Removal efficacy of propolis/calcium hydroxide medicaments from the root canal.

Muhammad Adeel Ahmed

doi:10.12669/pjms.37.7.4241

Abstract

Objective:To compare the removal efficacy of propolis and calcium hydroxide medicaments from the root canal using manual irrigation with sodium hypochlorite.Methods:A randomized controlled trial was conducted at the Department of Restorative Dentistry and Endodontics, College of Dentistry, King Faisal University for two months. Thirty single-rooted upper or lower permanent anterior teeth with sound root and closed apex were selected. After cleaning and shaping of canal by protaper rotary, teeth were randomly divided into two groups. In group “A,” propolis paste was placed while calcium hydroxide was placed inside root canals in group “B,” followed by temporary restoration. After seven days, intracanal medicament was removed using 25 # K file and irrigated canal by 5 ml of 3.0% sodium hypochlorite. A final irrigation of 2-ml of 17% EDTA for three minutes followed by 1-ml of normal saline was performed. A diamond disc was used to cut the crowns of the teeth from cemento-enamel junction and divide the roots into two halves. These sectioned halves were then observed under a stereomicroscope at 7X magnification and analyzed using Adobe Photoshop. Magnetic lasso tool was used to calculate the percentage of residual medicament in the canals by comparing the pixel proportion of the medicament with the total pixel proportion of the canal. Paired t-test was used to see the difference in the number of remaining remnants between propolis and calcium hydroxide. A p-value of less than 0.5 was considered statistically significant.Results:A statistically significant difference (p-value < 0.001) was observed in the percentage of remaining remnants between propolis (23.22%) and calcium hydroxide (38.58%) after thorough irrigation with sodium hypochlorite.Conclusion:Propolis is superior to calcium hydroxide in terms of their removal potency from the root canal after thorough irrigation with sodium hypochlorite.

Highlights

The success of endodontic treatment relies on proper cleaning and disinfection of the root canal from infectious microorganism.[1]
The results of the current study show statistically significant difference (p-value = 0.001) in the percentage of remaining remnants in the root canal between calcium hydroxide and propolis after thorough irrigation with sodium hypochlorite
The percentage of remaining remnants were calculated by highlighting the total area of the canal and the area covered by intracanal medicament

Summary

Introduction

The success of endodontic treatment relies on proper cleaning and disinfection of the root canal from infectious microorganism.[1]. Propolis is wax-cum-resin substance prepared by honeybees to protect their honey from contamination of microorganism.[4] It has an array of anti-bacterial, anti-oxidant, antiinflammatory properties, which render its use for multiple purposes in dentistry.[4] Numerous studies have recommended the use of propolis as an intracanal medicament due to its effectiveness against E. faecalis.[5,6] The mechanism of action of propolis is based on its effects on membrane permeability and membrane potential of E. faecalis.[6] Propolis was reported to remain unchanged by the buffering capacity of dentin in contrast to calcium hydroxide.[7] Awawdeh et al.[8] and Victorino et al.[9] showed that propolis was more efficient than calcium hydroxide against E. faecalis while Madhubala et al.[10] reported the efficacy of propolis as 100% against E. faecalis following a 7-day application

Methods

Results

Conclusion