Stretching new boundaries of endodontics with phytotherapy: A review of literature
Root canal treatment has been used as an ultimate boon for various clinical situations, bypassing unnecessary extractions and preserving precious dentoalveolar structures. Although, persistence of microorganisms due to complex anatomy of root structure makes the process complex and challenging. Hence, complete and thorough debridement of the root canal by various endodontic irrigants becomes a prime necessity. In recent times, herbal alternatives are gaining popularity as a means to overcome various limitations of the conventional chemical irrigants. For the ease of the readers, review of various studies, focusing on few herbal irrigants is summarised in tabular form for quick review & understanding. The tabular form is discussed under the heads viz. material/herbs with active constituent & its mechanism of action, investigators, aim and results/conclusion. We, as dentists of this new era are quite hopeful for these herbal materials to undergo further rigorous research in order to engrave their revolutionary marking in endodontic treatments and so more.
2. Vishnuvardhini S, Andamuthuet S, Ravi V, Prasad AS, Sivakumar JS. Herbendodontics-aPhytotherapy In Endodontics: A Review. Biomed. & Pharmacol. J 2018; 11(2):1073-1082
3. Zehnder M. Root canal irrigants. Journal of Endodontics. 2006;32(5):389-398.
4. Vinothkumar TS, Rubin MI, Balaji L, Kandaswamy D. In vitro evaluation of five different herbal extracts as an antimicrobial endodontic irrigant using real time quantitative polymerasechain reaction.J Conserv Dent 2013;16:167-170
5. Karkare SR, Ahire NP, Khedkar SU. Comparative evaluation of antimicrobial activity of hydroalcoholic extract of Aloe vera, garlic, and 5% sodium hypochlorite as root canal irrigants against Enterococcus faecalis: An in vitro study. J Indian Soc Pedod Prev Dent 2015;33:274-8.
6. 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. J Int Soc Prevent Communit Dent 2016;6:196-9
7. Seth M, Padhye L, Mandke L. Comparison of Antimicrobial Efficacy of Herbal Alternatives (Aloe vera extract & Tea tree oil) & 3% Sodium Hypochlorite against Enterococcus Faecalis, Candida Albicans & Mixed Culture: An In-Vitro Study. Arch of Dent and Med Res 2016;2(3):10-17
8. Noushad M C, Balan B, Basheer S, Usman SB, Muhammed Askar M K. Antimicrobial efficacy of different natural extracts against persistent root canal pathogens: An In vitrostudy.Contemp Clin Dent 2018;9:177-181
9. Jain PA, Tejaswi S, Parinitha MS et.al. Comparative evaluation of antibacterial activity of Punica granatum, Acacia nilotica and Emblica officinalis against Enterococcus faecalis and their smear layer removal ability when used as endodontic irrigants: an in-vitro study. International Journal of Research and Review. 2019; 6(8):184-194.
10. Gupta D, Kamat S, Hugar S, Nanjannawar G, Kulkarni R. A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study. J Conserv Dent 2020;23:97-101.
11. Madhavan S. & Muralidharan Comparing the antibacterial efficacy of intracanal medicaments in combination with clove oil against Enterococcus faecalis. Asian Journal of Pharmaceutical and Clinical Research. 2015;8(5):143-145.
12. Gupta-Wadhwa A, Wadhwa J, Duhan J. Comparative evaluation of antimicrobial efficacy of three herbal irrigants in reducing intracanal E. faecalis populations: An in vitro study. J Clin Exp Dent. 2016;8(3):230-5.
13. Roy M, Bhaumik T, Das UK, Mitra A. Comparative Evaluation of Effectiveness of Garlic Extract with Conventional Intracanal Irrigants on Candida Albicans – An In Vitro Study. IJIR 2017;3(7): 219-222.
14. Elheeny AAH. Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12‐month short‐term evaluation. Clin Exp Dent Res. 2019;5:420–426.
