Effects of phytochemical extracts on smear layer removal in root canal treatment
Keywords:
Endodontics, Natural products, Phytotherapy, Root Canal Irrigants.Abstract
Introduction: Studies suggested that phytochemical products are considered potential solutions to smear layer removal due to their biological safety in cleaning root canal systems, lower toxicity, lower irritant effect and antimicrobial effect.
Objective: The aim of the present study was to perform a systematic review to evaluate smear layer removal of root canal systems by different natural product solutions.
Methods: systematic review. Search of the literature was performed on Pubmed, Scopus, Cochrane, Web of Science, Scielo and Google Scholar according the PRISMA protocol. Studies were included if they performed the experiments of smear layer removal on extracted permanent human teeth. Articles published in any language without restriction of year of publication were included in this review. The risk of bias assessment in the included studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. The search strategy resulted in the retrieval of 6221 publications. After the eligibility criteria application, 8 articles were selected for analysis.
Results: It was observed that some natural products solutions showed effects on smear layer removal, especially on coronal third. The phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract demonstrated good potential of smear layer removal, however, its effectiveness and clinical applicability are still unclear.
Conclusions: Although the limitations of this study, it is possible to highlight those phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract that demonstrated good potential on SL removal.
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References
Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Investig. 2018 Mar;22(2):655-70. doi: 10.1007/s00784-018-2345-x
1007/s00784-018-2345-x [pii].
Haapasalo M, Qian W, Shen Y. Irrigation: beyond the smear layer. Endodontic Topics. 2012;27(1):35-53. doi: 10.1111/etp.12030.
Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. Journal of endodontics. 1983;9(4):137-42. doi: 10.1016/S0099-2399(83)80032-6.
Violich DR, Chandler NP. The smear layer in endodontics – a review. International Endodontic Journal. [Article]. 2010 01//;43(1):2-15. doi: 10.1111/j.1365-2591.2009.01627.x.
Vivacqua‐Gomes N, Ferraz CCR, Gomes BPFA, Zaia AA, Teixeira FB, Souza‐Filho FJ. Influence of irrigants on the coronal microleakage of laterally condensed gutta‐percha root fillings. International Endodontic Journal. 2002;35(9):791-5. doi: 10.1046/j.1365-2591.2002.00569.x.
Ok E, Adanir N, Ozturk T. Antibacterial and smear layer removal capability of oregano extract solution. European journal of dentistry. 2015 Jan-Mar;9(1):20-4. doi: 10.4103/1305-7456.149633.
Candeiro GTdM, Matos IBd, Costa CFED, Fonteles CSR, Vale MSD. A comparative scanning electron microscopy evaluation of smear layer removal with apple vinegar and sodium hypochlorite associated with EDTA. Journal of Applied Oral Science. 2011;19(6):639-43. doi: 10.1590/S1678-77572011000600016.
Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, et al. A New Solution for the Removal of the Smear Layer. Journal of endodontics. 2003 2003/03/01/;29(3):170-5. doi: https://doi.org/10.1097/00004770-200303000-00002.
Qian W, Shen Y, Haapasalo M. Quantitative Analysis of the Effect of Irrigant Solution Sequences on Dentin Erosion. Journal of endodontics. 2011 2011/10/01/;37(10):1437-41. doi: https://doi.org/10.1016/j.joen.2011.06.005.
Saghiri MA, García-Godoy F, Asgar K, Lotfi M. The effect of Morinda Citrifolia juice as an endodontic irrigant on smear layer and microhardness of root canal dentin. Oral Science International. 2013 2013/05/01/;10(2):53-7. doi: https://doi.org/10.1016/S1348-8643(12)00073-0.
Malheiros CF, Marques MM, Gavini G. In vitro evaluation of the cytotoxic effects of acid solutions used as canal irrigants. Journal of endodontics. 2005 Oct;31(10):746-8. doi: 10.1097/01.don.0000157994.49432.67.
Marins JS, Sassone LM, Fidel SR, Ribeiro DA. In vitro genotoxicity and cytotoxicity in murine fibroblasts exposed to EDTA, NaOCl, MTAD and citric acid. Braz Dent J. 2012;23(5):527-33. doi: 10.1590/s0103-64402012000500010.
