Evaluation of smear layer removal and antimicrobial efficacy of intracanal herbal irrigants

Aim: To evaluate and compare the efficiency of Triphala, Neem, the combination of Triphala, Neem and 3% sodium hypochlorite (NaOCI) in the removal of smear layer (SL) evaluated using scanning electron microscope (SEM) and antimicrobial efficacy against standard culture strains of Enterococcus faecalis. Methods: Seventy-five extracted human permanent teeth were divided into Group I control and Group II experimental, which was further subdivided into Group IIA, IIB, IIC, IID with 3% NaOCI, 5% Triphala extract, 7.5% Neem extract, and alternate use of Triphala and Neem and extracts as irrigants, respectively. The microbial sample was streaked on the agar plates to check colony-forming units/ml (CFU's) after inoculation and incubation at pre- and postirrigation. Teeth that were instrumented, and irrigated were split longitudinally, and examined using SEM under ×400, ×1000 to determine the debris and SL. Results: Statistically significant reduction of CFU's was noted at postirrigation in Sub Group IIA, IIB, IIC, and IID with a mean rank of 31.77, 46.7, 34.53, and 9, respectively. SL removal was significant (P = 0.001), with Group IID exhibiting a lower mean rank, followed by B, C, A, and Group I. Conclusion: The antimicrobial effect and SL removal efficacy were maximum for Group IID, which can be considered an effective herbal alternative in endodontic therapies.