15. Ghonmode WN, Balsaraf OD, Tambe VH, Saujanya KP, Patil AK, Kakde DD. Comparison of the antibacterial efficiency of neem leaf extracts, grape seed extracts and 3% sodium hypochlorite against E. feacalis – An in vitro study. J Int Oral Health 2013; 5(6):61-6.
16. Cecchin D, Farina AP, Souza MA, Albarello LL, Schneider AP, Vidal CMP, Bedran-Russo AK. Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants. J Den 2015; 43(6):695-702.
17. Margono A, Angellina AN, Suprastiwi E. The Effect of Grape Seed Extraction Irrigation Solution towards Cleanliness the Smear Layer on Apical Third of the Root Canal Wall. J Int Dent Med Res 2017; 10(2): 244-247
18. D'Aviz FS, Lodi E, Souza MA, Farina AP, Cecchin D. Antibacterial Efficacy of the Grape Seed Extract as an Irrigant for Root Canal Preparation. Eur Endod J 2020; 1: 35-9
19. Nayak A, Ranganath N, G Soumya B, Kishore B, Mithun K. Evaluation of antibacterial and anticandidial efficacy of aqueous and alcoholic extract of neem (Azadirachta indica) an in vitro study. International Journal of Research in Ayurveda & Pharmacy, 2(1), Jan-Feb 2011 230-235
20. Tyagi SP, Sinha DJ, Garg P, Singh UP, Mishra CC, Nagpal R. Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica (Neem) and 5% sodium hypochlorite on Candida albicans biofilm formed on tooth substrate: An in-vitro study. J Conserv Dent 2013;16:532-535
21. Rosaline H, Kandaswamy D, Gogulnath D, Rubin M I. Influence of various herbal irrigants as a final rinse on the adherence of Enterococcus faecalis by fluorescence confocal laser scanning microscope. J Conserv Dent 2013;16:352-355
22. Dutta A, Kundabala M. Comparative anti-microbial efficacy of Azadirachta indica irrigant with standard endodontic irrigants: A preliminary study. J Conserv Dent. 2014;17(2):133-137
23. Podar R, Kulkarni GP, Dadu SS, Singh S, Singh SH. In vivo antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite as root canal irrigants. Eur J Dent 2015; 9:529-34.
24. Daga P, Asrani H, Farista S, Mishra P. Comparative Evaluation of Antimicrobial Efficacy of Neem, Miswak, Propolis, and Sodium Hypochlorite against Enterococcus faecalis using EndoVac. Int J Prosthodont Restor Dent 2017; 7(2):60-65.
25. Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod. 2010; 36(1):83-86.
26. Pujar M, Patil C, Kadam A. Comparison of antimicrobial efficacy of Triphala, (GTP) Green tea polyphenols and 3% of sodium hypochlorite on Enterococcus faecalis biofilms formed on tooth substrate: in vitro. JIOH Volume 3; Issue 2:
27. Sebatni MA, Kumar AA. Smear layer removal efficacy of herbal extracts used as endodontic irrigants: An in vitro study. Endodontology 2017; 29:35-8.
28. Divia AR, Nair MG, Varughese JM, Kurien S. A comparative evaluation of Morinda citrifolia, green tea polyphenols, and Triphala with 5% sodium hypochlorite as an endodontic irrigant against Enterococcus faecalis: An in vitro study. Dent Res J (Isfahan). 2018; 15(2):117-122.
29. 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. Iran Endod J. 2012; 7(2):88-97.
30. Ranjitha GR, Mutha SR, Anithakumari R, Vikram R, Kumar N, Shivekshith AK. Comparative evaluation of smear layer removal efficacy of three herbal irrigants in the apical third of the root canal: An in vitro scanning electron microscopic study. SRM J Res Dent Sci 2020;11: 61-5.
31. Mali S, Singla S, Tyagi P, Sharma A, Talreja N, Gautam A. Comparative evaluation of the efficacy of different herbal irrigants on the removal of smear layer of primary teeth: A scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2020;38:374-80.