Margono A, Angelina AN, Suprastiwi E. The effect of grape seed extraction irrigation solution towards cleanliness the smear layer on apical third of the root canal wall. Journal of International Dental and Medical Research. 2017;10(2):244-7.
Dadalioǧlu I, Evrendilek GA. Chemical Compositions and Antibacterial Effects of Essential Oils of Turkish Oregano (Origanum minutiflorum), Bay Laurel (Laurus nobilis), Spanish Lavender (Lavandula stoechas L.), and Fennel (Foeniculum vulgare) on Common Foodborne Pathogens. Journal of Agricultural and Food Chemistry. 2004 2004/12/01;52(26):8255-60. doi: 10.1021/jf049033e.
Baydar H, Sağdiç O, Özkan G, Karadoğan T. Antibacterial activity and composition of essential oils from Origanum, Thymbra and Satureja species with commercial importance in Turkey. Food Control. 2004 2004/04/01/;15(3):169-72. doi: https://doi.org/10.1016/S0956-7135(03)00028-8.
Al-Sabawi N, K. Al Sheikh Abdal A-K, Taha M. The antimicrobial activity of salvadora persica solution (MISWAK-SIWAK) as root canal irrigant (A comparative study). Univ Sharjah J Pure Appl Sci. 2007;4(3):69-91.
Babaji P, Jagtap K, Lau H, Bansal N, Thajuraj S, Sondhi P. Comparative evaluation of antimicrobial effect of herbal root canal irrigants (Morinda citrifolia, Azadirachta indica, Aloe vera) with sodium hypochlorite: An in vitro study. Journal of International Society of Preventive & Community Dentistry. 2016;6(3):196-9. doi: 10.4103/2231-0762.183104.
Shingare P, Chaugule V. Comparative evaluation of antimicrobial activity of miswak, propolis, sodium hypochlorite and saline as root canal irrigants by microbial culturing and quantification in chronically exposed primary teeth. Germs. [Report]. 2011;1:12-21.
Ali SA, Hussain M, Shah H, Khan H. Smear layer removal efficacy of conventional endodontic irrigants v/s phytochemical extracts-an in vitro study. Pakistan Oral & Dental Journal. 2018;38(2):254-8.
Hammer KA, Dry L, Johnson M, Michalak EM, Carson CF, Riley TV. Susceptibility of oral bacteria to Melaleuca alternifolia (tea tree) oil in vitro. Oral Microbiology and Immunology. 2003;18(6):389-92. doi: 10.1046/j.0902-0055.2003.00105.x.
Lima IFP, Vieira WdA, Bernardino ÍdM, Costa PA, Lima APB, Pithon MM, et al. Influence of reminder therapy for controlling bacterial plaque in patients undergoing orthodontic treatment: A systematic review and meta-analysis. Angle Orthodontist. [Systematic Review Article]. 2018;88(4):483-93. doi: 10.2319/111117-770.1.
Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer’s Manual: The Joanna Briggs Institute; 2018.
Sadr Lahijani MS, Raoof Kateb HR, Heady R, Yazdani D. The effect of German chamomile ( Marticaria recutita L.) extract and tea tree ( Melaleuca alternifolia L.) oil used as irrigants on removal of smear layer: a scanning electron microscopy study. International Endodontic Journal. 2006;39(3):190-5. doi: 10.1111/j.1365-2591.2006.01073.x.
Murray PE, Farber RM, Namerow KN, Kuttler S, Garcia-Godoy F. Evaluation of Morinda citrifolia as an endodontic irrigant. Journal of endodontics. 2008 Jan;34(1):66-70. doi: 10.1016/j.joen.2007.09.016.
Balto H, Ghandourah B, Al-Sulaiman H. The efficacy of Salvadora persica extract in the elimination of the intracanal smear layer: A SEM study. The Saudi dental journal. 2012 Apr;24(2):71-7. doi: 10.1016/j.sdentj.2012.01.002.
Bolhari B, Sharifian MR, Aminsobhani M, Monsef Esfehani HR, Tavakolian P. Assessing the efficacy of citrus aurantifolia extract on smear layer removal with scanning electron microscope. Iranian endodontic journal. 2012;7(2):88-97. doi: 10.22037/iej.v7i2.2533.
Chhabra N, Gyanani H, Kamatagi L. Smear layer removal efficacy of combination of herbal extracts in two different ratios either alone or supplemented with sonic agitation: An in vitro scanning electron microscope study. Journal of Conservative Dentistry. 2015;18(5):374-9. doi: 10.4103/0972-0707.164035.
Davoudi A, Razavi SA, Mosaddeghmehrjardi MH, Tabrizizadeh M. The Effect of Fragaria vesca Extract on Smear Layer Removal: A Scanning Electron Microscopic Evaluation. Iranian endodontic journal. 2015;10(3):204-7. doi: 10.7508/iej.2015.03.012.
Hülsmann M, Heckendorff M, Schäfers F. Comparative in‐vitro evaluation of three chelator pastes. International Endodontic Journal. 2002;35(8):668-79. doi: 10.1046/j.1365-2591.2002.00543.x.
Madison JG, Hokett SD. The effects of different tetracyclines on the root surface of instrumented, periodontically involved human teeth: a comparative scanning electron study. Journal of Periodontology. 1997;68:739-45.
Schäfer E, Lohmann D. Efficiency of rotary nickel–titanium FlexMaster instruments compared with stainless steel hand K‐Flexofile−Part 2. Cleaning effectiveness and instrumentation results in severely curved root canals of extracted teeth. International Endodontic Journal. 2002 2002/06/01;35(6):514-21. doi: 10.1046/j.1365-2591.2002.00515.x.
Hülsmann M, Heckendorff M, Lennon Á. Chelating agents in root canal treatment: mode of action and indications for their use. International Endodontic Journal. 2003;36:810-30. doi: 10.1111/j.1365-2591.2003.00754.x.
Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: A comparative SEM investigation. Journal of endodontics. 1997 1997/05/01/;23(5):301-6. doi: https://doi.org/10.1016/S0099-2399(97)80410-4.
Iona VS, Vasile L. Recovery of Total Polyphenolic Compounds from Different Grape Skins Varieties, Under Enzymatic Treatment. Analele Universitatii din Oradea, Fascicula: Ecotoxicologie, Zootehnie si Tehnologii de Industrie Alimentara. 2010:1283-93.
Avallone R, Zanoli P, Puia G, Kleinschnitz M, Schreier P, Baraldi M. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol. 2000 Jun 1;59(11):1387-94. doi: 10.1016/S0006-2952(00)00264-1.
Soukoulis S, Hirsch R. The effects of a tea tree oil‐containing gel on plaque and chronic gingivitis. Australian Dental Journal. 2004;49(2):78-83. doi: 10.1111/j.1834-7819.2004.tb00054.x.
Darout I, Christy A, Skaug N, Egeberg PK. Identification and quantification of some potentially antimicrobial anionic components in Miswak extract. Indian Journal of Pharmacology. 2000;32:11-4.
Corrêa FOB, Sampaio JEC, Júnior CR, Orrico SRP. Influence of Natural Fruit Juices in Removing the Smear Layer from Root Surfaces — An In Vitro Study. Journal of the Canadian Dental Association. 2004 Novembro;70(10):697-702.
Kuah HG, Lui JN, Tseng PS, Chen NN. The effect of EDTA with and without ultrasonics on removal of the smear layer. Journal of endodontics. 2009 Mar;35(3):393-6. doi: 10.1016/j.joen.2008.12.007.
Upadhyay A, Singh DK. Pharmacological effects of sapindus mukorossi. Revista do Instituto de Medicina Tropical de São Paulo. 2012 September-October;54(5):273-80. doi: 10.1590/S0036-46652012000500007.
Torabinejad M, Cho Y, Khademi AA, Bakland LK, Shabahang S. The Effect of Various Concentrations of Sodium Hypochlorite on the Ability of MTAD to Remove the Smear Layer. Journal of endodontics. 2003 2003/04/01/;29(4):233-9. doi: https://doi.org/10.1097/00004770-200304000-00001.
Dai S, Xiao G, Dong N, Liu F, He S, Guo Q. Bactericidal effect of a diode laser on Enterococcus faecalis in human primary teeth--an in vitro study. BMC Oral Health. 2018;18(1):1-7. doi: 10.1186/s12903-018-0611-6.
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