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VOLUME 16 , ISSUE S2 ( September, 2023 ) > List of Articles

ORIGINAL RESEARCH

Clinical and Radiographic Evaluation of Nigella sativa and Aloe vera as Pulpotomy Medicaments in Primary Teeth: A Randomized Controlled Trial

Rana M Sharaf, Noha S Kabil, Fadia S Youssef, Basma G Awad

Keywords : Aloe vera, Formocresol, Nigella sativa, Primary molars, Pulpotomy, Randomized controlled trial

Citation Information :

DOI: 10.5005/jp-journals-10005-2657

License: CC BY-NC 4.0

Published Online: 01-11-2023

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


Abstract

Aim: To evaluate the clinical and radiographic efficacy of Nigella sativa and Aloe vera as pulp medicaments in primary molars in comparison to formocresol. Materials and methods: This randomized controlled trial is a three-arm, parallel-group study. This research included 66 vital, carious primary molars that required pulpotomy treatment in 4–7-year-old children. Teeth were randomly assigned to one of the three groups: groups (1–3) Nigella sativa, Aloe vera, and formocresol, respectively. All teeth were covered with stainless steel crowns (SSC) after the pulpotomy procedure was done and were assessed clinically and radiographically at 3, 6, and 12 months following Zurn and Seale criteria. Results: After 12 months, the clinical success rate was found to be 40, 90, and 72.7% for Nigella sativa, Aloe vera, and formocresol groups, respectively. While the radiographic assessment showed a success rate of 20, 72.7, and 81.8%, respectively. Conclusion: Aloe vera can be considered as an alternative pulpotomy medicament to formocresol. On the other hand, Nigella sativa is not recommended to be used in pulpotomy procedures. Further long-term follow-up clinical studies and histological studies are recommended. Clinical significance: Although formocresol is the most popular used material in pulp therapy, concerns were raised regarding its toxicity and carcinogenicity by the International Agency for Research on Cancer (IARC). Consequently, herbal medicine is expanding rapidly worldwide nowadays and herbal extracts are suggested as an alternative to formocresol for their proposed antibacterial and anti-inflammatory properties.

