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Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 9-12

A trial to compare the diffusion capability of ions via dentinal tubules of three different Ca(OH)2-containing herbal pastes and compare it with the Ca(OH)2 paste with saline

1 Department of Conservative Dentistry and Endodontics, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal East, India
2 Department of Conservative Dentistry and Endodontics, Dental College, Regional Institute of Medical Sciences, Lamphelpat, Imphal West 795004, India
3 Department of Paediatric and Preventive Dentistry, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal East, Manipur, India

Date of Submission27-Feb-2022
Date of Acceptance07-Mar-2022
Date of Web Publication25-Mar-2022

Correspondence Address:
Dr. Ningthoukhongjam Rati Devi
Department of Conservative Dentistry and Endodontics, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal East, Manipur.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJO.INJO_6_22

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Background: The antimicrobial property of calcium hydroxide [Ca(OH)2] is broadly utilized. It has the capability to dissolve organic tissues as well as to inactivate bacterial endotoxins. The goal of this trial is to compare the capability of three different Ca(OH)2-containing herbal pastes with diffuse ions via dentinal tubules, as well as the Ca(OH)2 paste in addition to saline. Materials and Methods: In this trial, 60 single-rooted premolar teeth were utilized. The root canals were prepared after the tooth crowns were removed. Four groups were produced based on the channel to be utilized for formulating calcium hydroxide pastes: Ca(OH)2 saline paste (control group), Ca(OH)2 neem, Ca(OH)2 aloe vera, and Ca(OH)2 turmeric paste (groups II, III, and IV). Calcium hydroxide herbal paste dressings were employed after biomechanical preparation followed by sealing with resin-based cement. The teeth were positioned in containers filled with distilled water, and the pH of the water was recorded at 3-, 24-, and 168-h intervals. Results: The current trial found that all herbal pastes permitted ion diffusion, but aloe vera pastes permitted for more ion diffusion and a significant upsurge in pH, indicating improved backing for calcium hydroxide activity. Conclusion: Aloe vera improved Ca(OH)2 diffusion via dentinal tubules, boosting its activity; hence, we recommend it as a channel for intracanal medication placement.

Keywords: Ca(OH)2, dentinal tubules, diffusion capability

How to cite this article:
Devi NR, Lairenlakpam R, Kangabam N, Atom J, Singh NS, Devi LS. A trial to compare the diffusion capability of ions via dentinal tubules of three different Ca(OH)2-containing herbal pastes and compare it with the Ca(OH)2 paste with saline. Int J Oral Care Res 2022;10:9-12

How to cite this URL:
Devi NR, Lairenlakpam R, Kangabam N, Atom J, Singh NS, Devi LS. A trial to compare the diffusion capability of ions via dentinal tubules of three different Ca(OH)2-containing herbal pastes and compare it with the Ca(OH)2 paste with saline. Int J Oral Care Res [serial online] 2022 [cited 2022 May 25];10:9-12. Available from: https://www.ijocr.org/text.asp?2022/10/1/9/340920

  Introduction Top

To upsurge, the disinfection of the root system antimicrobial intracanal drugs is utilized. Calcium hydroxide [Ca(OH)2] has long been admired for its biological as well as antibacterial properties, as well as its ability to dissolve living tissues and weaken the bacterial endotoxin. The bonding capacity is based on Ca(OH)2 to maintain a proper pH hinge on the distribution of hydroxyl ions [OH]. The breakdown of calcium hydroxide paste into calcium in addition to hydroxyl ions is a factor in its function as a root canal treatment. Hydroxyl ions [OH] free radicals react violently with a wide range of biomolecules. Due to the impeccability of its re-operation, this free radical rarely spread far from its source. The cytoplasmic bacterial membrane is damaged, proteins are released, and bacterial deoxyribonucleic acid is damaged, all contributing to the harmful influences of hydroxyl ions on bacterial cells.[1],[2],[3],[4] Various carriers, including distilled water, camphorated monochlorophenol, common saline, cresatin, glycerine, together with propylene glycol, have been used to coat root canals with Ca(OH)2 powder (PG). Curcumin is a major component of Curcuma longa bioactive yellow. “Indian Neem” is another name for Azadirachta indica. It acts primarily as an anti-adherence agent. It affects the ability of bacteria to colonize by changing their adhesion. Antioxidant properties are present in it. It has antibacterial activity counter to Enterococcus faecalis and Candida albicans.[5],[6],[7] The seeds of the neem tree contain azadirachtin, a second metabolite. It works primarily as an antifeedant together with growth inhibitor.[5]Aloe barbadensis Miller, otherwise referred as aloe vera, is a plant with potential benefits. Vitamins, enzymes, minerals, sugars, lignin, saponins, salicylic acids, along with amino acids are all found in aloe. The purpose of the trials was to compare the three different Ca(OH) forces, of which two containing herbal pastes to dispense ions via dental tubes, and the Ca(OH)2 salt adhesive.

