Root Canal Irrigation Research Articles

Can herbal products be alternative root canal irrigation solutions in primary teeth? An in vitro study

To evaluate antimicrobial properties and smear layer removal efficiency of various plant extracts and apple cider vinegar (AV). A total of 112 primary molars roots were randomly divided into two groups (n = 56) for antimicrobial test and infected with E faecalis and Candida albicans then divided again into 7 groups (n = 8) as physiological saline (PS), NaOCI, white tea (WT), Helichrysum arenarium (HA), AV, Citrus lemon (CL), and Anzer thyme (AT). Disinfecting abilities were measured with ImageJ. In the smear layer removal efficiency test, prepared 70 roots were divided into 7 groups (n = 10) as in the antimicrobial test also 2 subgroups were designed as with or without EDTA usage (n = 5). All samples were examined under SEM. Open dentin tubule percentage was evaluated with ImageJ. HA and CL showed higher antibacterial activity against E. faecalis than PS (p = 0.038, p = 0.009) Antifungal activity of AV against C. albicans was higher than saline (p < 0.001). AV in the coronal third and CL in the middle third removed more smear layer than saline and NaOCI (p < 0.05). In the coronal region, HA and AV showed similar smear layer removal efficacy to NaOCl + EDTA (p > 0.05). CL, HA, and AV presented statistically similar results to NaOCl + EDTA in smear layer removal efficacy in the middle region (p > 0.05). CL and AV have antimicrobial efficacy against E. faecalis and C. albicans respectively and smear layer removal activity.

An in vitro scanning electron microscopic study: smear layer removal by chelat activation methods

Background: The process of mechanical root canal preparation creates smear layer. The smear layer can prevent the penetration of intracanal medicaments into dentinal tubules and influence the adaptation of filling materials to canal walls. The purpose of this study is to compare the smear layer removal ability of root canal irrigation methods with chelat solution. Materials and Methods: 45 extracted human premolar roots were selected and randomly divided into 3 groups (n=15) based on root canal irrigation methods with 17% EDTA solution: (1) Conventional needle irrigation, (2) Ultrasonic activation, (3) Sonic activation. The roots were prepared with Reciproc Blue 25 file and was removed smear layer by 3 different methods of irrigation. The study sample was then sectioned longitudinally with a diamond cutting disc, randomly selecting half of the root. After undergoing sample processing, the half roots were observed and evaluated for the presence of smear layer under a scanning electron microscope with a magnification of 1000 times according to Torabinejad (2003). Results: In cervical, the average smear layer score of the 3 study groups was not statistically significant (p&gt;0.05). In the middle, apical and over the root canal, the average smear layer score of the sonic activation method was lower than that of the other 2 groups. Conclusion: Sonic irrigation is more effective in removing smear layer than conventional needle irrigation and ultrasonic irrigation activation. Key words: smear layer, ultrasonic, sonic.

Comparison of vapor bubble kinetics and cleaning efficacy of different root canal irrigation techniques in the apical area beyond the fractured instrument

Background/purposeIntracanal fractured instruments hamper adequate root canal disinfection. The aim of this study was to evaluate vapor bubble kinetics and cleaning efficacy of different irrigation techniques in the apical area beyond the fractured instrument. Materials and methodsSixty curved root canal models, in which a 3-mm fragment of a #20 K-file or a WaveOne Gold Primary (WOG) instrument was intentionally separated at 3 mm from the apical foramen, were irrigated with laser-activated irrigation with photon-induced photoacoustic streaming (LAI-PIPS; 20 mJ/15 Hz), laser-activated irrigation using an Er:YAG laser unit (LAI; 30 mJ/20 Hz), or ultrasonic-activated irrigation (UAI) for 5 s. Vapor bubble velocity and counts were analyzed using high-speed video imaging. To evaluate canal wall cleanliness, 40 canals of extracted human teeth with an intentionally separated 3-mm WOG fragment in the canal at 3 mm from the apical foramen were irrigated with LAI-PIPS, LAI, UAI or conventional syringe irrigation, using 17% EDTA (30 s, two cycles), saline (30 s), and 3% NaOCl (30 s, three cycles) as irrigants. Debris and smear layer on the apical canal wall beyond the fractured instrument were scored using scanning electron microscopy. ResultsLAI-PIPS and LAI demonstrated higher vapor bubble counts than UAI. The WOG fragment permitted higher bubble velocity and count than the K-file fragment. LAI-PIPS and LAI showed better debris and smear removal than the other techniques. ConclusionLAI and LAI-PIPS demonstrated higher vaporized bubble kinetics and better cleaning efficacy in the apical area, even in the presence of a fractured instrument.

