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Information about the root dentin micro-hardness of endodontically treated teeth is scarce. This study is one of the few studies that examines the effect of endodontic materials on root dentin micro-hardness. In the present study, the ability of the Knoop micro-hardness test to detect surface changes of dentin after treatment with MTAP, Calcium hydroxide and aloe vera was demonstrated.
After 14 days, least reduction of root dentin micro hardness was found to be in the control group, followed by the aloe vera group, calcium hydroxide group and MTAP group. MTAP showed highest reduction in micro-hardness when compared to all the other groups. This could be explained by the demineralizing effects of this acidic antibiotic mixture. The demineralization effect is due to the reduction in phosphate/amide I ratio after MTAP treatment when compared to untreated dentine.
Although Ca(OH)2 is the most commonly used intracanal medicament, but in the present study, Ca(OH)2 also showed reduction in root dentin micro-hardness at moderate to intermediate level. This result was similar to Yassen GH, Platt JA et al in 2013. The destruction caused could be due to highly alkaline inorganic molecule with pH of 11.8 resulting in either denaturing of organic matrix or breakdown of dentin inorganic structure. Another reason for this reduction can be due to its small molecular size, it can penetrate the intrafibrillar structure of mineralized collagen fibrils which causes changes in the three-dimensional confirmation of tropocollagen, leading to a decreased micro-hardness of dentin.
In the present study, group treated with Aloe Vera showed lowest reduction of root dentin micro-hardness. There is scarcity in the literature regarding effects of Aloe Vera on micro hardness of root dentin. However, Sinha et al in 2016 claimed that Aloe Vera had no adverse effect on the shear bond strength of dentin.
There are certain limitations of this study. Firstly, it was an in vitro study. The study was done on the extracted teeth and the results may vary when performed in the vital teeth. And secondly, the result might vary if the medicament was filled till the root apex or not since the penetration depth of each medicament was not checked.
As per the present study, calcium hydroxide and MTAP when used as an intracanal medicament was found to have reduced the root dentin micro-hardness in greater amount when compared to aloe vera. The use of aloe vera as an intracanal medicament is therefore recommended.
Success of endodontic treatment relies upon the elimination of bacteria from the root canal. The use of a root canal medicament has been considered one of the steps necessary to reduce further the microbial population prior to root ﬁlling. Various intracanal medicaments have been tried in endodontic treatment. Aloe Vera shows promising results in terms of good antimicrobial properties and less effects on micro-hardness of root dentin. Further in vivo studies are required to confirm the same.
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