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VOLUME 24 , ISSUE 9 ( September, 2023 ) > List of Articles


Clinical and Radiographic Evaluation of Various Herbal Products Used with Zinc Oxide as an Obturating Material in Primary Teeth: An In Vivo Study

Sunil, Asib Ahmad, Aparna Singh, Vasundhara Megha

Keywords : Aloe vera, Azadirachta indica, Curcumin, Pulpectomy, Zinc oxide eugenol

Citation Information : Sunil, Ahmad A, Singh A, Megha V. Clinical and Radiographic Evaluation of Various Herbal Products Used with Zinc Oxide as an Obturating Material in Primary Teeth: An In Vivo Study. J Contemp Dent Pract 2023; 24 (9):692-699.

DOI: 10.5005/jp-journals-10024-3559

License: CC BY-NC 4.0

Published Online: 13-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To compare the clinical and radiographically mixture of zinc oxide with Aloe vera, Curcumin and neem as an obturating material for pulpectomy. Materials and methods: The study comprised of age group 4–8 years children requiring endodontic treatment for at least a single primary molar tooth. Sixty primary molar teeth from 43 children were divided equally and randomly into four study groups. The materials used for obturation were zinc oxide powder (ZnO) and Eugenol (ZOE) (group I), ZnO and Aloe vera Gel (group II), ZnO and Curcumin Powder (group III), ZnO and neem extract (group IV). They were evaluated clinically and radiographically at immediate postoperative and then at 1-, 3-, 6-, and 9-month intervals. Results: At the end of 9 months, the Chi-square test revealed 100% success rate for recovery of pain in group I and III, 66.66% in group II and 93.3% in group IV. The success rates for absence of abscess and for periradicular radiolucency in group I, III, and group IV were 100% and 66.6% for group II. The success rate for periapical radiolucency in group I and group III was 100%, in group II 66.6% and in group IV 93.35%. The success rate for all the groups shows 100% success in terms of pathological root resorption. Conclusion: Zinc oxide eugenol has proven to be the best obturating material. ZnO with Aloe vera showed a success rate which is significantly lower than the other medicaments. ZnO with Curcumin and ZnO with neem had shown promising clinical and radiographical results. Clinical significance: ZnO with Curcumin and ZnO with neem can be used as a root canal filling material in primary teeth with further follow-up studies.