The Effect of a Novel Silver-Citrate Root Canal Irrigation Solution (BioAkt), Ethylenediamine Tetraacetic Acid (EDTA), and Citric Acid on the Microhardness of Root Canal Dentin: A Comparative In Vitro Study.

Background and objective The use of a chelating agentas an adjunct to disinfectant irrigation is very necessary to remove the smear layer formed during root canal treatment. However, the decalcifying solutionshave a negative impact on dentin microhardness, which might affectthe result of endodontic therapy. The aim of this study is to evaluate the effect of 17% ethylenediamine tetraacetic acid (EDTA), a novel silver-citrate root canal irrigation solution (BioAkt), 10% citric acid, and 40% citric acid on the microhardness of root canal dentin. Materials and methods Forty-five single-root teeth were distributed equally into five groups A, B, C, D, and Etreated withdistilled water as a control, 17% EDTA, BioAkt, 10% citric acid, and 40% citric acid, respectively. The dentin microhardness was measured before and after the experiment, and the collected data were analyzed using paired sample T-test, One-way ANOVA test, and least significant difference (LSD) test (multiple comparisons), (P < 0.05). Result The results showed that the averages of dentin microhardness values before the experiment were 62.83 kg/mm², 65.34 kg/mm², 64.79 kg/mm², 62.95 kg/mm², and 56.47 kg/mm² for groups A, B, C, D, and E, respectively, while the averages after the experiment were 62.60 kg/mm², 54.92 kg/mm², 54.50 kg/mm², 51.31 kg/mm², and 49.37kg/mm² accordingly. Statistical analysis revealed that17% EDTA, BioAkt, 10% citric acid, and 40% citric acid decreased the dentin microhardness significantlycomparing with the negative control group, without statistical differences among them. Conclusion The chelating agents 17% EDTA, BioAkt, 10% citric acid, and 40% citric acid declined the microhardness of root canal dentin similarly, which might have possible effects on endodontic treatment and the properties of root canal filling materials as well.

COMPARITVE STUDY OF SMEAR LAYER REMOVAL AND ANTIBACTERIAL ACTIVITY OF SILVER, CHITOSAN NANOPARTICLES AND SODIUM HYPOCHLORITE AGAINST ENTEROFECALIS WHEN USED AS ROOT CANAL IRRIGANTS- IN VITRO STUDY

Background: As a very resistant microorganism in infected root canals, Enterococcus faecalis (E. faecalis) can stubbornly survive lethal challenges and invade dentinal tubules, making it the most persistent pathogen in root canal treatment. Enterococcus faecalis (E. faecalis) is the most commonly encountered microorganism detected in persistent root canal infections. These bacteria possess certain virulence factors, invade dentinal tubules and resist nutritional deprivation. Proper irrigation is an essential step for success in root canal therapies which is achieved by using excellent endodontic irrigants. Aim: To evaluate the antimicrobial efficacy of Sodium Hypochlorite (NaOCl), Silver Diamine Fluoride (SDF), Chitosan Nanoparticles (CNPs) root canal irrigants against the bacterial strain of Enterococcus Faecalis (E. faecalis) using agar well diffusion method. Materials and Methods: In this in-vitro study, the test materials were manipulated in accordance with the manufacturer’s instructions. The antimicrobial properties of root canal irrigants were evaluated by using agar diffusion method using bacterial strain of Enterococcus faecalis (ATCC 29212). 0.25 mL of each irrigant was placed on to 6.5 mm diameter blotting papers which were placed in 7 mm diameter wells on the Mueller Hinton agar plates. Later, E. faecalis strains were inoculated with sterile cotton swab on to the agar plates. Results: The p-value Sodium Hypochlorite showed the greatest zone of inhibition followed by SDF and Chitosan Nanoparticles respectively (p Sodium Hypochlorite showed the greatest zone of inhibition followed by SDF, Bioactive Glass Nanoparticles and Chitosan Nanoparticles respectively. Conclusion: Sodium Hypochlorite was the most effective root canal irrigant followed by SDF ,whereas Chitosan Nanoparticles was the least efficacious compared to the rest against Enterococcus Faecalis.

