Effects of intracanal Curcumin, Aloe vera, and Calcium hydroxide during four weeks on pH changes in simulated root surface resorption defects: An in vitro study

Abstract

Introduction: Commonly used intracanal medicaments in the treatment of external inflammatory root resorption have shown adverse effects, resulting in an increasing tendency to use natural and/or herbal medicaments. The present experimental study aimed to evaluate the effects of aloe vera and curcumin, as two natural intracanal medicaments, on the pH of the external root surface, in comparison with calcium hydroxide, as a common chemical agent used in endodontic treatments. Materials and methods: In this in vitro study, 92 permanent teeth, including incisors, canines, and mandibular premolars, with one root, a single root canal, and no previous endodontic treatment, were randomly divided into four groups. All samples were decoronated to achieve a length of 14 mm from the apex, and the root canals were prepared using the ProTaper rotary system. To simulate external inflammatory root resorption lesions, a cavity with a diameter of 1.4 mm and a depth of 0.7 mm was prepared on the buccal surface of each root, 5 mm from the apex. The root canals in each of the study groups were filled with one of the medicaments, including aloe vera, curcumin, and calcium hydroxide. Also, the root canals of 23 teeth, assigned as the control group, were filled with normal saline. The pH was measured in each vial after 20 minutes, 24 hours, and 7, 14, 21, and 28 days using a digital pH meter. The data were reported using descriptive statistical methods (mean ± standard deviation) and analyzed using repeated-measures ANOVA. Statistical significance was set at P<0.05, and SPSS 20 was used for statistical analyses. Results: At the baseline (day 0), days 1 and 7, the mean pH of both aloe vera and curcumin groups was higher than the mean pH of the calcium hydroxide and normal saline groups (all P<0.05). On day 14, the mean pH of the aloe vera group was higher than the calcium hydroxide and normal saline groups (both P<0.05). On days 21 and 28, the mean pH in the aloe vera group was higher than the mean pH of all other groups (all P<0.05). All other intergroup differences at each time point, were not statistically significant (all P>0.05). Conclusion: The current in vitro study demonstrated that curcumin and aloe vera could be considered effective alternatives for chemical agents to be used in EIRR treatment. However, the effect was more significant in teeth treated with aloe vera gel.