title: Effectiveness of chamomile (Matricaria recutita L.), MTAD and sodium hypochlorite irrigants on smear layer.
abstract: BACKGROUND
  Endodontic success depends heavily on effective chemo-mechanical debridement of root canals through the use of instruments and irrigating solutions.
  
  
  OBJECTIVE
  To compare the effectiveness of chamomile hydroalcoholic extract, Biopure™ mixture of tetracycline isomer, acid and detergent (MTAD) and 2.5 % sodium hypochlorite (NaOCl) on removal of the smear layer.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Thirty extracted single-rooted, primary human teeth were allocated at random into three experimental groups of 10 teeth each. For each tooth, the canal was prepared using the step-back technique. During instrumentation, 2 ml of the irrigant was used for at least 10 s after each file and 10 ml as a final flush for 2 min for chamomile and NaOCL irrigants. Whereas for MTAD, an initial rinse with 1.3 % NaOCl for a cumulated period of 20 min, and use of MTAD as the final rinse for a period of 5 min was followed. Longitudinal grooves were made on root segments, then split into two halves with a chisel, stored in 2.5 % glutaraldehyde solution and fixed in ethanol series. Specimens were examined for the smear layer according to Hulsmann et al. (Int Endod J 35:668-679, 2002) criteria using a scanning electron microscope.
  
  
  METHODS
  Kruskal-Wallis and Mann-Whitney U tests were used.
  
  
  RESULTS
  The most effective result in removal of smear layer occurred with the use of MTAD, followed by chamomile extract. The chamomile extract was found to be significantly more effective than 2.5 % NaOCl solution which had only minor effects.
  
  
  CONCLUSIONS
  The efficacy of chamomile to remove the smear layer was superior to 2.5 % NaOCl alone, but less effective than MTAD mixture.
authors.affiliation: Department of Paedodontics and Preventive Dentistry, Rama Dental College Hospital and Research Centre, # A/1-8, Lakhanpur, Kanpur, 208024, Uttar Pradesh, India, vatsalashankar@yahoo.co.in.
authors.forename: V
authors.initials: V
authors.lastname: Venkataram
authors.forename: S T
authors.initials: ST
authors.lastname: Gokhale
authors.forename: M
authors.initials: M
authors.lastname: Kenchappa
authors.forename: R
authors.initials: R
authors.lastname: Nagarajappa
mesh_terms: D020843:Chamomile; D003786:Dental Pulp Cavity; D003804:Dentin; D003902:Detergents; D004492:Edetic Acid; D006801:Humans; D008422:Materials Testing; D031168:Matricaria; D008855:Microscopy, Electron, Scanning; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000295:instrumentation; D016369:Smear Layer; D012964:Sodium; D012973:Sodium Hypochlorite; D018709:Statistics, Nonparametric; D013752:Tetracycline; D019227:Tooth Apex
chemical_list: D003902:Detergents; D012388:Root Canal Irrigants; D004492:Edetic Acid; D012964:Sodium; D012973:Sodium Hypochlorite; D013752:Tetracycline