  1. Radhakrishna AN, Menni AC, Prasad MG, et al. The success rate of endoflas powder mixed with Curcumin gel as obturating material in primary molars: case-series. J Biomed and Pharma Res 2017;6(2):100–106. PMID: 101671502.
  2. Wasnik MB, Mittal R, Sajjanar A, et al. Comparative evaluation of antimicrobial efficacy of zinc oxide eugenol with zinc oxide mixed with three herbal products to be used as root canal filling material: An in vitro study. Int J Clin Pediatr Dent 2022;15(S-1):40–46. DOI: 10.5005/jp-journals-10005-2129.
  3. Bommareddy CS, Ramkumar H, Dakshinamurthy S, et al. Clinical and radiographic evaluation of Curcumin as an obturation material in deciduous teeth: A randomized controlled trial. Int J Clin Pediatr Dent 2022;15(S-1):35–39. DOI: 10.5005/jp-journals-10005-2128.
  4. Bawazir OA, Salama FS. Clinical evaluation of root canal obturation methods in primary teeth. Pediatr Dent 2006;28(1):39–47. PMID: 16615374.
  5. Hashieh IA, Ponnmel L, Camps J. Concentration of eugenol apically released from ZOE based sealers. J Endocrinol 1999;22:713–715. DOI: 10.1016/S0099-2399(99)80114-9.
  6. Balakrishnan R, Dubey S, Dhole TKN, et al. Comparative antimicrobial efficacy of Metapex, Metronidazole, BioPure MTAD, Aztreonam on Bacteroides fragilis and Propionibacterium acne. J Conserv Dent 2013;16(4):327–330. DOI: 10.4103/0972-0707.114361.
  7. Kamat S, Rajeev K, Prahlad S. Role of herbs in endodontics: An update. Endodontology 2010;23:98–102. DOI: 10.4103/0970-7212.352026.
  8. Meena M, Figueiredo NR, Trivedi K. Aloe vera – An update for dentistry. J Dentofacial Sci 2013;2(4):1–4. Corpus ID: 76174616.
  9. Suvarna R, Bhat SS, Hegde KS. Antibacterial activity of turmeric against Enterococcus faecalis – An in vitro study. Int J Curr Microbioal App Sci 2014;3(2):498–504. ISSN: 2319-7706.
  10. Sahebalam R, Bagheri H, Jafarzadeh H, et al. Tooth discoloration and solubility of zinc oxide eugenol combined with different concentrations of nano-curcumin: An in vitro study. J Dent Shiraz Univ Med Sci 2023;24(2): 226–234. DOI: 10.30476/dentjods.2022.92933.1687.
  11. Menni AC, Ambati NR, Prasad MG. Clinical and radiographic evaluation of Curcumin Gel mixed Endoflas (CGE) powder as obturating material in primary molars. Brazilian Dent Sci 2020;23(1):1–8. DOI: 10.14295/bds.2020.v23i1.1733.
  12. Bohora A, Hegde VI, Kokate SH. Comparison of the antibacterial efficiency of neem leaf extract and 2% sodium hypochlorite against E. faecalis, C. albicans and mixed culture – An in vitro study. Endodontology 2010;22(1):8–12. DOI: 10.4103/0970-7212.351972.
  13. Kriplani R, Thosar N, Baliga MS, et al. Comparative evaluation of antimicrobial efficacy of various root canal materials along with Aloe vera used in primary teeth. J Clin Pediatr Dent 2013;37(3):257–262. DOI: 10.17796/jcpd.37.3.j62u53q2300484x5
  14. Khairwa A, Bhat M, Sharma R, et al. Clinical and radiographic evaluation of zinc oxide with Aloe vera as an obturating material in pulpectomy: An in vivo study. J Ind Soc Pedod Prev Dent 2014;32(1):33–36. DOI: 10.4103/0970-4388.127051.
  15. Patel DG, Fernandes S, Bafna Y, et al. Comparative evaluation of zinc oxide-eugenol and zinc oxide with neem oil in root canal treatment of primary teeth: Split-mouth study with 12 months follow-up. AYU 2022;43:8–12. DOI: 10.4103/ayu.ayu_435_20.
  16. Perera WPTD, Dissanayake RK, Ranatunga UI, et al. Curcumin loaded zinc oxide nanoparticles for activity-enhanced antibacterial and anticancer applications. Royal Soc Chem Adv 2020;10:785–795. DOI: 10.1039/D0RA05755J.
  17. Sohail MF, Rehman M, Hussain SZ, et al. Green synthesis of zinc oxide nanoparticles by neem extract as multi-facet therapeutic agents. J Drug Delivery Sci Techn 2020;59:101–119. DOI: 10.1016/j.jddst.2020.101911.
  18. Singh A, Gupta N, Agarwal N, et al. A comparative volumetric of four obturating techniques in primary teeth using cone beam computed tomography. Pediatr Dent 2017;39(2):111–116.
  19. Meizarini A, Aryati, Riawan W, et al. Anti-inflammatory properties of a wound dressing combination of zinc oxide and turmeric extract. Vet World 2018;11(1):25–29. DOI: 10.14202/vetworld.2018.25-29.
  20. Widjaja J, Diyatri I, Riawan W, et al. New insight into the role of a combination of zinc oxide and turmeric rhizome liquid extract in osteogenic marker expression. J Ind Prosthodont Soc 2021; 21:262–268. DOI: 10.4103/jips.jips_120_21.
  21. Gunes H, Gulen D, Mutlu R, et al. Antibacterial effects of Curcumin: An in vitro minimum inhibitory concentration study. Toxicol Ind Health 2016;32(2):246–250. DOI: 10.1177/07482337134984
