifty diabetic patients requiring root canal treatment were assigned into groups I, II, and III. In group I, no intracanal medicament was placed. In groups II and III, calcium hydroxide and triple antibiotic pastes were placed as intracanal medicaments, respectively. Patients were instructed to record their pain on days 1, 2, 3, 7, and 14. Inter-appointment flare-up was evaluated using verbal rating scale (VRS). Results: Overall incidence of inter-appointment flare-up among diabetic patients was found to be 16%. In group I, 50% of the patients and in group II, 15% of the patients developed inter-appointment flare-up. However, no patients in group III developed inter-appointment flare-up. The comparison of these results was found to be statistically significant (P = 0.002; χ2 = 12.426). However, with respect to intergroup comparison, only the difference between groups I and III was found to be statistically significant (P = 0.002; χ2 = 12.00). Conclusions: Calcium hydroxide and triple antibiotic paste are effective for managing inter-appointment flare-ups in diabetic patients. Triple antibiotic paste is more effective than calcium hydroxide in preventing the occurrence of flare-up in diabetic patients.
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Affiliation(s)
- Swathi Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal, Karnataka, India
| | - A R Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Manuel S Thomas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Vishal Bhat
- Department of Pharmacology, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka, India
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