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.

Abstract

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. 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. 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. 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.