Knowledge, attitude, and practice of ultrasonics in endodontic treatment: A Survey among general practitioners and endodontists.

The use of ultrasonics (US) has greatly expanded in the field of dentistry. Over the past few decades, the application of US has increased substantially in endodontics owing to the predictable prognosis and ease of operation. The objective of this survey was to determine the knowledge, practice, and attitude of US in endodontics among the general practitioners, postgraduates, and endodontists. An electronic questionnaire containing 16 questions regarding the knowledge, attitude, and practice of US in endodontics was circulated among the general dentists, postgraduates, and endodontists and the responses were collected online. Data were statistically examined using IBM SPSS software. A total of 202 dentists (general dentists = 92, endodontists = 77, and postgraduates = 33) participated in the survey. Eighty-nine percent of them were aware of the use of US in endodontics, 36.1% of them preferred using US in the removal of pulp chamber calcifications, pulp stones, access refinement, and troughing hidden canals, and 61.4% chose <3% sodium hypochlorite for root canal irrigation with US. The cost of the ultrasonic unit and heat generation during procedures were considered the greatest limitation in using the US. The majority of the dentists were well aware of the use of US and its advantages in various endodontic procedures but they did not use it routinely in their practice. The use of US has been reported to have greatly increased the predictability of endodontic treatment.

Role of Herbs in Endodontics: An Update

Treatment involving Endodontics and root canal therapy comprises of extirpation of infected pulpal tissue along with a variety of microbial organisms from root canal spaces for prevention of any increase in infection of peri- radicular soft tissues while at the same time allowing the healing of surrounding tissues. Performing root canal therapy includes the usage of different chemical-based irrigating medications for disinfecting root canal or endodontic space. The most commonly used chemical irrigating agents are sodium hypochlorite, chlorhexidine, or EDTA. Irrigation is a repeatedly used process that is performed for reducing the total bacterial count within any root canal(s). To accomplish good irrigation, large assortments of irrigating medications are commercially available as of this day. However, these agents or drugs may prove to be toxic, have various safety concerns, and may exhibit various side effects. Due to this reason, different alternatives of herbal derivation are used as endodontic or root canal irrigants as these have distinctly high safety profiles and are less cytotoxic. Herbal irrigating products are largely popular as a result of ease of availability, greater cost-effectiveness, and increase in shelf life as well as low degree of toxicity. In recent years, an increase in the trend for seeking natural-based remedies in all types of treatment protocols in dentistry is being explored. This branch of herbal medications is known as ‘ethnopharmacology’ or ‘phytotherapy’. Hence, the current review paper aims at an overview of various plant-derived endodontic irrigating agents along with their effectiveness in irrigating root canals during endodontic therapy.

Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis.

Accumulated hard tissue debris (AHTD) is an inevitable by-product during endodontic treatment and is difficult to remove completely using traditional syringe and needle irrigation (SNI). Adjunctive irrigation is proposed to assist the clean-up of AHTD. This systematic review and meta-analysis aimed to evaluate the AHTD removal efficacy of different root canal irrigation devices using micro-computed tomography (Micro-CT). A literature search was carried out within the main scientific databases until 20 June 2022. All results were screened with detailed eligibility criteria. Eleven studies were included for analysis. SNI, passive ultrasonic irrigation (PUI), negative pressure systems, sonically activated irrigation (SAI), mechanical-activated system and laser-activated irrigation (LAI) were assessed. PUI is superior to SNI for debris removal and LAI has better AHTD removal performance than PUI. The negative pressure system and mechanical-activated system were proved to be less effective. Registration: PROSPERO (CRD42021273892).