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  1. Kher MS, Rao A. Pulp therapy in primary teeth. in: contemporary treatment techniques in pediatric dentistry. Contemp Treat Tech Pediatr Dent 2019;75–98. DOI: 10.1007/978-3-030-11860-0_3
  2. Bhujel N, Duggal MS, Saini P, et al. The effect of premature extraction of primary teeth on the subsequent need for orthodontic treatment. Eur Arch Paediatr Dent 2016;17(6):423–434. DOI: 10.1007/s40368-016-0247-7
  3. Smaïl-Faugeron V, Glenny AM, Courson F, et al. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2018;5(5):CD003220. DOI: 10.1002/14651858.CD003220.pub3
  4. American Academy of Prediatric Dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Pediatr Dent 2014;37(6):212–229.
  5. Dean JA, Avery DR, McDonald RE. Dentistry for the child and adolescent. 10th ed. McDonald and Avery's Dentistry for the Child and Adolescent; 2016. pp. 1–721.
  6. Cogliano VJ, Grosse Y, Baan RA, et al. Meeting report: summary of IARC monographs on formaldehyde, 2-butoxyethanol, and 1-tert-butoxy-2-propanol. Environ Health Perspect 2005;113(9):1205–1208. DOI: 10.1289/EHP.7542
  7. Bossù M, Iaculli F, Di Giorgio G, et al. Different pulp dressing materials for the pulpotomy of primary teeth: a systematic review of the literature. J Clin Med 2020;9(3). DOI: 10.3390/jcm9030838
  8. Matole V, Thorat Y, Ghurghure S, et al. A brief review on herbal medicines. Res J Pharmacogn Phytochem 2021;13(2):101–102. DOI: 10.52711/0975-4385.2021.00016
  9. Kumar G, Jalaluddin M, Rout P, et al. Emerging trends of herbal care in dentistry. J Clin Diagn Res 2013;7(8):1827–1829. DOI: 10.7860/JCDR/2013/6339.3282
  10. Subramanyam D, Somasundaram S. Clinical and radiographic outcome of herbal medicine versus standard pulpotomy medicaments in primary molars: a systematic review. J Clin Diagnostic Res 2017;11(10):12–16. DOI: 10.7860/JCDR/2017/30878.10716
  11. Alolofi H, El-Sayed M, Taha S. Clinical and radiographical evaluation of propolis and thymus vulgaris extracts compared with formocresol pulpotomy in human primary molars. BDJ Open 2016;2:16005. DOI: 10.1038/bdjopen.2016.5
  12. Zhang QW, Lin LG, Ye WC. Techniques for extraction and isolation of natural products: a comprehensive review. Chin Med 2018;13:20. DOI: 10.1186/s13020-018-0177-x
  13. Ramachandra CT, Srinivasa Rao P. Processing of Aloe vera leaf gel: a review. Am J Agric Biol Sci 2008;3(2):502–510. DOI: 10.3844/ajabssp.2008.502.510
  14. Zurn D, Seale N. Light-cured calcium hydroxide vs formocresol in human primary molar pulpotomies: a randomized controlled trial derek. Pediatr Dent 2008;30(1):34–41.
  15. Subramanyam D, Somasundaram S. Clinical and radiographic evaluation of Aloe vera vs formocresol as a pulpotomy medicament in primary molars: a double blinded randomized controlled trial. Int J Clin Pediatr Dent 2020;13(2):138–143. DOI: 10.5005/jp-journals-10005-1724
  16. Kadali NS, Alla RK, Guduri V, et al. Mineral trioxide aggregate: an overview of composition, properties and clinical applications. Int J Dent Mater 2020;2(1):11–18. DOI: 10.37983/IJDM.2020.2103
  17. Gasong BT, Hartanti AW, Tjandrawinata RR. Antibacterial activity of Nigella sativa L. seed oil in water emulsion against dental cariogenic bacteria. Int J Pharm Sci Res 2017;8(7):3155–3161. DOI: 10.13040/IJPSR.0975-8232.8(7).3155-61
  18. Ahmad A, Husain A, Mujeeb M, et al. A review on therapeutic potential of Nigella sativa: a miracle herb. Asian Pac J Trop Biomed 2013;3(5):337–352. DOI: 10.1016/S2221-1691(13)60075-1
  19. Saikiran KV, Kamatham R, Sahiti PS, et al. Pulpotomy medicaments in primary teeth: a literature review of natural alternatives. SRM J Res Dent Sci 2018;9(4):181. DOI: 10.4103/srmjrds.srmjrds_14_18
  20. Besra M, Kumar V. In vitro investigation of antimicrobial activities of ethnomedicinal plants against dental caries pathogens. 3 Biotech 2018;8(5):257. DOI: 10.1007/s13205-018-1283-2
  21. Alemi M, Sabouni F, Sanjarian F, et al. Anti-inflammatory effect of seeds and callus of Nigella sativa L. Extracts on mix glial cells with regard to their thymoquinone content. AAPS PharmSciTech 2013;14(1):160–167. DOI: 10.1208/s12249-012-9899-8
