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OBJECTIVES: This study aimed to evaluate Emblica officinalis (Indian gooseberry or amla) as an acid etchant and matrix metalloproteinase (MMP) inhibitor, and to compare its effect on the microshear bond strength of composite resin with orthophosphoric acid (OPA) and 2% chlorhexidine (CHX) as an acid etchant and MMP inhibitor, respectively. MATERIALS AND METHODS: The etching effect and MMP-inhibiting action of amla on dentin samples were confirmed by scanning electron microscopy (SEM) and gelatin zymography, respectively. Dentinal slabs (3 mm thick) from 80 extracted human molars were divided into 10 and 20 samples to form 2 control groups and 3 experimental groups. Groups 1, 2, and 4 were etched with OPA and groups 3 and 5 with amla juice. An MMP inhibitor was then applied: CHX for group 2 and amla extract for groups 4 and 5. Groups 1 and 3 received no MMP inhibitor. All specimens received a standardized bonding protocol and composite resin build-up, and were subjected to microshear bond strength testing. The force at which the fracture occurred was recorded and statistically analyzed. RESULTS: Amla juice had a similar etching effect as a self-etch adhesive in SEM and 100% amla extract was found to inhibit MMP-9 by gelatin zymography. The microshear bond strength values of amla were lower than those obtained for OPA and CHX, but the difference was not statistically significant. CONCLUSIONS: Amla has a promising role as an acid etchant and MMP inhibitor, but further studies are necessary to substantiate its efficacy.
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CONTEXT: Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant. Although it fulfills most of the requisites of an ideal irrigant, it has certain drawbacks, chiefly severe soft-tissue damage. Allium sativum (garlic extract) is a proven antimicrobial agent that has the ability to dissolve inorganic tissue with minimal toxicity. However, its ability to remove smear layer (SL) is not known. Conventional hand-held syringe irrigation is ineffective in removing canal debris. The use of newer irrigation systems is limited owing to their high cost. Modified evacuation system (MES) may prove to be an effective yet economical alternative. AIMS: This study aims to evaluate the SL removing capacity of garlic extract as an alternative to 5% NaOCl and the use of modified evacuation system for removal of irrigant along with debris from root canals. SETTINGS AND DESIGN: Sixty-eight single-rooted mandibular premolars were divided into 8 Groups: Two control Groups A and B (4 samples each) and six experimental Groups C to H (10 samples each). Garlic extract was prepared at a concentration of 64 mg/ml. MES was set up using 21-gauge flat-end needle fixed onto chair side high-volume evacuation system. SUBJECTS AND METHODS: Control groups were irrigated with normal saline, Groups C and D with 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA), Groups E and F with garlic extract and 17% EDTA and Groups G and H with plain garlic extract. MES was used in Groups B, D, F, and H. Scanning electron microscope analysis was done to view SL at coronal, middle, and apical thirds. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: Groups A and B showed least scores. At coronal and middle thirds, Group D shows better results, followed by Groups F and H. Apically, Group F showed better results. Groups C and H, and E and G showed similar results. All groups with MES showed better results. CONCLUSIONS: A. sativum has an SL removal capacity. MES is effective in debris removal.
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INTRODUCTION: Although success of endodontic therapy has significantly improved in the last few decades due to the introduction of novel materials and techniques, failures of endodontic therapy requiring re-treatment still comprise a significant percentage of patients requiring root canal treatment. AIM: To evaluate and compare the effective removal of gutta percha and sealer, amount of apical debris extrusion and time required for gutta percha removal using various endodontic files. MATERIALS AND METHODS: Total 48 extracted mandibular premolars were mounted on acrylic blocks and endodontic procedure was carried out using size 40 K file and obturated using guttapercha and zinc oxide eugenol sealer. After one month storage, samples were decoronated, mounted on screw capped vials and subjected to removal of obturated material by four instruments: H files, safe sided H files, protaper universal retreatment rotary system and ultrasonic retreatment tip, grouped as 1, 2, 3, and 4 respectively. Only 2mm of obturated material from the coronal part was removed using no. 3 Gates Glidden drill, guttapercha was softened with a drop of xylene for 2 mins for each canal and retreatment was performed. The retreatment procedure was said to be complete when no visible debris were observed on the instrument flutes. The samples split into two halves and examined under stereomicroscope, photographed, assessed using AUTOCAD software and percentage of remaining filling material in coronal, middle, apical thirds of the canal was calculated in mm(2). Retreatment time was recorded in seconds and apically extruded debris was assessed by microbalance in grams for each tooth. The data was analyzed by using descriptive statistics, ANOVA and Scheffe's post hoc test through SPSS for windows (v 16.0). RESULTS: The ultrasonic retreatment tip had less percentage of residual guttapercha/sealer, shorter mean operating time and little apical extrusion with a significant difference (p<0.05) between the other groups. CONCLUSION: All techniques retained guttapercha/sealer remnants within the root canal. The ultrasonic retreatment tip proved to be an efficient method of removing obturated material. It was fastest with least apical debris extrusion.