Effect of Calendula officinalis Linn in Oral health- A Review

Calendula officinalis L., a member of the Asteraceae family, is often known as English Marigold or Pot Marigold. Marigold is an annual or perennial herb traditionally used to treat wounds, ulcers, herpes, scars, skin damage, frostbite, and blood purification. It is mainly used to treat disorders as an anti-diabetic, anti-ulcer, anti-inflammatory, and analgesic activity because of its numerous biological properties. This plant has a high concentration of medicinally active substances such as carotenoids, flavonoids, glycosides, steroids and sterols, quinines, volatile oil, and amino acids. The plant extract, as well as the pure compound derived from it, has been shown to have a variety of pharmacological properties, including anti-cytotoxic, hepatoprotective, and spasmolytic effects, among others. It is used to treat oral mucositis, angular cheilitis, periodontal bone loss, leukoplakia and also used as a root canal irrigant, intracanal medicament, and anti-plaque agent in dentistry. It also helps to heal and manage microbial plaque in gingivitis and periodontitis, boosting immunity. The most significant obstacle and concern is the lack of knowledge regarding the effects of C.officinalis on oral tissues, their mechanisms of action, and their adverse effects. Hence, this review has explored the various medicinal properties of C.officinalis useful in the multiple fields of dentistry.

Antimicrobial Peptides Active in In Vitro Models of Endodontic Bacterial Infections Modulate Inflammation in Human Cardiac Fibroblasts.

Endodontic and periodontal disease are conditions of infectious origin that can lead to tooth loss or develop into systemic hyperinflammation, which may be associated with a wide variety of diseases, including cardiovascular. Endodontic and periodontal treatment often relies on antibiotics. Since new antimicrobial resistances are a major threat, the use of standard antibiotics is not recommended when the infection is only local. Antimicrobial peptides were recently demonstrated to be valid alternatives for dental treatments. The antimicrobial peptide M33D is a tetrabranched peptide active against Gram-negative and Gram-positive bacteria. It has a long life, unusual for peptides, because its branched form provides resistance to proteases. Here the efficacy of M33D and of its analog M33i/l as antibiotics for local use in dentistry was evaluated. M33D and M33i/l were active against reference strains and multidrug-resistant clinical isolates of Gram-negative and Gram-positive species. Their minimum inhibitory concentration against different strains of dental interest was between 0.4 and 6.0 μM. Both peptides acted rapidly on bacteria, impairing membrane function. They also disrupted biofilm effectively. Disinfection of the root canal is crucial for endodontic treatments. M33D and M33i/l reduced E. faecalis colonies to one-twentieth in a dentin slices model reproducing root canal irrigation. They both captured and neutralized lipopolysaccharide (LPS), a bacterial toxin responsible for inflammation. The release of IL-1β and TNFα by LPS-stimulated murine macrophages was reduced by both peptides. Human cardiac fibroblasts respond to different insults with the release of proinflammatory cytokines, and consequently, they are considered directly involved in atherogenic cardiovascular processes, including those triggered by infections. The presence of M33D and M33i/l at MIC concentration reduced IL6 release from LPS- stimulated human cardiac fibroblasts, hence proving to be promising in preventing bacteria-induced atherogenesis. The two peptides showed low toxicity to mammalian cells, with an EC50 one order of magnitude higher than the average MIC and low hemolytic activity. The development of antimicrobial peptides for dental irrigations and medication is a very promising new field of research that will provide tools to fight dental infections and their severe consequences, while at the same time protecting standard antibiotics from new outbreaks of antimicrobial resistance.

Comparison Of An Experimental Root Canal Irrigant (Sapindus Mukorossi) And Ethylenediaminetetraacetic Acid On Microhardness Of Human Dentin.