  Materials and Methods Top

Sixty newly extracted teeth were cleaned and stored according to instructions. Carborundum disc was used to decorate teeth where cementoenamel meets. The trench was adjusted to a # 40k file, and the working length is determined. Using a 2 mL disposable syringe, irrigation of the root canal was accomplished utilizing distilled water via the ironing process. The water roots were rinsed utilizing saline solution followed by drying with paper-absorbing points after this time.

Four groups are produced on the basis of the channel utilized to prepare Ca(OH)2 pastes:

Ca(OH)2—saline paste (group 1) (produced by blending 1 g of CaOH plus 1 mL of saline);

Ca(OH)2—neem paste (group 2) (formulated by blending 1 g of CaOH plus 1 mL of neem extract);

Ca(OH)2—aloe vera paste (group 3) (produced by blending 1 g of CaOH plus 1 mL of extracted aloe vera).

Ca(OH)2—turmeric paste (group 4) (produced by blending 1 g of CaOH plus 1 mL of turmeric paste).

Following biomechanical adjustment, the above-mentioned intracanal drugs were inserted into the trench followed by sealing with the cement (resin-based). The teeth are then relocated to areas filled with clear water. Using a pH meter, the pH of water is measured periodically for 3, 24, and 168 h.

  Results Top

[Table 1] shows that Ca(OH)2 and aloe vera intracanal medicament group (7.55 ± 0.31) have the highest pH, followed by turmeric (7.14 ± 0.32), neem (6.88 ± 0.10), and saline and Ca(OH)2 (6.72 ± 0.19), which had a very low pH. All these differences in numbers were statistically significant using the one-way analysis of variance (ANOVA) (P < 0.05). [Table 2] illustrates that the highest pH scores were in the group Ca(OH)2 and aloe vera intracanal medicament (7.98 ± 0.05), followed by the neem group (7.46 0.09) and then turmeric group (7.23 ± 0.02), and very low pH in saline in addition to Ca(OH)2 (6.34 ± 0.01), with all these statistically significant differences (P = 0.05). [Table 3] shows that the highest pH scores were in the Ca(OH)2 group and aloe vera intracanal medicament (7.93 ± 0.02), tailed by turmeric (7.33 ± 0.04), neem (7.14 ± 0.06), and saline and Ca(OH)2 (6.58 ± 0.05) groups; besides all these differences in values were statistically significant (P = 0.05).
Table 1: Comparison of mean pH scores at 3 h using one-way ANOVA

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Table 2: Comparison of mean pH scores at 24 h using one-way ANOVA

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Table 3: Comparison of mean pH scores at 168 h using one-way ANOVA XXX

