Comparing the efficacy of herbal irrigants using laser activation in removing endodontic pathogens: An in vitro analysis.

Context: The removal of harmful endodontic pathogens involves the mechanical enlargement of the root canal space along with the use of irrigants to improve debridement and disinfection. Although this is effective in most of the cases, failures still do occur due to the microorganisms which remain inside the root canal system.

Aim: This research aims to assess the antibacterial efficacy of Azadirachta indica and Morinda citrifolia, comparing them with 3% sodium hypochlorite (NaOCl), while also examining the impact of laser activation on these irrigants.

Methodology: Sixty-four single-rooted teeth with single canal were selected and decoronated to a standard length of 16 mm. All the samples were cleaned of debris and autoclaved. Two samples were selected randomly to check the complete disinfection, and the rest were inoculated with Enterococcus faecalis and Streptococcus mutans. Biofilm formation was checked in two randomly selected samples after 7 days. The remaining samples were then divided into three groups, namely A, B, and C. Then, each group was subdivided into two subgroups (A1, A2, B1, B2, C1, and C2). Group A was irrigated with 3% NaOCl solution. Group B was irrigated with A. indica extract, and Group C was irrigated with M. citrifolia extract. The subgroups A2, B2, and C2 were activated with Biolase diode laser, and colony-forming units (CFUs) were counted for all samples.

Statistical analysis: Statistical analysis was done using analysis of variance and paired t-test.

Results: The mean and standard deviation of CFUs in all the groups before and after laser activation denote no significant difference.

Conclusion: The antibacterial activity of A. indica and M. citrifolia was comparable with 3% NaOCl. Hence, they can be used as an alternative to the most commonly used chemical root canal irrigants. Laser activation can be used as an adjuvant in eradication of microbes from the root canal system.