Clinical and Radiographic Evaluation of Allium sativum Oil (Garlic Oil) in Comparison with Formocresol in Primary Molar Pulpotomy

Evaluation of Cytotoxicity of Allium sativum (Garlic Extract) against Human Dental Pulp Fibroblasts

Background

Vital pulp therapy procedures in primary dentition focuses on preservation and maintenance of pulp tissue that has been compromised due to caries, trauma, etc. Several pulp dressing materials have been used in primary teeth and some natural materials from the field of traditional medicine have also been introduced as medicaments in vital pulp therapy. The understanding of biologic and cytotoxic properties of newer materials is important for safe clinical usage. The biologic compatibility of these newer materials is imperative to limit or avoid tissue irritation or degeneration.

Aim

To evaluate the cytotoxic effects of Allium sativum on cultured human primary dental pulp fibroblasts.

Materials and methods

Primary pulp fibroblasts were cultured from the pulp tissue obtained from extracted deciduous primary canines and central incisor teeth. The freshly prepared concentrations of 1000, 500, 250, 125, and 62.5 µg/mL A. sativum extract were added to the 96-well plate in triplicates to which culture medium containing fourth passage cell suspension was added previously. Cells without treatment served as control, while cells treated with 5% dimethyl sulfoxide (DMSO) served as toxic control. After the addition of experimental and control agents, cells were incubated for 24 and 48 hours at 37°C in 5% CO2 atmosphere. After the incubation period, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to determine the number of viable cells. Absorbance was read with a microplate reader at 570 nm wavelength and the relative viability of dental pulp fibroblasts at various concentrations was expressed as color intensity of the experimental wells relative to that of control. The percentage of cell viability was also calculated accordingly.

Results

The MTT assay results revealed that A. sativum extract, in all the concentrations tested at both the time intervals maintained a cell viability of greater than 90%. At 24 hours, the mean absorbance value of untreated control wells was recorded as 0.84400 ± 0.00916 with 100% cell viability. Among all the concentrations of garlic extract tested, highest mean absorbance value of 0.83933 ± 0.00550 with 99.44% cell viability was recorded for 62.5 µg/mL concentration. At 48 hours, the mean absorbance value of untreated control wells was recorded as 1.22767 ± 0.01106 with 100% cell viability, and the highest mean absorbance value of 1.22567 ± 0.01006 with 99.83% cell viability was recorded for 62.5 µg/mL concentration. The cell viability did not seem to be affected by the concentration of A. sativum extract at 24 hours. However, at 48 hours, the sensitivity of the cells was observed to be dependent on the concentration of A. sativum with a decrease in the viability of cells noted with the increase in concentration.

Conclusion

A. sativum extract is noncytotoxic in nature and preserves the vitality of cultured human primary dental pulp fibroblasts making it a suitable material for use in vital pulp therapy procedures of primary teeth.

How to cite this article

Devaraju R, Reddy D, Paul ST, et al. Evaluation of Cytotoxicity of Allium sativum (Garlic Extract) against Human Dental Pulp Fibroblasts. Int J Clin Pediatr Dent 2024;17(2):143-148.

Does the use of natural products for endodontic therapy in primary teeth have sufficient evidence for clinical practice? A scoping review

OBJECTIVES

The use of natural products for pulp therapy has experienced a remarkable advancement in recent years. The aim was to provide a critical appraisal of the safety and efficacy of natural products for endodontic therapy in primary teeth and verify whether their uses in clinical practice have sufficient evidence.

MATERIALS AND METHODS

Two reviewers searched ten databases (Cochrane, DOSS, Embase, Google Scholar, LILACS, OpenGrey, Proquest, PubMed, Scopus, and Web of Science) until January 2022, identifying references that evaluated the safety and efficacy of the use of natural products for endodontic therapy in primary teeth. Cohort, randomized, and non-randomized clinical trials were included.

RESULTS

A total of 3583 references were initially identified. From the 63 studies retrieved for full-text reading, 37 fulfilled the selection criteria and were included in the qualitative analysis. The studies investigated 19 natural products for pulpotomy medicament, irrigating solution, intracanal medication, and root canal filling material. Most studies showed similar efficacy of natural products and their control groups; however, many methodological biases and concerns about the safety and efficacy of natural products were identified, questioning their clinical applicability.

CONCLUSIONS

The included studies provided insufficient evidence to support safe and effective clinical application of natural products for endodontic therapy in primary teeth. Future well-designed studies with representative samples are needed to support the use of natural products for endodontic therapy in primary teeth.

CLINICAL RELEVANCE

The use of natural products for endodontic therapy in primary teeth requires caution by clinicians, due to the insufficient available evidence.

The clinical and radiographic evaluation of Allium sativum oil (garlic oil) in comparison with mineral trioxide aggregate in primary molar pulpotomy

BACKGROUND

Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth.

MATERIALS AND METHODS

This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance.

RESULTS

The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant.

CONCLUSION

According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.