What question did this study set out to answer?

The aim is to evaluate the effectiveness of an ethyl acetate fraction of Salvadora persica in removing smear layers and penetrating dentinal tubules.

May 17, 2026Open Access

Smear Layer Removal and Dentinal Tubules Penetration of an Ethyl Acetate Fraction of Salvadora persica Combined with Low-concentration Sodium Hypochlorite

AKAndina RP KusumaUniversitas Gadjah Mada DRDiatri Nari RatihUniversitas Gadjah Mada DIDyah IrnawatiUniversitas Gadjah Mada

Key Points

The aim is to evaluate the effectiveness of an ethyl acetate fraction of Salvadora persica in removing smear layers and penetrating dentinal tubules.
40 human single-rooted premolars were allocated into four groups: saline, FEA miswak, FEA miswak + 1.25% NaOCl, and EDTA.
Smear layer removal was assessed using scanning electron microscopy; dentinal tubule penetration was measured with crystal violet bleaching.
FEA miswak + NaOCl group showed comparable smear layer scores to EDTA (p > 0.05).
Mean penetration depth of FEA miswak + NaOCl was 201.39 µm, and FEA miswak alone was 212.71 µm.

Abstract

Aims: To evaluate the smear layer removal ability, dentin mineral alteration, and dentinal tubules penetration of an ethyl acetate fraction (FEA) of Salvadora persica (Miswak) at 5 mg/mL, used alone and in combination with 1.25% sodium hypochlorite (NaOCl), compared with saline, 2.5% NaOCl, and EDTA.Materials and methods: Forty human single-rooted premolars extracted for orthodontic purposes were prepared using rotary instrumentation.Specimens were randomly allocated into four groups (n = 10): saline (negative control), FEA miswak (5 mg/mL), FEA miswak + 1.25% NaOCl, and EDTA (positive control).Smear layer removal was evaluated using scanning electron microscopy (SEM) with a four-grade ordinal scoring system, and dentinal mineral content was analyzed using energy-dispersive X-ray spectroscopy (EDX).Dentinal tubule penetration was assessed by crystal violet bleaching depth.Statistical analysis was performed using the Kruskal-Wallis test with post-hoc comparisons for smear layer scores and one-way ANOVA with Bonferroni correction for penetration depth.Results: Significant differences were observed among irrigation groups in smear layer removal (p 0.05), while FEA miswak alone performed significantly better than saline.Dentinal tubules penetration differed significantly between groups (p 0.05). Conclusion:The FEA miswak, particularly when combined with low-concentration NaOCl, demonstrated smear layer removal comparable to EDTA and enhanced dentinal tubules penetration, with minimal mineral alteration.Clinical significance: Conventional root canal irrigation requires multiple solutions, is time-consuming, and risks dentin over demineralization.This study addresses the clinical need for simplified, multifunctional irrigants that maintain efficacy while preserving dentin integrity.The FEA miswak + low-concentration NaOCl combination offers translational potential as a single-dose root canal irrigant, potentially reducing chair time and adverse tissue effects in endodontic practice.

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