Customised enriched coconut oil as panacea for oral biofilm mediated diseases - A prospective study.

Aims: To evaluate a customised enriched formulation of coconut (CEC) oil with Arimedadi Tailam (AT) and 0.2% chlorhexidine mouth rinse (CHX) for their plaque control and potential anticaries effects using the oratest in healthy volunteers. Settings and Design: Parallel, double-blinded (outcome assessor and statistician), randomised controlled institution-based pilot study. Methods and Materials: 60 adults (18-22 years) having DMFT score of 2-11, gingival and plaque index as zero, no history of antibiotics for one month or fluoride application in 2 weeks were randomly divided (computer-generated list) and allocated into 3 groups (A-CHX, B-CEC, C-AT) of 20 subjects each based on the intervention. Oratest at baseline, days 15 and 30 were recorded. Statistical Analysis Used: Due to 5 dropouts on day 30, data were analysed based on the intention-to-treat (ITT) approach. The difference in oratest scores (baseline vs. day 15 and 30) were found to be normally distributed (Shapiro-Wilk test and Levene's test). One way ANOVA followed by Tukey's post hoc test was used to determine the statistically significant difference (P < 0.05) between groups. Results: Plaque and gingival index was zero throughout the study period. Difference in oratest scores was highest with CEC oil, followed by CHX and AT though there was no statistically significant differences between groups at baseline vs day 15 (P = 0.203) and baseline vs day 30 (P = 0.085) and between oils from baseline vs day 30 (P = 0.068). Conclusions: Within the limitations of the pilot study, both oils are comparable to CHX for their antiplaque and anticaries potential. Clinically, CEC was better than AT though statistical difference was not there.

Treasure from trash - Is Ecoenzyme the new panacea in conservative dentistry and endodontics?

Context: Endodontic biofilm eradication is achieved by chemo-mechanical disinfection. The search for a safer, nontoxic irrigant led us to a natural product, Ecoenzyme. Aim: This study aims to analyze Ecoenzyme (EE) and explore its antimicrobial and biofilm disrupting activity against a 1-week mature multi-species biofilm. Materials and Methods: Qualitative assessment of the phytochemicals present in EE was conducted. Minimal inhibitory concentration (MIC), minimum bactericidal concentration, and zone of inhibition (ZOI) were recorded. Multi-species biofilm of Streptococcus mutans (MTCC 497), Lactobacillus acidophilus (MTCC 10307), and Enterococcus faecalis (ATCC 29212) was grown and time-kill assay was performed to test biofilm disruption for EE, 3.5% sodium hypochlorite (NaOCl) (control). Student's t-test and one-way ANOVA with post hoc analysis were conducted for ZOI and time-kill assay, respectively. Statistical significance was set at P ≤ 0.05. Results: EE contained secondary metabolites having antibacterial properties. MIC was 25% (S. mutans), 50% (E. faecalis), and >50% (L. acidophilus). EE disrupted ~90% of biofilm species in 5 min of exposure while NaOCl achieved ~99.9% reduction. Further reduction by EE progressed over 20 min after which no viable bacteria in the biofilm was cultivable. Conclusions: Lemon peel Ecoenzyme (EE) is antimicrobial with effective biofilm-disrupting properties on a mature multi-species biofilm. However, its effects were slower than 3.5% sodium hypochlorite.

Can natural irrigants replace sodium hypochlorite? A systematic review.

CONTEXT: Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored. AIMS: This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite. SETTINGS AND DESIGN REGISTRATION: This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence. RESULTS: Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success. CONCLUSIONS: The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.

Solitary bone cysts-A rare occurrence with bilaterally symmetrical presentation.

Solitary bone cysts (SBCs) are bone cavities that lack a true epithelial lining. They are more commonly seen during the first 2decades of age.Very few cases have been reported over 40 years of age.SBCs are usually discovered as an accidental coexisting finding during a routine radiologic examination or during another unrelated dental complaint. They present as a unilocular or multilocular radiolucent lesion associated with vital teeth with mild or no cortical expansion. Bilateral presentation is however very rare. We present a case of 52-year-old female patient with bilateral presentation of SBCs.