The treatment of infected root canals is one of the most essential areas in dentistry. The endodontic therapy comprises of a sequence of steps that includes the purging of disease and infectious tissues from the root canal system. The objective of the study is to compare the effect of an experimental herbal root canal irrigant (Sapindus mukorossi) and Ethylenediaminetetraacetic acid, on the micro hardness of human dentin. Ninety single rooted teeth were collected displayed intact external morphology the selected teeth were than divided randomly into 3 groups (n=30); 1 control and 2 experimental groups: Group A consisted of specimen treated with Ethanolic extract of Sapindus mukorossi. Group B consisted of specimen treated with 17% Ethylenediaminetetraacetic acid and Group C (control group) consisted of specimen of roots were sectioned immersed in distilled water. After the removal of crowns, the roots were sectioned embedded in the polymer resin leaving the root dentine exposed, the micro hardness was determined. Then, the samples from each group were treated with respective irrigant solution for 15 minutes and then observation regarding the micro hardness were noted again by using Vickers micro hardness tester. Analysis of data were obtained by application of Wilcoxon signed rank test. The study revealed that there was no significant difference noted in dentin microhardness of group "A" sample after dipping in experimental irrigant solution (Sapindus mukorossi). However, the study found significant difference in context of decrease in dentin microhardness after dipping a sample in a group "B" irrigant solution (17% Ethylenediaminetetraacetic acid). In order to preserve the strength of dentin that will ultimately be beneficial for increase in survival of teeth in function, probably the herbal extract of Sapindus mukorossi would be better candidate for future endeavour and presented as an economic and effective alternative amongst root canal irrigants.

Enterococcus faecalis rnc gene modulates its susceptibility to disinfection agents: a novel approach against biofilm

BackgroundEnterococcus faecalis (E. faecalis) plays an important role in the failure of root canal treatment and refractory periapical periodontitis. As an important virulence factor of E. faecalis, extracellular polysaccharide (EPS) serves as a matrix to wrap bacteria and form biofilms. The homologous rnc gene, encoding Ribonuclease III, has been reported as a regulator of EPS synthesis. In order to develop novel anti-biofilm targets, we investigated the effects of the rnc gene on the biological characteristics of E. faecalis, and compared the biofilm tolerance towards the typical root canal irrigation agents and traditional Chinese medicine fluid Pudilan.MethodsE. faecalis rnc gene overexpression (rnc+) and low-expression (rnc−) strains were constructed. The growth curves of E. faecalis ATCC29212, rnc+, and rnc− strains were obtained to study the regulatory effect of the rnc gene on E. faecalis. Scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and crystal violet staining assays were performed to evaluate the morphology and composition of E. faecalis biofilms. Furthermore, the wild-type and mutant biofilms were treated with 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and Pudilan. The residual viabilities of E. faecalis biofilms were evaluated using crystal violet staining and colony counting assays.ResultsThe results demonstrated that the rnc gene could promote bacterial growth and EPS synthesis, causing the EPS-barren biofilm morphology and low EPS/bacteria ratio. Both the rnc+ and rnc− biofilms showed increased susceptibility to the root canal irrigation agents. The 5% NaOCl group showed the highest biofilm removing effect followed by Pudilan and 2% CHX. The colony counting results showed almost complete removal of bacteria in the 5% NaOCl, 2% CHX, and Chinese medicine agents’ groups.ConclusionsThis study concluded that the rnc gene could positively regulate bacterial proliferation, EPS synthesis, and biofilm formation in E. faecalis. The rnc mutation caused an increase in the disinfectant sensitivity of biofilm, indicating a potential anti-biofilm target. In addition, Pudilan exhibited an excellent ability to remove E. faecalis biofilm.

Root canal irrigation system using remotely generated high-power ultrasound

Root canal treatment is performed to remove the bacteria proliferating in the root canals of a tooth. Many conventional root canal irrigation methods use an instrument inserted into the root canals. However, bacteria removal is often incomplete in the apical region of the root canal, and the treatment carries clinical risks, such as instrument fracture and extrusion of irrigation liquid through the canal apex. We here suggest a novel, remotely generated high-intensity ultrasound irrigation system that exhibits better irrigation performance and a reduced clinical risk. Our device employs powerful ultrasonic waves generated by a transducer placed outside a target tooth. The generated ultrasonic waves are guided to travel into the root canals. In the root canals of the target tooth, acoustic cavitation occurs, and vapor bubbles are created. The dynamic motions of vapor bubbles create remarkable cleaning effects. Using root canal models, we tested the cleaning performance of the proposed system and compared it with other conventional irrigation methods. The results revealed that biofilm in the apical region of the root canal models can be removed exclusively using the proposed system, thus demonstrating an improvement in cleaning performance. We also measured pressure at the apex of the root canals of an extracted tooth while operating the proposed system. Our system exhibited a smaller pressure compared to the syringe irrigation method, thus suggesting a reduced risk of apical extrusion of the irrigation liquid. Since the proposed system operates without inserting instruments into the root canal, it can clean multiple root canals in a tooth simultaneously with a single treatment. The proposed device would be a breakthrough in root canal treatment in terms of irrigation performance, clinical safety, and ease of treatment.