32. Murray PE, Farber RM, Namerow KN, Kuttler S, Garcia-Godoy F. Evaluation of Morinda citrifolia as an endodontic irrigant. J Endod. 2008;34(1):66-70.
33. Choudhary E, Indushekar K R, Saraf BG, Sheoran N, Sardana D, Shekhar A. Exploring the role of Morinda citrifolia and Triphala juice in root canal irrigation: An ex vivo study.J ConservDent 2018;21:443-449.
34. Singh M, Singh S, Salgar AR, Prathibha N, Chandrahari N, Swapna LA. An In Vitro Comparative Evaluation of Antimicrobial Efficacy of Propolis, Morinda Citrifolia Juice, Sodium Hypochlorite and Chlorhexidine on Enterococcus faecalis and Candida albicans. J Contemp Dent Pract 2019;20(1):40-45.
35. Kamath U, Sheth H, Ramesh S, Singla K. Comparison of the Antibacterial Efficacy of Tea Tree Oil with 3% Sodium Hypochlorite and 2% Chlorhexidine against E. faecalis: An in vitro Study. J Contemp Dent 2013; 3(3):117-120.
36. Thosar N, Basak S, Bahadure RN, Rajurkar M. Antimicrobial efficacy of five essential oils against oral pathogens: An in vitro study. Eur J Dent 2013;7:71-7.
37. Shakouie S, Eskandarinezhad M, Gasemi N, Salem Milani A, Samiee M, Golizadeh S. An In Vitro Comparison of the Antibacterial Efficacy of Triphala with Different Concentrations of Sodium Hypochlorite. Iran Endod J. 2014;9(4):287-9.
38. Satti P, Kakarla P, Avula SS, Muppa R, Rompicharla SV, Biswas S. Indigenous irrigants as potent antimicrobials in endodontic treatment: An in vitro study. J Indian Soc Pedod Prev Dent 2019;37:275-81.
39. Praveenkumar. S. Mandroli and Kishor Bhat. An in vitro evaluation of antibacterial activity of curcumin against common endodontic bacteria. J App Pharm Sci, 2013; 3(10):106-108.
40. Neelakantan P, Subbarao C, Sharma S, Subbarao CV, Garcia-Godoy F, Gutmann JL. Effectiveness of curcumin against Enterococcus faecalis biofilm. Acta Odontol Scand. 2013;71(6):1453-1457.
41. Saxena D, Saha SG, Saha MK, Dubey S, Khatri M. An in vitro evaluation of antimicrobial activity of five herbal extracts and comparison of their activity with 2.5% sodium hypochloriteagainst Enterococcus faecalis .Indian J Dent Res 2015;26:524-527.
42. Chaitanya BV, Somisetty KV, Diwan A, et al. Comparison of Antibacterial Efficacy of Turmeric Extract, Morinda Citrifolia and 3% Sodium Hypochlorite on Enterococcus faecalis: An In-vitro Study. J Clin Diagn Res. 2016;10(10):ZC55-ZC57.
43. Bhardwaj A, Velmurugan N, Sumitha, Ballal S. Efficacy of passive ultrasonic irrigation with natural irrigants (Morinda citrifolia juice, Aloe Vera and Propolis) in comparison with 1%sodium hypochlorite for removal of E. faecalis biofilm: An in vitro study.Indian J Dent Res 2013;24:35-41.
44. Subbiya A, Mahalakshmi K, Pushpangadan S, Padmavathy K, Vivekanandan P, Sukumaran VG. Antibacterial efficacy of Mangifera indica L. kernel and Ocimum sanctum L. leavesagainst Enterococcus faecalis dentinal biofilm.J Conserv Dent 2013;16:454-457.
45. A. R Prabhakar, V.V.R.Krishna Murthy. Vallu, Yavagal C. Ocimum Sanctum as an Intracanal Irrigant in Contemporary Paediatric Endodontics- An In Vivo Study. Int J Oral Health Med Res 2015;2(4):6-9.