Comparative Evaluation of Microhardness, Smear Layer Removal Efficacy and Depth of Penetration Using Punica granatum, Emblica officinalis and Sodium Hypochlorite As Endodontic Irrigants: An In Vitro Study.

Abstract

Introduction Root canal morphology tends to be complicated by natureand dealing with this intricacy can be challenging because it makes it difficult to completely disinfect the root canal space.The success of root canal therapy is also determined by the biomechanical preparation of the canal with the application of instruments and irrigating solutions.Due to the fact that the root dentin surface continues to interact with the irrigating solution during preparation, it's critical to evaluate the mechanical characteristics and smear layer removal. Though sodium hypochlorite (NaOCl) is the most commonly used irrigant due to its tissue-dissolving abilities, it has certain drawbacks which include the inability to remove the smear layer and also affects the mechanical properties of root dentin. To overcome these limitations, a variety of herbal substitutes likePunica granatumand Emblica officinaliswhich possess anti-bacterial and anti-fungal properties can be used as endodontic irrigants.Several studies on the anti-bacterial properties of natural irrigants of pomegranateand amla were reported. However, the mechanical properties and smear layer removal of Punica granatum and Emblica officinalis have not been explored in the field of endodontics. Aim The main aim of this in vitro study is to compare and evaluate microhardness, smear layer removal efficacy and depth of penetration of herbal and conventional irrigants. Materials and methods Thirty-six palatal roots of maxillary molars were decoronated and instrumented up to F3. These roots were sectioned longitudinally and divided into three test groups: Group 1: 12.5% Punica granatum;Group 2: 6.25% Emblica officinalis; control: Group 3: 2.5% NaOCl. All specimens were irrigated with 5ml of each irrigant for 5 minutes. Microhardness of root dentin was measured using a Vickers diamond intender, smear layer removal using a scanning electron microscope (SEM) and depth of penetration using a stereomicroscope. The data was analyzed using one-way ANOVAand the inter-group comparison using Tukey's post hoc test. Results Statistical analysis was done using one-way analysis of variance (ANOVA) and Tukey's post hoc test using SPSSsoftware version 17.0 (SPSS Inc., Chicago ). The highest microhardness was seen in Group 1(cervical: 53.8375±1.35956, middle: 53.9875±1.01761, apical: 53.6875± 1.63133)while Group 2(cervical: 43.2750±1.73596, middle: 43.3125±1.17648, apical: 43.8000± ​​​​​​​1.32665) and Group 3 (cervical: 42.7250±​​​​​​​2.93391, middle: 41.9625±​​​​​​​1.66985, apical: 42.0250±​​​​​​​2.21085) showed significant reduction in root dentin hardness. Regardingsmear layer removalGroup 1 (1.3750±​​​​​​​0.51755), and Group 2 (1.2500±​​​​​​​0.46291) reveals greater smear removal in the middle third of the root dentin compared with Group 3 (2.3750±​​​​​​​0.51755), which showed the least smear layer removal. A greater depth of penetration was seen in Group 1 (0.5488± 0.05222) and Group 2 (0.5263±​​​​​​​0.05181)than in Group 3 (0.3087±​​​​​​​0.05743). Conclusion The present study reveals that the least reduction of microhardness was seen in Punica granatum followed by Emblica officinalis and NaOCl. The smear layer removal efficacy and depth of penetration were greater in Punica granatum and Emblica officinalis than in NaOCl. It was concluded that as these herbal irrigants are biocompatible agents, they can be considered for future use in root canal treatment.