Comparative Study Assessing the Canal Cleanliness Using Automated Device and Conventional Syringe Needle for Root Canal Irrigation-An Ex-Vivo Study.

The success of endodontic treatment relies on both apical and coronal sealing. To achieve a good three-dimensional seal, the removal of the smear layer becomes mandatory. This study aims to assess the difference in debris accumulation and smear layer formation while using automated root canal irrigation and conventional syringe needle irrigation. Single-rooted human mandibular premolar teeth (n = 30) which were indicated for orthodontic extractions were selected. An endodontic access cavity was prepared, and a glide path was created. Based on the irrigation protocol decided upon for the study, the teeth were randomly allocated into three study groups, namely Group 1, where the manual syringe needle irrigation method was adopted; Group 2, in which automated root canal irrigation was undertaken; and Group 3, in which teeth remained un-instrumented as it was considered the Control group. The teeth were decoronated at the cement-enamel junction (CEJ) and were subjected for scanning electron microscopy (SEM) examination. Debris and smear layers were viewed in 1000× magnification and scored. A statistically significant (p < 0.05) lower mean debris and smear layer score (p < 0.05) was observed in both study groups when compared with the control group. However, no significant difference (p > 0.05) in the debris and smear layer was observed between the manual syringe needle irrigation and automated irrigation, although automated irrigation devices can be a potential alternative. The present study concluded that the efficacy of smear layer removal remained the same with both automated irrigation and manual syringe irrigation.

Confocal Laser Microscopic Evaluation of the Efficiency of Strawberry Extract as root canal irrigation with Different Activation Techniques on E- Faecalis Biofilm Eradication. (An In-Vitro Study)

Confocal Laser Microscopic Evaluation of the Efficiency of Strawberry Extract as root canal irrigation with Different Activation Techniques on E- Faecalis Biofilm Eradication. (An In-Vitro Study)

Farklı Tiplerdeki Kök Kanal Yıkama Solüsyonlarının İnsan Osteoblastik Hücre Canlılığı Üzerine Etkileri

ABSTRACT&#x0D; Objective: Root canal irrigation is very important for successful root canal treatment. During this procedure, root dentin and periapical tissues are in contact with irrigation solutions. These solutions should ideally remove pulpal tissues without damaging the oral tissues. The aim of this study was to evaluate the effects of 7 different irrigation solutions (Rocanal, BioPure MTAD, SmearClear, chlorhexidine gluconate, EDTA, hydrogen peroxide, NaOCl) on the viability of human osteoblastic cell lines (SaOS-2).&#x0D; Methods: The tested solutions were diluted with culture medium and prepared in 6 different concentrations (1:2, 1:4, 1:8, 1:16, and 1:32). SaOS-2 cells were exposed to all concentrations of irrigation solutions, respectively (n = 12). Cell culture medium without test material was used as a control group. Cell viability was evaluated with the MTT cytotoxicity test. The cell viability of the control group was equal to 100%, and the data were statistically evaluated by One-way ANOVA and post-hoc Tukey's HSD tests.&#x0D; Results: All tested solutions had cytotoxic effects on SaOS-2 cells at all concentrations (P &lt; 0.05). There was difference in percentage between the cell viability values of the materials (P

Antimicrobial Efficacy of Different Root Canal Irrigants in Primary Teeth: Clinical Study

Antimicrobial Efficacy of Different Root Canal Irrigants in Primary Teeth: Clinical Study

Effect of Chloroform Application on Roughness and Wettability of the Root Canal Walls in Endodontic Retreatment.