  22. Mistry KS, Sanghvi Z, Parmar G, et al. The antimicrobial activity of Azadirachta indica, Mimusops elengi, Tinospora cardifolia, Ocimum sanctum and 2% chlorhexidine gluconate on common endodontic pathogens: An in vitro study. Euro J Dent 2014;8(2):172–177. DOI: 10.4103/1305-7456.130591.
  23. Ramar K, Mungara J. Clinical and radiographic evaluation of pulpectomies using three root canal filling materials: An in-vivo study. J Ind Soc Pedod Prev Dent 2010;28(1):25–28. DOI: 10.4103/0970-4388.60481.
  24. Bonab SS, Samiei M, Moghanlou AS. Effects of intracanal curcumin and aloe vera on PH changes in simulated root surface resorption defects: An in vitro study. Iranian Endod J 2022;17(4):172–178. DOI: 10.22037/iej.v17i4.35570.
  25. Cox ST Jr, Hembree JH Jr, McKnight JP. The bactericidal potential of various endodontic materials for primary teeth. Oral Surg Oral Med Oral Pathol 1978;45:947–954. DOI: 10.1016/s0030-4220(78)80017-6.
  26. Spencer CG, Campbell PM, Buschang PH, et al. Antimicrobial effects of zinc oxide in an orthodontic bonding agent. Angle Orthod 2009;79(2):317–322. DOI: 10.2319/011408-19.1.
  27. Barr ES, Flatiz CM, Hicks MJ. A retrospective radiographic evaluation of primary molar pulpectomies. Pediatr Dent 1991;13:4–9. PMID: 1945984.
  28. Gould JM. Root canal therapy for infected primary molar teeth – preliminary report. ASDC J Dent Child 1972;39:269–273. PMID: 4558529.
  29. Coll JA, Josell S, Casper JS. Evaluation of an one-appointment formocresol pulpectomy technique for primary molars. Pediatr Dent 1985;7:123–129. PMID: 3859843.
  30. Kurian B, Swapna DV, Nadig RR, Ranjini MA, Rashmi K, Bolar SR. Efficacy of calcium hydroxide, mushroom and Aloe vera as an intracanal medicament against Enterococcus faecalis: An in vitro study. Endodontology 2016;28:137–142. DOI: 10.4103/0970-7212.195427.
  31. Hayes SM. Lichen planus-report of successful treatment with Aloe vera. Gen dent 1999;47:268–272. PMID: 10687438.
  32. Yamaguchi I, Mega N, Sanada H. Components of the gel Aloe vera (L) burm. F Biosic Biotechnol Biochem 1993;57:1350–1352. DOI: 10.1271/bbb.57.1350.
  33. Chamele J, Bhat C. Efficacy of turmeric extract as an intracanal medicament in deciduous teeth against Enterococcus faecalis: An in vitro study. Int J Curr Microbio App Sci 2014;3:17–25. ISSN: 2319-7706.
  34. Mandroli PS, Bhat K. An in-vitro evaluation of antibacterial activity of Curcumin against common endodontic bacteria. J Applied Pharma Sci 2013;3(10):106–108. DOI: 10.7324/JAPS.2013.31018.
  35. Akram M, Shahab-Uddin AA, Usmanghani K, Hannan A, Mohiuddin E, Asif M. Curcuma longa and Curcumin: A review article. Rom J Biol Plant Biol 2010;55:65–70.
  36. Purohit RN, Bhatt M, Purohit K, et al. Clinical and radiological evaluation of turmeric powder as a pulpotomy medicament in primary teeth: An in vivo study. Int J Clin Pediatr Dent 2017;10(1): 37–40. DOI: 10.5005/jp-journals-10005-1404.
  37. Hugar SM, Kukreja P, Hugar SS, et al. Comparative evaluation of clinical and radiographic success of formocresol, propolis, turmeric gel, and calcium hydroxide on pulpotomized primary molars: A preliminary study. Int J Clin Pediatr Dent 2017;10(1):18–23. DOI: 10.5005/jp-journals-10005-1400.
  38. Prashant GM, Chandu GN, Murulikrishna KS, et al. The effect of mango and neem extract on four organisms causing dental caries: Streptococcus mutans, Streptococcus salivavius, Streptococcus mitis, and Streptococcus sanguis: An in vitro study. Ind J Dent Res 2007;18:148–151. DOI: 10.4103/0970-9290.35822.
  39. Hegde V, Kesaria, DP. Comparative evaluation of antimicrobial activity of neem, propolis, turmeric, liquorice and sodium hypochlorite as root canal irrigants against E. Faecalis and C. Albicans – An in vitro study. Endodontology 2013;25:38–45. DOI: 10.4103/0970-7212.352328.
  40. Turner CE, Williamson DA, Stroud PA, et al. Evaluation and comparison of commercially available Aloe vera L. products using size exclusion chromatography with refractive index and multi-angle laser light scattering detection. Int Immuno Pharmacol 2004;4:1727–1737. DOI: 10.1016/j.intimp.2004.07.004.
  41. Reddy S, Ramakrishna Y. Evaluation of antimicrobial efficacy of various root canal filling materials used in primary teeth: A microbiological study. J Clin Pediatr Dent 2007;31(3):193–198. DOI: 10.17796/jcpd.31.3.t73r4061424j2578.
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