Research of the major methods and clinical outcomes of irrigation in endodontics: a systematic review

Abstract

Introduction: In the context of endodontic treatment, mainly endodontic irrigation, endodontic therapy promotes the removal of debris from the pulp tissue, seeking cleaning and asepsis against various microorganisms. Objective: Carried out a systematic review of the main methods and clinical outcomes of irrigation in endodontics, presenting information on the effectiveness and biocompatibility on the dentin surface. Methods: The present study followed by a systematic review (PRISMA). The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. Results and Conclusion: The success of endodontic treatment depends on eradicating microbes (if present) from the root canal system and preventing reinfection. In research comparing the effectiveness of EDTA 17% maleic acid to 7%, and observed a greater effectiveness of maleic acid in removing the smear layer from the apical third of single-adicular human teeth. When compared to maleic acid, 5% of 17% EDTA proved to be equally effective. Irrigation with 70% ethanol showed a significantly higher percentage of clean root canal walls and greater depth of clean dentinal tubules when compared to irrigation with 2.5% sodium hypochlorite and 17% EDTA-T. The volume of irrigants and agitation act to reduce the microhardness of dentin in the root canal. The smallest reduction in hardness was found in the EDTA + NaOCl association, which can be explained by the fact that one substance has the power to neutralize the other. An alternative EDTA (EDTA - T) to the conventional one was studied and showed good results to remove the smear layer and a good antimicrobial action, but showed a greater potential to generate inflammation than conventional 17% EDTA and 10% citric acid. Finally, one study showed that PUI with continuous irrigation and SAF were more effective than EndoVac and the conventional syringe in removing the drug Ca(OH)2 from a standardized artificial groove in the apical part of the root canal.

In vitro apical microleakage evaluation for different endodontic sealers by spectrophotometric analysis: an observational study

“…For greater exposure of the dentinal tubules, to create a dentine substructure, and to remove the smear layer, an ultrasonic endoactivator device was utilized to stir the irrigant. 41 The instrumentation methodology was the same for all the obtained samples in attempts to lessen the number of variables across groups. The Protaper next file (PTN) rotary system was used for instrumentation manufactured by Dentsply from X1(0.17/04) through X4(0.40/0.06) were the only kind of rotary file protapers utilized for instrumenting all samples to guarantee uniform instrumentation methodology for all models.…”

Sodium hypochlorite as an endodontic irrigant and its effect on dentine: a review of literature

“…Although root canals are shaped mechanically either by hand or rotary instrumentation, the eradication of microorganisms is completed by adequate irrigation. 4,5,6 The combination of mechanical debridement and the use of an adequate canal irrigant results in an even greater decrease of the microbial population. 7,8,9,10 Sodium hypochlorite, as the irrigant, is responsible for the dissolution of organic pulpal tissue.…”

“…22 The effect of sodium hypochlorite on root canal dentine Irrigation with sodium hypochlorite has an effect on mechanical effects of dentine including flexural strength, microhardness and elasticity. 4…”

In vitro evaluation of three engineered multispecies endodontic biofilms on a dentinal disk substrate

“…The root canal system, on the other hand, has an extremely complicated anatomy, with isthmuses, lateral extensions, apical deltas, lateral canals, and dentinal tubules providing protection to microorganisms from instruments and disinfectants [ 6 ]. Furthermore, the bacteria’s biofilm lifestyle in the root canal adds to the difficulty [ 7 ]. The microbial cells are immersed in a self-produced extracellular matrix and adhere to the canal walls.…”