The success of root canal therapy depends on root canal irrigation, disinfection, and sealing of root canal. Wettability and roughness of root dentine surface are important factors in root canal disinfection and sealing. This study aimed to assess the effect of chloroform application on roughness and wettability of the root canal walls in endodontic retreatment. This in vitro experimental study evaluated 70 sound extracted human anterior teeth. The specimens were then randomly assigned to 7 groups as follows: Chloroform (group 1), 1g gutta percha+chloroform (group 2), 2g gutta percha+ chloroform (group 3), 1g gutta percha+ 1g sealer+ chloroform (group 4), 2g gutta perch+ 2g sealer+chloroform (group 5), 1g sealer + chloroform (group 6) and 2g sealer + chloroform (group 7). One drop of distilled water was placed on each tooth to measure the contact angle and wettability. Photographs were obtained of an area measuring 50×50 µm2 in three directions under an atomic force microscope to measure the roughness. The tooth blocks were exposed to the abovementioned mixtures for 10 min, and then rinsed with saline. The roughness and wettability of each sample were measured before and after treatment. Data was analyzed using one-way ANOVA and Tukey's test. The roughness of all groups significantly decreased following treatment, except for groups 1 and 4. The contact angle increased in all groups after treatment (except for the chloroform group), which indicated decreased wettability. The roughness and the contact angle have shown no correlation. Application of chloroform for removal of gutta-percha and sealer in endodontic retreatment decreases the roughness and wettability of dentine.

Inhibition of green okra (Abelmoschus esculentus) extract against Enterococcus faecalis in tooth root canals

Enterococcus faecalis is a bacterium that is often found in root canals of teeth and can survive in them even after treatment. The use of 2.5% NaOCl as a root canal irrigation material has disadvantages; toxic and irritating, so other alternatives are needed. Green okra extract contains flavonoids, alkaloids, saponins, tannins, and terpenoids which have antibacterial properties. This study aims to determine the inhibition of green okra extract against E.faecalis. It was doneexperimental laboratory research with a posttest-only control group design. The inhibition test used the disc diffusion method which consisted of 5 research groups,i.e. green okra extract with concentrations of 1.563%, 3.125%, 6.25%, 12.5%, and 2.5% NaOCl. Data were analyzed using non-pa-rametric statistical testsKruskal Wallis and Mann Whitney. The average of the inhibition zone diameter of the green okra extract concentrations were 1.563% (0 mm), 3.125% (0 mm), 6.25% (15.9 mm), 12.5% (18.03 mm), and 2.5% NaOCl (24.07 mm). The Kruskal Wallis test showed a significance value of 0.000 (p&lt;0.05) which meant that there was a difference in the research group, followed by the Mann Whitney test which showed there were significant differences between all research groups except between green okra extract concentrations of 1.563% and 3.125%. It was concluded that green okra extract had an inhibitory effect on the growth of E.faecalis at concentrations of 6.25% and 12.5%.

Comparative Evaluation of the Antibacterial Efficacy of Chlorhexidine and 810 nm Diode Laser in the Disinfection of Root Canals Contaminated With Enterococcus faecalis: An In Vitro Study.

Introduction: This study compared the antibacterial efficacy of three different root canal irrigants, sodium hypochlorite, chlorhexidine and 810 nm diode laser and diode laser in combination with chlorhexidine in root canals contaminated with Enterococcus faecalis.Methods: Fifty extracted mandibular first premolars were decoronated at the cementoenamel junction and cut at the apical end; biomechanical preparation was done, autoclaved and contaminated with Enterococcus faecalis. The specimens were divided into five groups containing 10 teeth each: group I: saline (negative control), group II: 2.5% sodium hypochlorite, group III: 2% chlorhexidine gluconate solution, group IV: diode laser, and group V: diode laser in combination with 2% chlorhexidine. Disinfection was carried out, after which dentinal shavings were collected from the specimens of each group. Antimicrobial efficacy was tested by counting the colony-forming units of viable Enterococcus faecalis on the agar plates. One-way ANOVA and Scheffe’s post hoc test were done to analyse the results.Results: Diode laser with chlorhexidine group showed minimum colony-forming units followed by the diode laser group. The post hoc test showed a statistically significant difference between saline, 2.5% sodium hypochlorite and 2% chlorhexidine groups (P = 0.001) and a non-significant difference between diode laser and diode laser with chlorhexidine group (P = 0.997).Conclusions: Diode laser can be used as a root canal disinfectant alone or in combination with chlorhexidine.