Frankincense Versus Sodium Hypochlorite for Root Canal Disinfection

Summary

This research study is being done to find out if a natural ingredient called frankincense can clean infected root canals as effectively as the standard cleaning solution currently used in dentistry. When a tooth's nerve dies from infection, dentists use a strong cleaning liquid, called sodium hypochlorite, to kill bacteria inside the tooth before filling it. This liquid works well, but it can sometimes irritate the gums or taste unpleasant. Frankincense, a natural substance long used in Oman, has shown early signs in laboratory studies that it may also fight bacteria effectively, with fewer side effects. In this study, patients needing root canal treatment for an infected, dead tooth will be randomly placed into one of two groups. One group will have their tooth cleaned with the standard liquid. The other group will have their tooth cleaned with the frankincense-based liquid. Before and after cleaning, a small, painless sample will be taken from inside the tooth to measure how much bacteria is present, using a lab test called PCR. The results from both groups will then be compared to see which cleaning liquid removes more bacteria. Patients who are between 18 and 50 years old, and who need root canal treatment for a dead/infected tooth, may be able to join. The study involves no extra visits beyond normal root canal treatment.

Timeline

Start

2027-01-19

Primary completion

2027-12-07

Completion

2028-05-07

Publications

• Background Gutmann JL, Manjarres V. Historical and Contemporary Perspectives on the Microbiological Aspects of Endodontics. Dent J (Basel). 2018 Sep 22;6(4):49. doi: 10.3390/dj6040049.
• Background Palwankar D, Garg A, Tandan M, Bhasin P, Sachdeva A, Palwankar P. Antimicrobial efficacy of two commercially available herbal products with and without ultrasonic activation in primary endodontic infections: A randomized clinical trial. J Conserv Dent Endod. 2024 Mar;27(3):305-309. doi: 10.4103/JCDE.JCDE_308_23. Epub 2024 Mar 6.
• Background Das A, et al. Comparative evaluation of herbal irrigants on root canal microflora: a clinical study. J Conserv Dent. 2024;27(2):120-126.
• Background Almohareb RA, et al. Antibacterial efficacy of frankincense extract against Enterococcus faecalis: an in vitro study. Saudi Dent J. 2025;37(1):45-52.
• Background Di Stefano M, et al. Chemical composition and antimicrobial activity of Boswellia sacra essential oils. Microorganisms. 2020;8(6):984.
• Background Abushouk S, Lundy F, Linden G, Abdel Hamid MM, Ibrahim Y, El Karim I. Quantitative Analysis of Candidate Endodontic Pathogens and Their Association with Cause and Symptoms of Apical Periodontitis in a Sudanese Population. Eur Endod J. 2021 Apr;6(1):50-55. doi: 10.14744/eej.2020.52297. Epub 2021 Mar 3.
• Background Zhang D, Shen Y, de la Fuente-Nunez C, Haapasalo M. In vitro evaluation by quantitative real-time PCR and culturing of the effectiveness of disinfection of multispecies biofilms in root canals by two irrigation systems. Clin Oral Investig. 2019 Feb;23(2):913-920. doi: 10.1007/s00784-018-2515-x. Epub 2018 Jun 15.
• Background Swimberghe RCD, Coenye T, De Moor RJG, Meire MA. Biofilm model systems for root canal disinfection: a literature review. Int Endod J. 2019 May;52(5):604-628. doi: 10.1111/iej.13050. Epub 2018 Dec 20.
• Background Siqueira JF Jr, Rocas IN. Present status and future directions: Microbiology of endodontic infections. Int Endod J. 2022 May;55 Suppl 3:512-530. doi: 10.1111/iej.13677. Epub 2022 Jan 13.
• Background Cai C, Chen X, Li Y, Jiang Q. Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. Biomed Res Int. 2023 Jan 13;2023:8858283. doi: 10.1155/2023/8858283. eCollection 2023.

Drugs

Indications