IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS) e-ISSN: 2278-3008, p-ISSN:2319-7676. Volume 9, Issue 2 Ver. VI (Mar-Apr. 2014), PP 06-10 www.iosrjournals.org www.iosrjournals.org 6 | Page Role of herbs in root canal irrigation-A review Pratishta Jain 1 , Manish Ranjan 2 1 (Final year BDS, Saveetha dental college, India) 2 (Department of Conservative dentistry & Endodontics, Saveetha dental college, India) Abstract: One of the major objectives of a root canal treatment is to disinfect the root canal system. Irrigation is carried out to reduce the number of bacteria in the root canals. For this purpose, a wide variety of synthetic drugs are available today but due to the ineffectiveness, safety concerns and side effects of these synthetic drugs, the herbal alternatives for endodontic irrigants might be advantageous. Herbal alternatives are popular mainly due to their easy availability, cost effectiveness, increased shelf life and low toxicity. Thus this review aims at providing a comprehensive overview of the various herbal endodontic irrigants and their efficacy in carrying out root canal irrigation. Keywords: chlorhexidine, herbs, irrigation, root canal, sodium hypochlorite I. Introduction The main aim of an endodontic treatment is to remove the diseased tissue, eliminate bacteria from the root canal system and prevent its recontamination. [1] Irrigation is carried out to reduce the number of bacteria in the root canal system and to control the periapical disease. [2] A wide variety of synthetic antimicrobial agents have been used over the years as endodontic irrigants. Because of the increased antibiotic resistance to these antimicrobial agents, toxic and harmful side effects of few common antibacterial agents, there is a need for alternative agents which are affordable, non-toxic and effective. It has been found that natural plant extracts could be used as effective endodontic irrigants. [3] The ideal properties of a root canal irrigant are: it should be systemically nontoxic, should not harm the periodontal tissues, should not cause an anaphylactic reaction, should possess a broad antimicrobial spectrum, should be capable of dissolving necrotic pulp tissue, inactivating endotoxins, and either preventing the formation of a smear layer or dissolving it once it has formed. [4] Sodium hypochlorite (NaOCl) is one of the most widely used endodontic irrigant because of its ability to destroy a broad spectrum of microbes but it has some undesirable characteristics such as tissue toxicity, allergic potential, and disagreeable taste and inability to remove the smear layer. [5, 6, 7] For this reason Ethylenediaminetetraacetic acid (EDTA) was used, which effectively demineralises the smear layer [8] but has to be used along with NaOCl to remove the organic part [9] and does not have disinfective ability. [10] Chlorhexidine is another commonly used antimicrobial agent which is being used to irrigate the canals due to its wide spectrum antimicrobial activity, biocompatibility and ability to disinfect the infected root canals. However it does not have tissue dissolving capabilities [11] and also has some undesirable effects as it may discolour the teeth, [12] may lead to dryness of the oral cavity and may even cause burning sensation of the mouth. [13] To overcome the side effects of the above agents and to meet the requirements of an ideal irrigant, a new agent was introduced known as MTAD. It is an aqueous solution of 3% doxycycline, a broad-spectrum antibiotic; 4.2% citric acid, a demineralizing agent; and 0.5% polysorbate 80 detergent (Tween80). It also has some disadvantages such as high cost, reduced shelf life, less compatibility dental pulp cells. [14] Herbal or natural products have also become more popular today due to their high antimicrobial activity, biocompatibility, anti-inflammatory and anti-oxidant properties. [15] A wide variety herbal products have been used in the past in medicine. Thus the aim of this review is to enlist and describe the various herbal alternatives available today for use as effective endodontic irrigants. II. Herbal Endodontic Irrigants 2.1 Curcuma longa (Turmeric): Curcumin, a member of a ginger family possesses anti inflammatory [16], anti oxidant [17], anti microbial [18] and anti cancer activity [19]. In an in vitro study conducted by Prasanna Neelakantan, it has been shown that curcumin has significant anti bacterial activity against E.faecalis and can be used as an alternative to sodium hypochlorite for root canal irrigation. Thus this herb can be used especially in endodontics for root canal failure cases. [20]