Evaluation of the use of various herbal extracts and vinegar in primary teeth root canal irrigation

Aim: In this study, it was aimed to evaluate antimicrobial properties against E. faecalis and C. albicans, and smear layer removal efficiency of various plant extracts and apple cider vinegar. Material and Method: Roots randomly divided into two groups (n: 112) for antimicrobial study were infected with E. faecalis (n: 56) and C. albicans (n: 56). They were randomly divided into 7 groups (n: 8) as saline, NaOCI, white tea, Helichrysum arenarium, apple cider vinegar, citrus lemon, and Anzer thyme. Root canals were irrigated with solutions MBK / MFK values predetermined, after the application CFU counts were made with ImageJ program. In the evaluation of smear layer removal efficiency, prepared teeth (n: 70) were divided into 7 groups (n: 10) determined in the antimicrobial study. While 5 samples in each group were irrigated with only the tested solution, 5 samples were also irrigated with EDTA after irrigation. The roots were divided into two, and Scanning Electron Microscopy (SEM) images were taken from the coronal, middle, and apical regions at X1000 magnification. Open dentin tubule percentage was evaluated by using ImageJ program. Results: Helichrysum arenarium and citrus lemon showed higher antibacterial activity against E. faecalis than saline (p=0.038, p=0.009), similar to NaOCl (p> 0.05). It was determined that apple cider vinegar showed higher antifungal activity on C. albicans compared to saline (p <0.001) and similar to NaOCl (p> 0.05). In the removal of the smear layer, it was determined that apple cider vinegar in the coronal third and citrus lemon in the middle third removed more smear layer than saline and NaOCI (p<0.05) and there was no statistically significant difference between the groups and NaOCI-EDTA (p>0.05). In apical third, it was found that the apple cider vinegar and Anzer thyme groups showed similar results with the NaOCI-EDTA group (p> 0.05). Conclusion: Within the limitation of this study, citrus lemon, which can remove the smear layer and has an antibacterial effect against E. feacalis, and apple cider vinegar with antifungal effect against C. albicans can be recommended as an alternative to chemical irrigation solutions in primary teeth root canal irrigations. Furthermore, the use of Helichrysum arenarium, which has an antibacterial effect against E. feacalis, together with EDTA can be recommended as an alternative irrigation solution. Further studies are needed to be planned with existing herbal agents.