EFFICACY OF MORINDA CITRIFOLIA ASSOCIATED WITH MANUAL DYNAMIC AGITATION ON SMEAR LAYER REMOVAL: (IN VITRO SCANNING ELECTRON MICROSCOPIC STUDY)

Abstract

INTRODUCTION: Endodontic treatment requires chemo-mechanical preparation of root canal to minimize the intracanal bacterial load. However, mechanical debridement results in smear layer formation containing infected debris requiring its removal before obturation. AIM OF THE STUDY: To assess the efficacy of Morinda Citrifolia juice (MCJ) as final irrigation protocol associated with manual dynamic agitation on smear layer removal by using scanning electron microscope. MATERIALS AND METHODS: Forty-five human mandibular permanent premolar teeth with single canals were decoronated to a standard length of 15mm and instrumented using ProTaper Next rotary files (X3). Roots were divided into 3 equal groups (n=15) according to the final irrigant used: Group I: 6% MCJ, Group II: 6% MCJ + 17% EDTA, Group III (control group): 2.5% NaOCl + 17% EDTA. Manual dynamic agitation (MDA) was used to activate the irrigants in all groups. Teeth were then prepared for scanning electron microscopy evaluation, and smear layer removal was assessed.. Comparisons between the study groups were done using Kruskal Wallis test, while comparisons of different regions within each group were done using Friedman test. RESULTS: Along complete canal length, no significant difference was found between 6%MCJ+17% EDTA and 2.5% NaOCl + 17% EDTA (p=0.29). However, a significant difference was noted between 6%MCJ and 2.5% NaOCl + 17% EDTA (p=0.001). In all groups, the coronal third showed the best results (P = 0.02) and the apical third showed the worst (P = 0.007). CONCLUSION: The use of 6%MCJ+17% EDTA associated with MDA could be an alternative to 2.5% NaOCl + 17% EDTA for smear layer removal, however, MCJ alone isn’t effective in smear layer removal.