الفهرس 
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Abstract
Endodontic treatment aims to destroy and remove the microorganisms from root canal, and preventing the reinfection. However; the complexity of the root canal systems prevents the complete debridement and disinfection. Thus, the usage of intracanal medications is recommended for provoking root canal system disinfection.
Calcium hydroxide is the most commonly used between visits in root canal treatment due to its antibacterial and tissue dissolving properties. Despite its antibacterial and hard tissue inductive effect, it adversely affects the mechanical properties of root canal dentin.
Hence, phytotherapeutics has gained a great attention as an attempt to overcome the side effects of the chemical intracanal medications. Thus, the aim of the current study was to evaluate and compare the mechanical effect of Morinda Citrifolia, Triphala, German Chamomile, and lemon herbal extracts on root canal dentin in terms of fracture resistance and dentin microhardness. As well as their antibacterial effect on E.feacalis bacteria.
One hundred and twenty single rooted teeth were selected for the study. After performing access cavities, the working length was determined by passing sterile ISO K-file size 15 penetrating the apical foramen then subtracting 1mm, and the root canals were prepared using protaper universal rotary file sequence up to size F5 (50/0.05). NaOCL (5.25%) was used as an irrigating solution between each file. Smear layer was removed by using 5ml of 5.25% of Sodium hypochlorite solution followed by 5ml of 17% EDTA and 5 ml of saline solution.
Ninety teeth were randomly selected to evaluate the effect of the used intracanal medicaments on fracture resistance using Instron universal testing machine with a load cell of 5 KN after being randomly assigned into six groups:
1) group I (negative control): No intracanal medication was used.
2) group II: Root canals of the samples were medicated with paste of 6% Morinda cirtifolia extract in carboxy methyl cellulose.
3) group III: Root canals of the samples were medicated with paste of 25% German Chamomile in carboxy methyl cellulose.
4) group IV: Root canals of the samples were medicated with paste of 10% Triphala extract in carboxy methyl cellulose.
5) group V: Root canals of the samples were medicated with paste of fresh lemon solution in carboxy methyl cellulose.
6) group IV: Root canals of the samples were medicated with Ca(OH)2 paste.
Each group was divided into three subgroups according to timing of evaluation:
a. Subgroup A= after 24 hours.
b. Subgroup B= after 1 week.
c. Subgroup C= after 1 month.
The same samples used for determination of fracture resistance were used to determine the microhardness alteration after being removed from the acrylic blocks. The cervical cracked part of each root was removed, then 2mm thick horizontally sectioned specimen from each root was cut with a water-cooled diamond saw (Isomet). The microhardness measurements were performed using a Vickers Microhardness Tester at three points for each sample on the top dentin surface of each specimen.
For the evaluation of the antibacterial efficacy of these tested herbal extracts, thirty-five samples were assigned randomly into seven groups (n = 5 each) according to the type of intracanal medication used:
1) group I (negative control): No bacterial inoculation as well as no intracanal medication was used.
2) group II (untreated): No intracanal medication was used (only saline).
3) group III: Root canals of the samples were medicated with paste of 6% Morinda cirtifolia extract in carboxy methyl cellulose.
4) group IV: Root canals of the samples were medicated with paste of 25% German Chamomile in carboxy methyl cellulose.
5) group V: Root canals of the samples were medicated with paste of 10% Triphala extract in carboxy methyl cellulose.
6) group VI: Root canals of the samples were medicated with fresh lemon solution in carboxy methyl cellulose.
7) group VII: Root canals of the samples were medicated with Ca(OH)2 (Metapaste).
The apical foramen was sealed with cyanoacrylate and they were coated with two layers of nail varnish. Each root canal was filled with the E.faecalis suspension that was adjusted for 0.5 McFarland turbidity standard, then submerged in the prepared bacterial suspension in sterile coded sealed flasks incubated for 72 hours.
The results of the current study showed that each of Morinda Citrifolia, German Chamomile, and Triphala had no significant effect either on the fracture resistance or the microhardness through the different times of testing. While lemon showed a significant decrease of both fracture resistance and microhardness at each of one week and one month testing times when compared to the negative control group. In addition, there were significant differences between one day and one week, and between one day and one month, while there was no significant difference between one week and one month testing times.
On the other hand, Ca(OH)2 showed a significant decrease of both fracture resistance and microhardness at each of one week and one month testing times, when compared to the negative control group. In addition, there were significant differences between one day and one week, and between one day and one month, while there was no significant difference in the fracture resistance between one week and one month testing times. However, there was a significant difference between mean values of microhardness of one week and one month testing times.
Regarding the antibacterial effect of the used intracanal medicaments, the four used herbal extracts showed a significant decrease in the bacterial count in comparison to the Ca(OH)2 group where Morinda Citrifolia showed the least bacterial count followed by Triphala, German Chamomile then lemon. While Ca(OH)2 showed the highest reduction in bacterial count when compared to the four herbs.