Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4460-4468
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4460
Endodontic irrigants from a comprehensive perspective
Rayana Duarte Khoury, Lara Steffany de Carvalho, Mauro Felipe Rios do Nascimento, Fadi Alhussain, Amjad Abu Hasna
Rayana Duarte Khoury, Amjad Abu Hasna, Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
Lara Steffany de Carvalho, Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
Mauro Felipe Rios do Nascimento, School of Dentistry, The National Institute of Higher Education and Postgraduate Studies Padre Gervásio-INAPÓS, Pouso Alegre 37550-121, MG, Brazil
Fadi Alhussain, School of Dentistry, Syrian Private University, Al Kiswah 877C+P2, Damascus, Syria
Amjad Abu Hasna, School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador
Author contributions: Khoury RD, de Carvalho LS, do Nascimento MFR, Alhussain F, and Abu Hasna A developed the concept and methodology; Khoury RD, de Carvalho LS, do Nascimento MFR, and Alhussain F performed the analysis and investigation; Khoury RD and Abu Hasna A wrote the original draft of the manuscript and supervised the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amjad Abu Hasna, DDS, MSc, PhD, Assistant Professor, Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, Av. Engenheiro Francisco José Longo, 777 Jardim São Dimas, São José dos Campos 12245000, São Paulo, Brazil. d.d.s.amjad@gmail.com
Received: December 20, 2023
Revised: May 6, 2024
Accepted: June 3, 2024
Published online: July 26, 2024
Processing time: 192 Days and 8.5 Hours
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.