A Multi-Criteria Approach for Comparison of Ginger Extract and Conventional Irrigants in Root Canal Treatment

Abstract

Background Considering the importance of irrigation in dental root canal treatment, there is an urgent need to find a risk-free bioactive and antibacterial endodontic solution. Enterococcus faecalis, an anaerobic gram-positive coccus, has been identified as the main reason for endodontic infections. Several studies have been conducted on E. faecalis and periapical infection. Nowadays, plants used in traditional medicine play a role that is widely appreciated by researchers. One of these herbs is ginger which shows an acceptable antimicrobial effect on E. faecalis. Due to the highly crucial role that irrigation plays in the success of endodontic treatment, a comprehensive survey based on several criteria, namely, scientific, technical, and empirical, is required to address the goal of determining the best endodontic solution. Methodology The most important criteria are antibacterial activity, risks and hazards, cost, and availability. In this study, the analytical network process (ANP), which is a multi-criteria decision-making method, was applied to determine the best endodontic irrigant. Results Several alternatives were investigated using the ANP. In this study, 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine were at the top of the list. According to the sensitivity analysis, 10% ethanolic ginger extract showed comparable results to 2.5% NaOCl. Conclusions To carefully prioritize endodontic irrigants a wide range of standards and criteria should be considered. Considering the low risk, great wettability, and active compounds of ginger extract, it can be a promising viable risk-free solution for root canal treatments.

Keywords: anp; antimicrobial efficacy; enterococcus faecalis; ethanolic extract; ginger; naocl.

Figure 1. Hierarchy structure of the studied problem.

Figure 2. Decision-making process.

Figure 3. Structure of gingerol, an active component of ginger extract.

Figure 4. Sensitivity analysis to assess the effects of weight change in the risk criteria.

GINGER-E = ethanolic ginger extract; NaOCl = sodium hypochlorite; CHX = chlorhexidine

Figure 5. Sensitivity analysis based on accessibility of each solution.

GINGER-E = ethanolic ginger extract; GINGER-W: water-based (aqueous) ginger extract; NaOCl = sodium hypochlorite

Figure 6. Sensitivity analysis based on surface tension.

GINGER-E = ethanolic ginger extract, GINGER-W = water-based (aqueous) ginger extract; NaOCl = sodium hypochlorite