Endodontic irrigants from a comprehensive perspective

Abstract

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping. It reviews commonly used endodontic irrigant, namely sodium hypochlorite (NaOCl), herbal extracts, chlorhexidine (CHX), and chelating agents, highlighting their properties, applications, and potential drawbacks. NaOCl, a key antimicrobial agent, demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity. Herbal extracts, gaining recognition in endodontics, present an alternative with potential advantages in preserving dentin integrity. CHX, known for its broad-spectrum antimicrobial activity, is discussed in both liquid and gel formulations, emphasizing its role in reducing smear layer formation and preserving hybrid layer durability. Chelating agents, specifically ethylenediaminetetraacetic acid and citric acid, play a vital role in removing the smear layer, enhancing dentin permeability, and facilitating the penetration of antimicrobial agents. The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures. It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

Keywords: Root canal irrigants; Sodium hypochlorite; Chlorhexidine; Chelating agents; Plant extracts

Core Tip: To increase the effectiveness of mechanical preparation and bacterial removal, irrigation is necessary. The dentist must be familiar with their different modes of action, indications, advantages, and disadvantages. This article provides an overview of the characteristics of the main endodontic irrigants for the professional class. The primary irrigants used in the field of endodontics include sodium hypochlorite, chlorhexidine, ethylenediaminetetraacetic acid, tetracycline antibiotics, TetraClean, calcium hydroxide, distilled water, and herbal irrigants. It was concluded that none of these irrigants are ideal, making it necessary to evaluate each case individually for their use and conduct further research to identify the best candidate.