Herbal medicaments in endodontics – Current guidelines for in vivo studies in India

Abstract

Elimination of bacteria from infected root canal systems is a challenging task. Various techniques have been described to reduce the number of bacteria within the root canal system, which include chemomechanical instrumentation, use of various irrigants to remove or dissolve organic and inorganic debris, and to destroy bacteria. The intracanal medicament plays a key role in the success of root canal treatment. With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Natural products are known to play an important role in human life. The use of herbal products as mouthwash has been tried and tested in the literature. However, the use of herbal intracanal medicament has been shown promising results when used under in vitro conditions, but in vivo studies are very scarce. This may be due to the limited supporting literature available to use it as intracanal medicament in patients due to the ethical concern. Hence, the purpose of this review is to highlight the current guidelines (laid by the drugs and cosmetics act as per the Gazette of India) regarding the use of herbal medicaments for the clinical trials in endodontics.

Antimicrobial effect of Pentaclethra Macroloba plant extract against Enterococcus Faecalis

“…With the increase in bacterial resistance due to the indiscriminate use of antibiotics, an increase in the development of other classes of antimicrobials for infection control can be noted. Products extracted from roots, barks, and seeds have been an important source of research to formulate new drugs with antimicrobial action (Dotta et al, 2015;Al-Ansari et al, 2019;Kishan et al, 2019;Souza et al, 2022). Pentaclethra macroloba is a native Amazonian tree commonly known as "pracaxi" that stands out due to its eco-sustainable exploitation (Teixeira et al, 2020), its antibacterial action against Grampositive (Staphylococcus spp.…”

“…The chemical-mechanical procedures performed during endodontic treatment are important to obtain cleaning, shaping, debridement, and consequently, bacterial reduction for peri-radicular tissue repair to occur (Siqueira Júnior et al, 2018). However, sometimes only the action of endodontic files in association with irrigants is not enough to eliminate microorganisms from the root canal system (RCS) (Kishan et al, 2019). Thus, additional methods such as the use of intracanal medication with antibacterial action are necessary to optimize the disinfection of the RCS, mainly in cases where the infection is persistent even after the end of the endodontic therapy and there is presence of pain or constant exudation (Zancan et al, 2016).…”