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  Discussion Top

The most common root canal dressing utilized in endodontics is calcium hydroxide. The dissociation of calcium hydroxide into ionic forms, such as calcium as well as hydroxyl ions, is the key to its success as a root canal dressing. These hydroxyl ions form an alkaline environment, which aids in the use of the alkaline phosphatase enzyme, promoting the formation of mineral tissue, and thus aids repair.[6],[7],[8],[9],[10] For proper functioning, hydroxyl ions must be dispersed with dentin in addition to the remaining pulp tissue at a high enough concentration to release the pH needed to destroy bacteria in the root canals and dental tubes. The biological and antimicrobial properties of calcium hydroxide are explained by the activity of these ions in the tissues as well as bacteria. The mechanism of activity of the intracanal drug produced from natural extraction, according to studies,[11],[12],[13] was in the cell membrane, unsettling its formation, preventing membrane formation, and inhibiting cellular respiration, leading to cell leakage and death.[14] Proper intracanal medicine will have the best antibacterial and anti-inflammatory properties and the least number of side effects. E. faecalis is a Gram-positive facultative anaerobe. It has a strong link between secondary and chronic diseases. It is found in 24–77%. Because E. faecalis begins to grow, there is an urgent need to find other ways to completely eradicate the virus. Due to its high pH, Ca(OH)2 converts bacterial lipopolysaccharides into cell wall.[15],[16] However, because this high pH is not maintained, it has been revealed to be futile in killing E. faecalis.[17] Ayurveda mainly uses neem. Nimbidin is an active ingredient. Some active ingredients such as nimbolide and nimbidic acid are extracted from nimbidin. Antioxidants are abundant in neem. It prevents the growth of Streptococcus mutans and E. faecalis bacteria. Alkaloids, glycosides, flavonoids, steroids, anthraquinone, along with tannic acid all have anti-neem properties. The respiratory chain is blocked to combine mitochondrial oxidative phosphorylation with these active ingredients. As a result, anti-adhesion activity occurs, disrupting bacterial adhesion.[18] Aloe vera gel, also known as mucilage, has a wide range of therapeutic uses. Glycosides, saponins, flavonoids, and steroids are the active ingredients. The respiratory chain is inhibited by uncoupling mitochondrial oxidative phosphorylation with these active constituents. It accomplishes this by affecting microbial adhesion. In dentistry, it reduces adhesion. It has had a significant impact on E. faecalis. Sulfur, lupeol, salicylic acid, urea nitrogen, cinnamic acid, along with phenols are the six antiseptic agents found in aloe vera. Wound healing is aided by polysaccharides found in the gel of the leaves. Protein, minerals, carbohydrates, and moisture are all present. It has an anti-inflammatory effect. It is an antioxidant with a lot of punch. It works well against E. faecalis. Because commercially existing intracanal medicaments have a variety of cytotoxic effects, interest has swung to extracting medicine from plants. C. longa has been shown to treat chronic infection and inflammation in the mouth.[9] Ca(OH)2 has been revealed to offer a more bacterial-free canal than a canal that has not been dressed. Nevertheless, Ca(OH)2 alone will not be able to eliminate all of the bacteria in the root canal. The main canal, along with the lateral plus accessory canals, is all colonized by E. faecalis.[11] A high pH value produces more hydroxyl ions, which are toxic to a wide range of bacteria. Ca(OH)2 has a number of uses in dentistry, comprising inter-appointment treatment for flare-up cases, pulp capping agents, in addition to root canal sealers. Nevertheless, Ca(OH)2 will not be able to eliminate all of the bacteria in the root canal.[13] Fungi, bacteria, and viruses are all inhibited by all of them. Ca(OH)2 impedes the growth of E. faecalis in the root canal, which suppresses lymphocytes and leads to failure.[19] Due to the presence of phytochemicals in studies, herbal preparations are utilized in modern science. The trial found that aloe vera plus Ca(OH) paste had the highest pH at 3 and 24 h, whereas at 168 h, Ca(OH)2 plus saline had the lowest pH. Aloe vera has a higher diffusion capability than turmeric, neem, as well as Ca(OH)2 pastes at 3, 24, and 168 h.

  Conclusion Top

Plants provide a significant amount of new chemicals and raw materials. It has the probability to make a substantial influence to the pharmaceutical industry in the near future. Herbs have a number of advantages, comprising low toxicity, ease of availability, amplified shelf-life, and cost-effectiveness. Herbs show promise in in vitro experiments, but more preclinical and clinical research is needed to ensure their use. Before concluding that herbs are a viable alternative to synthetic medications, their biocompatibility and safety must be assessed. Taking into account the limitations of the in vitro trial, it can be speculated that aloe vera is permitted for improved Ca(OH)2 diffusion via dentinal tubules, boosting its activity, as well as that it should be utilized as a channel for positioning intracanal medicament.

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Conflicts of interest

There are no conflicts of interest.

  References Top

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  [Table 1], [Table 2], [Table 3]


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