Review highlights most effective irrigation protocols in endodontic therapy
An umbrella review published in the Dentistry Journal in June synthesizes current scientific evidence on the effectiveness of irrigation protocols in endodontic therapy. The study evaluated 13 high-quality systematic reviews and meta-analyses to determine which irrigants and techniques offer the best clinical outcomes in root canal disinfection.
Sodium hypochlorite was confirmed as the most effective primary irrigant due to its superior ability to dissolve organic tissue and eliminate bacteria, the study noted. It also found that passive ultrasonic irrigation significantly improves microbial reduction and apical healing compared to conventional methods. Quantitative analysis revealed statistically significant benefits of passive ultrasonic irrigation, particularly in complex canal systems.
Chlorhexidine was identified as a biocompatible alternative, offering prolonged antimicrobial activity through its substantivity, though it was less effective than sodium hypochlorite in overall disinfection. The review also examined the role of chelating agents that enhance smear layer removal but may compromise dentin integrity if overused.
Despite the growing variety of irrigation techniques — including laser and sonic activation — evidence-based, standardized protocols remain limited, according to the study. The authors call for more consistent clinical guidelines and well-designed comparative trials to support informed decision-making in endodontic treatment planning.
Read more: Multidisciplinary Digital Publishing Institute
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