  22. Bourgou S, Pichette A, Marzouk B, et al. Antioxidant, anti-inflammatory, anticancer and antibacterial activities of extracts from nigella sativa (black cumin) plant parts. J Food Biochem 2012;36(5):539–546. DOI: 10.1111/j.1745-4514.2011.00567.x
  23. Reynolds T. Aloes: the genus Aloe. CRC Press; 2004. p. 66.
  24. Hamman JH. Composition and applications of Aloe vera leaf gel. Molecules 2008;13(8):1599–1616. DOI: 10.3390/molecules13081599
  25. Fani M, Kohanteb J. Inhibitory activity of Aloe vera gel on some clinically isolated cariogenic and periodontopathic bacteria. J Oral Sci 2012;54(1):15–21. DOI: 10.2334/josnusd.54.15
  26. Subramaniam P, Dwivedi S, Uma E, et al. Effect of pomegranate and aloe vera extract on streptococcus mutans: an in vitro study. Dent Hypotheses 2012;3(3):99. DOI: 10.4103/2155-8213.103920
  27. Jain I, Jain P, Bisht D, et al. Use of traditional Indian plants in the inhibition of caries-causing bacteria–Streptococcus mutans. Braz Dent J 2015;26(2):110–115. DOI: 10.1590/0103-6440201300102
  28. Jain S, Rathod N, Nagi R, et al. Antibacterial effect of Aloe vera gel against oral pathogens: an in-vitro dtudy. J Clin Diagn Res 2016;10(11):ZC41–ZC44. DOI: 10.7860/JCDR/2016/21450.8890
  29. Mahabala K, Shrikrishna S, Natarajan S, et al. Ethanolic extracts of Aloe vera and propolis as cavity disinfectants: an in vitro study. Dent Hypotheses 2016;7(2):61. DOI: 10.4103/2155-8213.183769
  30. Shi Y, Wei K, Lu J, et al. A Clinic trial evaluating the effects of aloe vera fermentation gel on recurrent aphthous stomatitis. Can J Infect Dis Med Microbiol 2020;2020:8867548. DOI: 10.1155/2020/8867548
  31. Vu NB, Chuenchompoonut V, Jansisyanont P, et al. Acemannan-induced tooth socket healing: a 12-month randomized controlled trial. J Dent Sci 2021;16(2):643–653. DOI: 10.1016/j.jds.2020.10.003
  32. Reddy V, Popuri SK, Velagala D, et al. Comparative evaluation of formocresol, propolis and growth factor as pulpotomy medicaments in deciduous teeth- an invivo study. J Clin Diagnostic Res 2019;29–34. DOI: 10.7860/JCDR/2019/41222.13098
  33. 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
  34. Gonna S, Ghoname N, Kabbash A, et al. Efficacy of Aloe vera as a pulpotomy agent in children primary teeth: clinical and radiographic studies. J Gastroenterol Hepatol Res 2019;8(5):2946–2951.
  35. Yousry Y, Abd Al Latif A, Abd Al Gawad R. Clinical and radiographic evaluation of vital pulpotomy in primary molar using antioxidant mix as a novel pulpotomy medication versus formcresol: a randomized clinical trial. Adv Dent J 2021;3(1):12–23. DOI: 10.21608/adjc.2020.21483.1053
  36. Haideri S, Koul M, Raj R, et al. To evaluate and compare the clinical and radiographic outcomes of formocresol, mineral trioxide aggregate, electrocautery, and bioactive glass when used for pulpotomy in human primary teeth. J Pharm Bioallied Sci 2021;13(Suppl 2):S1251–S1258. DOI: 10.4103/jpbs.jpbs_23_21
  37. Dumne SL, Rajan M, Vachhani K, et al. A comparative evaluation of formocresol versus aloe vera as pulpotomy agent. Int J Heal Allied Sci 2020;6(6):10–13. DOI: 10.4103/2278-344X.96404
  38. Hashem SN, Fawzy MI, Mostafa MH. Comparative study of some natural materials versus traditional medicaments used for pulp treatment of primary teeth. Al-Azhar Dent J Girls 2019;6(1):25–30. DOI: 10.21608/adjg.2019.28396
  39. Omar OM, Khattab NM, Khater DS. Nigella sativa oil as a pulp medicament for pulpotomized teeth: a histopathological evaluation. J Clin Pediatr Dent 2012;36(4):335–341. DOI: 10.17796/jcpd.36.4.n6674435856q86w8
  40. Kalra M, Garg N, Rallan M, et al. Comparative evaluation of fresh aloe barbadensis plant extract and mineral trioxide aggregate as pulpotomy agents in primary molars: a 12-month follow-up study. Contemp Clin Dent 2017;8(1):106–111. DOI: 10.4103/ccd.ccd_874_16
  41. Vázquez B, Avila G, Segura D, et al. Antiinflammatory activity of extracts from Aloe vera gel. J Ethnopharmacol 1996;55(1):69–75. DOI: 10.1016/S0378-8741(96)01476-6
  42. Gala-García A, Teixeira KIR, Mendes LL, et al. Effect of aloe vera on rat pulp tissue. Pharm Biol 2008;46(5):302–308. DOI: 10.1080/13880200801887138
  43. Elseena J, Shilpa J, Mariya J. Aloe vera and its biological activities. World J Curr Med Pharm Res 2021;3(2):21–26. DOI: 10.37022/wjcmpr.vi.167
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