The Effect of Root Canal Irrigants on Dentin: a Focused Review

Overview

Journal Restor Dent Endod

Date 2020 Aug 26

PMID 32839720

Citations 25

Authors

Priti Pragati Rath

Cynthia Kar Yung Yiu

Jukka Pekka Matinlinna

Anil Kishen

Prasanna Neelakantan

Affiliations

Soon will be listed here.

Abstract

Despite the vast literature on the effects of root canal irrigants on the dentin characteristics, the precise effects of clinically relevant irrigation sequences remain unclear. In this review, we systematically dissect the role of different sequential irrigation approaches that are used in clinical endodontics. Using a systematic search strategy, we attempt to answer the question: 'Which irrigating sequence has the most deleterious effects on dentin structure and properties?' The effect of irrigants on the dentin composition and mechanical properties have been reviewed. A wide variety of concentrations, duration and techniques have been employed to characterize the effects of chemicals on dentin properties, thus making it impossible to draw guidelines or recommendations of irrigant sequences to be followed clinically. It was apparent that all the studied irrigation sequences potentially result in some deleterious effects on dentin such as decrease in the flexural strength, microhardness, modulus of elasticity and inorganic content and organic-inorganic ratio of the dentin. However, the literature still lacks comprehensive investigations to compare the deleterious effect of different irrigation sequences, using a wide variety of qualitative and quantitative methods. Such investigations are essential to make clinical recommendations and strategize efforts to minimize chemically-induced damage to dentin characteristics.

Citing Articles

Effect of phthalocyanine, methylene blue and toluidine blue photosensitizers on the adhesive interface of fiber posts: a confocal laser microscopy study.

Gok T, Er Karaoglu G, Korucu H Lasers Med Sci. 2025; 40(1):106.

PMID: 40042533 PMC: 11882690. DOI: 10.1007/s10103-025-04369-z.

A Systematic Review of the Comparative Efficacy of Lactobacillus Probiotics and Sodium Hypochlorite as Intracanal Irrigants Against Enterococcus faecalis.

Mrinalini M, Gupta A, Abraham D, Duraisamy A, Sharma R Cureus. 2024; 16(10):e70926.

PMID: 39502981 PMC: 11536786. DOI: 10.7759/cureus.70926.

[Repair of perirradicular tissues in non-surgical endodontic treatment. A review].

Castillo Paez J, Alvarez M Rev Cient Odontol (Lima). 2024; 12(3):e210.

PMID: 39444728 PMC: 11495172. DOI: 10.21142/2523-2754-1203-2024-210.

Endodontic irrigants from a comprehensive perspective.

Khoury R, de Carvalho L, do Nascimento M, Alhussain F, Abu Hasna A World J Clin Cases. 2024; 12(21):4460-4468.

PMID: 39070803 PMC: 11235474. DOI: 10.12998/wjcc.v12.i21.4460.

Effect of ultrasonic and Er,Cr:YSGG laser-activated irrigation protocol on dual-species root canal biofilm removal: An study.

Datla V, Uppalapati L, Pilli H, Mandava J, Kantheti S, Komireddy S J Conserv Dent Endod. 2024; 27(6):613-620.

PMID: 38989494 PMC: 11232759. DOI: 10.4103/JCDE.JCDE_126_24.

References

Estrela C, Estrela C, Barbin E, Spano J, Marchesan M, Pecora J . Mechanism of action of sodium hypochlorite. Braz Dent J. 2002; 13(2):113-7. DOI: 10.1590/s0103-64402002000200007. View

Sayin T, Serper A, Cehreli Z, Kalayci S . Calcium loss from root canal dentin following EDTA, EGTA, EDTAC, and tetracycline-HCl treatment with or without subsequent NaOCl irrigation. J Endod. 2007; 33(5):581-4. DOI: 10.1016/j.joen.2006.12.010. View

Baldasso F, Cardoso L, da Silva V, Morgental R, Kopper P . Evaluation of the effect of four final irrigation protocols on root canal dentin components by polarized light microscopy and scanning electron microscopy. Microsc Res Tech. 2017; 80(12):1337-1343. DOI: 10.1002/jemt.22946. View

Nissan R, Segal H, Pashley D, Stevens R, Trowbridge H . Ability of bacterial endotoxin to diffuse through human dentin. J Endod. 1995; 21(2):62-4. DOI: 10.1016/S0099-2399(06)81096-4. View

Grawehr M, Sener B, Waltimo T, Zehnder M . Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J. 2003; 36(6):411-7. DOI: 10.1046/j.1365-2591.2003.00670.x. View

Dotto L, