Context: The smear layer produced during the instrumentation of the root canal contains both organic and inorganic components, and it is recommended to be removed as it has a mixture of bacteria and their byproducts. Irrigants like sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), endodontic irrigant, citric acid, etc., possess the ability to remove the smear layer. Considering the antimicrobial effect, antiinflammatory, cavity disinfectant, nontoxicity, better taste, and aroma of herbal products, a novel approach has been introduced in the field of endodontics.
Aims: To assess the efficacy of passion fruit juice in removing the smear layer and its erosive potential in root canals after instrumentation by scanning electron microscopy.
Materials and methods: About 35 single-rooted premolars were divided into five groups—30% passion fruit extract (PFE), 17% EDTA, 17% EDTA + 5.25% NaOCl, 30% PFE + 17% EDTA, and saline. Following irrigation with the above irrigants, each tooth was split into two halves and examined and scored for smear layer removal (modified Torabinejad's criteria) using a scanning electron microscope.
Statistical analysis: Overall comparison of the irrigant's action on removing the smear layer and their erosive potential was done using the Kruskal–Wallis test, and intergroup comparison of the irrigant action was done using the Mann–Whitney U test. All the statistical analyses were set with a significance level of p < 0.05.
Results: A total of 30% PFE produced less erosion and statistically significant smear layer removal in the coronal and middle third of the root. When combined with 17% EDTA, it effectively removed the smear layer in all three-thirds of the root. Around 30% PFE + 17% EDTA is less erosive when compared to 17% EDTA + 5.25% NaOCl.
Conclusion: This study revealed that 30% PFE and 30% PFE + 17% EDTA are promising irrigants as root canal disinfectants in endodontics.
Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smears layer removal: an SEM analysis. Int Endod J 2005;38(5):285–290. DOI: 10.1111/j.1365-2591.2005.00930.x
Yamada RS, Armas A, Goldman M, et al. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: part 3. J Endod 1983;9(4):137–142. DOI: 10.1016/S0099-2399(83)80032-6
Mello I, Kammerer BA, Yoshimoto D, et al. Influence of final rinse technique on ability of ethylenediaminetetraacetic acid of removing smear layer. J Endod 2010;36(3):512–514. DOI: 10.1016/j.joen.2009.11.004
Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod 2002;28(1):17–19. DOI: 10.1097/00004770-200201000-00004
Spencer HR, Ike V, Brennan PA. Review: the use of sodium hypochlorite in endodontics potential complications and their management. Br Dent J 2007;202(9):555–559. DOI: 10.1038/bdj.2007.374
Hariharan VS, Nandlal B, Srilatha KT. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: a scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2010;28(4):271–277. DOI: 10.4103/0970-4388.76157
Pujar M, Patil C, Kadam A. Comparison of antimicrobial efficacy of Triphala, (GTP) Green tea polyphenols and 3% of sodium hypochlorite on Enterococcus faecalis biofilms formed on tooth substrate: in vitro. J Int Oral Health 2011:3(2):23–29.
Gupta A, Duhan J, Sangwan P, et al. The effectiveness of three different plant extracts used as irrigant in removal of smear layer: a scanning electron microscope study. J Oral Health Dent 2015;9(1):16–22.
Ok E, Adanir N, Ozturk T. Antibacterial and smear layer removal capability of oregano extract solution. Eur J Dent 2015;9(1):20–24. DOI: 10.4103/1305-7456.149633
Patel SS. Morphology and pharmacology of Passiflora edulis – a review. J Herb Med Toxicol 2009;3(1):1–6.
Rees JS, Loyn T, Rowe W, et al. The ability of fruit teas to remove smear layer: an in vitro study of tubule patency. J Dent 2006;34(1):67–76. DOI: 10.1016/j.jdent.2005.03.006
Jayahari NK, Niranjan NT, Kanaparthy A. The efficacy of passion fruit juice as an endodontic irrigant compared with sodium hypochlorite solution: an in vitro study. J Investig Clin Dent 2014;5(2):154–160. DOI: 10.1111/jicd.12023
Gayathri K, Prathima GS, Sajeev R. Antimicrobial efficacy of passion fruit extract against Enterococcus faecalis- an in vitro study. Int J Sci Res 2020;76–78.
Singh S, Das D. Passion fruit: a fetched passion for dentists. Int J Pharm Sci Res 2013;4(2);754–757.
Kuruvilla A, Jaganath BM, Krishnegowda SC, et al. A comparative evaluation of smear layer removal by using EDTA, etidronic acid, and maleic acid as root canal irrigants: An in vitro scanning electron microscopic study. J Conserv Dent 2015;18(3):247–251. DOI: 10.4103/0972-0707.157266
Jindal V, Palekar A, Jindal D. An in vitro comparative evaluation of smear layer removal using NaOCl, EDTA and MTAD solution as a final rinse- a scanning electron microscopic study. J Oral Health Res 2011;2(2):61–65.
Abou-Rass M, Patonai FJ Jr. The effects of decreasing surface tension on the flow of irrigating solutions in narrow root canals. Oral Surg Oral Med Oral Pathol 1982;53(5):524–526. DOI: 10.1016/0030-4220(82)90470-4
Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007;33(4):472–475. DOI: 10.1016/j.joen.2006.12.007
O'Connell MS, Morgan LA, Beeler WJ, et al. A comparative study of smear layer removal using different salts of EDTA. J Endod 2000;26(12):739–743. DOI: 10.1097/00004770-200012000-00019
Bohora A, Hegde V, Kokate S. 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