Abstract
Background
Endodontic success depends heavily on effective chemo-mechanical debridement of root canals through the use of instruments and irrigating solutions.
Objective
To compare the effectiveness of chamomile hydroalcoholic extract, Biopure™ mixture of tetracycline isomer, acid and detergent (MTAD) and 2.5 % sodium hypochlorite (NaOCl) on removal of the smear layer.
Study design
Randomised controlled trial.
Methods
Thirty extracted single-rooted, primary human teeth were allocated at random into three experimental groups of 10 teeth each. For each tooth, the canal was prepared using the step-back technique. During instrumentation, 2 ml of the irrigant was used for at least 10 s after each file and 10 ml as a final flush for 2 min for chamomile and NaOCL irrigants. Whereas for MTAD, an initial rinse with 1.3 % NaOCl for a cumulated period of 20 min, and use of MTAD as the final rinse for a period of 5 min was followed. Longitudinal grooves were made on root segments, then split into two halves with a chisel, stored in 2.5 % glutaraldehyde solution and fixed in ethanol series. Specimens were examined for the smear layer according to Hulsmann et al. (Int Endod J 35:668–679, 2002) criteria using a scanning electron microscope.
Statistics
Kruskal–Wallis and Mann–Whitney U tests were used.
Results
The most effective result in removal of smear layer occurred with the use of MTAD, followed by chamomile extract. The chamomile extract was found to be significantly more effective than 2.5 % NaOCl solution which had only minor effects.
Conclusions
The efficacy of chamomile to remove the smear layer was superior to 2.5 % NaOCl alone, but less effective than MTAD mixture.
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References
Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol. 2000;59:1387–94.
Beltz RE, Torabinejad M, Pouresmail M. Quantitative analysis of the solubilizing action of MTAD, sodium hypochlorite, and EDTA on bovine pulp and dentine. J Endod. 2003;29:334–7.
Davies AK, Cundall RB, Dandiker Y, Slifkin MA. Photo-oxidation of tetracycline adsorbed on hydroxyapatite in relation to the light-induced staining of teeth. J Dent Res. 1985;64:936–9.
Eick JD, Wilko RA, Anderson CH, Sorensen SE. Scanning electron microscopy of cut tooth surfaces and identification of debris by use of the electron microprobe. J Dent Res. 1970;49(suppl):1359–68.
Eisen D, Hakim MD. Minocycline-induced pigmentation. Incidence, prevention and management. Drug Saf. 1998;18:431–40.
Fidler P, Loprinzi CL, O’Fallon JR, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer. 1996;77:522–5.
Gilio VE, Cilento G. Light emission accompanies oxygen uptake during the peroxidative metabolism of tetracyclines. Photochem Photobiol. 1993;58:446–9.
Hammer KA, Dry L, Johnson M, et al. Susceptibility of oral bacteria to Melaleuca alternifolia (tea tree) oil in vitro. Oral Microbiol Immunol. 2003;18:389–92.
Hulsmann M, Heckendorff M, Schafers F. Comparative in vitro evaluation of three chelator pastes. Int Endod J. 2002;35:668–79.
Lai SC, Mak YF, Cheung GS, et al. Reversal of compromised bonding to oxidized etched dentine. J Dent Res. 2001;80:1919–24.
Lau C, Lu J, Kai M. Chemiluminescence determination of tetracycline based on radical production in a basic acetonitrile-hydrogen peroxide reaction. Anal Chim Acta. 2004;503:235–9.
Martins HM, Martins ML, Dias MI, Bernardo F. Evaluation of microbiological quality of medicinal plants used in natural infusions. Int J Food Microbiol. 2001;68:149–53.
McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod. 1975;1:238–42.
Michalska T, Lichszteld K, Nizinkiewicz K, et al. The extra-weak chemiluminescence generated during oxidation of some tetracycline antibiotics. II. Peroxidation. J Photochem Photobiol B. 1992;16:305–18.
Miskoski S, Sanchez E, Garavano M, et al. Singlet molecular oxygen-mediated photo-oxidation of tetracyclines: kinetics, mechanism and microbiological implications. J Photochem Photobiol B. 1998;43:164–71.
Park DS, Torabinejad M, Shabahang S. The effect of MTAD on the coronal leakage of obturated root canals. J Endod. 2004;30:890–2.
Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP. The effectiveness of different acid irrigating solutions in root canal cleaning after hand and rotary instrumentation. J Endod. 2006;32:993–7.
Ruszynska H, Borysewicz-Lewicka M, Marciniecka-Hedzelek J, Kurhanska-Flisykowska A, Surdacka A. Evaluation of therapeutic properties of a chamomile-containing toothpaste. Czas Stomatol. 1986;39:485–90.
Sadr Lahijani MS, Raoof Kateb HR, Heady R, Yazdani D. The effect of German chamomile (Matricaria recutita L.) extract and tea tree (Melaleuca alternifolia L.) oil used as irrigants on removal of smear layer: a scanning electron microscopic study. Int Endod J. 2006;39:190–5.
Safayhi H, Sabieraj J, Sailer ER, Ammon HP. Chamazulene: an antioxidant-type inhibitor of leukotriene B4 formation. Planta Med. 1994;60:410–3.
Sanchez AR, Rogers RS 3rd, Sheridan PJ. Tetracycline and other tetracycline-derivative staining of the teeth and oral cavity. Int J Dermatol. 2004;43:709–15.
Shabahang S, Pouresmail M, Torabinejad M. In vitro antimicrobial efficacy of MTAD and sodium hypochlorite. J Endod. 2003;29:450–2.
Shabahang S, Torabinejad M. Effect of MTAD on Enterococcus faecalis-contaminated root canals of extracted human teeth. J Endod. 2003;29:576–9.
Tay FR, Mazzoni A, Pashley DH, et al. Potential iatrogenic tetracycline staining of endodontically treated teeth via NaOCl/MTAD irrigation: a preliminary report. J Endod. 2006a;32:354–8.
Tay FR, Hiraishi N, Schuster GS, et al. Reduction in antimicrobial substantivity of MTAD after initial sodium hypochlorite irrigation. J Endod. 2006b;32:970–5.
Torabinejad M, Johnson WB. Irrigation solution and methods for use. US Patent and Trade mark Office. United States Patent Application 2003/0235804; December 25: 2003.
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. J Endod. 2003a;29:233–9.
Torabinejad M, Khademi AA, Babagoli J, et al. A new solution for the removal of the smear layer. J Endod. 2003b;29:170–5.
Torabinejad M, Shabahang S, Aprecio RM, Kettering JD. The antimicrobial effect of MTAD: an in vitro investigation. J Endod. 2003c;29:400–3.
Torabinejad M, Shabahang S, Bahjri K. Effect of MTAD on postoperative discomfort: a randomized clinical trial. J Endod. 2005;31:171–6.
Tubaro A, Zill C, Redaelli C, Della Loggia R. Evaluation of anti-inflammatory activity of a chamomile extract topical application. Planta Med. 1984;50:359–63.
Wiebe JA, Moore DE. Oxidation photosensitized by tetracyclines. J Pharm Sci. 1997;66:186–9.
Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigation solutions: part 3. J Endod. 1983;9:137–42.
Zhang W, Torabinejad M, Li Y. Evaluation of cytotoxicity of MTAD using the MTT- tetrazolium method. J Endod. 2003;29:654–7.
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Venkataram, V., Gokhale, S.T., Kenchappa, M. et al. Effectiveness of chamomile (Matricaria recutita L.), MTAD and sodium hypochlorite irrigants on smear layer. Eur Arch Paediatr Dent 14, 247–252 (2013). https://doi.org/10.1007/s40368-013-0062-3
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DOI: https://doi.org/10.1007/s40368-013-0062-3