Comparative Evaluation of Smear Layer Removal Efficacy of Neem Leaf Extract, Propolis, and Orange Oil when used as Endodontic Irrigants: An in vitro Scanning Electron Microscopic Study

Canal disinfection using Nd: YAG Laser, synchronized microbubble-photodynamic activation, and carbon quantum dots on microhardness, smear layer removal, and extrusion bond strength of zirconia post to canal dentin. An invitro scanning electron microscopic analysis

Evaluation of the impact of the latest root canal disinfectant, that is carbon quantum dots (CQDs), synchronized microbubble-photodynamic activation (SYMPA), and Nd: YAG laser along with ethylenediaminetetraacetic acid (EDTA) as a final irrigant on the Marten hardness (MH), smear layer (SL) removal, and extrusion bond strength (EBS) of zirconia post to the canal dentin. Eighty intact single-rooted premolars were obtained and disinfected using 0.5% chloramine-T solution. Root canal preparation was performed using ProTaper files followed by obturation. The post space was prepared for prefabricated zirconia post and all the teeth were randomly divided into four groups based on the disinfection used (n = 20 each) Group 1: 5.25% NaOCl + 17% EDTA (Control), Group 2: Nd: YAG laser + 17% EDTA, Group 3: SYMPA + 17% EDTA, and Group 4: CQDs + 17% EDTA. MH, SL removal, and EBS of zirconia post-bonded to root dentin were performed using a microhardness tester, scanning electron microscope (SEM), and universal testing machine, respectively. Both intragroup and intergroup comparisons were performed using one-way analysis of variance (ANOVA) and posthoc-Tukey test for significant difference (p < .05). Group 2 samples (Nd: YAG laser + 17% EDTA) (0.24 ± 0.06 GPa) exhibited highest values of MH. Samples in group 3 (SYMPA + 17% EDTA) treated teeth unveiled the lowest MH scores (0.13 ± 0.02 GPa). Moreover, the coronal third of Group 3 specimens (SYMPA and 17% EDTA) (1.54 ± 0.31) eliminated SL from the canal with the greatest efficacy as well as presented the highest EBS (10.13 ± 0.69 MPa). However, the apical third of Group 1 samples (5.25% NaOCl + 17% EDTA) (2.95 ± 0.33) exhibited the least efficient elimination of SL from the radicular dentin as well as the lowest bond strength (5.11 ± 0.19 MPa) of zirconia post to the dentin. The SYMPA technique with 17% EDTA proved highly effective in removing the SL from canal dentin and enhancing the EBS of zirconia posts. The least preferable method for SL removal and MH improvement was found to be 5.25% NaOCl + 17% EDTA. CQDs and Nd: YAG laser demonstrated satisfactory smear layer removal properties from the canal, along with achieving appropriate bond strength of zirconia posts. RESEARCH HIGHLIGHTS: Nd: YAG laser and 17% EDTA as canal disinfectant exhibited the highest values of MH. Specimens irrigated with SYMPA and 17% EDTA eliminated SL from the canal with the greatest efficacy. The coronal third of Group 3 (SYMPA + 17% EDTA) samples unveiled the highest zirconia post-bond integrity score to the canal dentin. Cohesive failure was a dominant failure type among different experimental groups.

Effect of herbal irrigants on surface roughness of intraradicular dentin using quantitative method of 3D surface texture analysis

Replacing the conventional endodontic irrigants with herbal agents could avoid complications associated with using sodium hypochlorite (NaOCl). Endodontic irrigants alter the surface roughness of the dentinal wall surface, which affects sealer mechanical retention. This study aimed to assess the effect of experimental herbal Moringa oleifera and orange peel extract irrigant on intraradicular dentin (IRD) surface roughness using quantitative 3D surface analysis by scanning electron microscopy (SEM) regarding the smear layer assessment. Sixty human root sections were divided into four groups (n = 15): NaOCl combined with 17% ethylenediaminetetraacetic acid (EDTA); negative control (saline); moringa extract (MO); and orange oil (OO). SEM images were assessed quantitatively for surface roughness (Ra) in the coronal, middle, and apical IRD. The data were analysed by Kruskal-Wallis, Friedman, and Dunn's tests. All groups showed statistically significant differences (P = 0.007). MO exhibited significantly greater Ra values at the coronal, middle, and apical root levels than OO (P = 0.007, 0.009, and 0.046, respectively). There was no significant change in Ra values at various root levels within each group at P = 0.091, 0.819, 0.819, and 0.549 for the EDTA, saline, MO, and OO groups. Considerable (IRD) surface roughness analysis makes Moringa extract a promising herbal endodontic irrigant alternative to the NaOCl plus EDTA regimen.

Assessment of Smear Layer Removal and Push-Out Bond Strength Efficacy of Traditional and Herbal Root Canal Irrigants Across Different Root Levels: An In Vitro Study

INTRODUCTION

Endodontic therapy requires meticulous root canal debridement, pathogen elimination, and effective obturation to prevent microbial intrusion. The presence of the smear layer hinders sealer penetration, compromising sealing effectiveness. Sodium hypochlorite and chlorhexidine are esteemed endodontic irrigants. Herbal extracts like neem and tulsi, with antimicrobial and anti-inflammatory properties, show promise for root canal irrigation. The study aimed to evaluate the efficacy of various irrigants in removing the smear layer and enhancing push-out bond strength at different root canal levels.

MATERIALS AND METHODS

One hundred mandibular premolars with single canals were collected, and 50 samples each were used for the smear layer and push-out bond strength analysis. Neem and tulsi extracts were prepared for irrigation. Teeth were decoronated, and up to 30 (6%) canals were prepared and were randomly divided into five groups based on irrigants used. A smear layer examination was conducted after longitudinally sectioning the tooth and sections were observed in a scanning electron microscope (SEM). Obturation was done in the remaining samples, and the push-out bond strength was assessed using a universal test machine.

RESULTS

Sodium hypochlorite showed the highest smear layer removal efficacy followed by chlorhexidine, neem, tulsi leaves with rose water extract, and normal saline. Chlorhexidine exhibited the highest push-out bond strength, with the coronal third presenting the strongest values, followed by neem, tulsi with rose water, normal saline, and sodium hypochlorite.

CONCLUSION

The study underscores the potential of herbal irrigants in endodontic therapy, indicating promising results while emphasizing the necessity for further clinical trials to validate their efficacy and other properties.

Canal disinfection using photo-chemically activated micro-bubble emulsion, Emblica officinalis, and Nd: YAP laser on smear layer and push-out bond strength of resin-based root canal sealer to the radicular dentin

AIMS

Evaluation of the effects of the latest root canal disinfectants i.e., Micro-bubble emulsion (MBE), Neodymium-doped yttrium aluminum perovskite (Nd: YAP), Emblica officinalis (E. officinalis) on the removal of smear layer (SL) and push out bond strength (PBS) of resin-based root canal sealer to the radicular dentin.

METHODS

The coronal portion of sixty single-rooted human mandibular premolar teeth was precisely sectioned at the cementoenamel junction. The canals were prepared to utilize ProTaper universal rotary files till F3. All the study specimens were divided into four groups based on the disinfection regime (n = 15) Group 1: 5.25% NaOCl, Group 2: MBE, Group 3: Nd: YAP laser and Group 4: E. officinalis extract. All the canals were then finally irrigated using 17% EDTA solution as a final disinfecting agent. SL removal assessment was performed on five samples from each group using a scanning electron microscope (SEM). Ten samples from each group were then filled with root canal filling material and the roots were sectioned. Push-out test and failure mode analysis were performed using the universal testing machine (UTM) and stereomicroscope respectively. The mean scores of PBS and SL removal were compared using a one-way analysis of variance (ANOVA) and Post Hoc Tukey's HSD test p = 0.05.

RESULTS

Group-2 (MBE + EDTA) coronal section (1.50 ± 0.23) exhibited the most effective eradication of SL from the canal space. The apical third of Group-1 (NaOCl+EDTA) (2.68 ± 0.82) samples demonstrated the least effective removal of SL from the radicular canal. The maximum score of PBS of AH plus sealer to the canal dentin was exhibited by the coronal section of Group-2 (MBE + EDTA) (9.55 ± 0.45 MPa) samples. However, the apical third of Group-1 (NaOCl+ EDTA) specimens (5.16 ± 0.32 MPa) demonstrated the minimum EBS.

CONCLUSION

MBE+ EDTA displayed better smear layer removal and bond integrity of AH plus sealer to the root canal dentin. Nd: YAP+ EDTA laser and E.officinalis displayed comparable outcomes to that of control NaOCl+ EDTA.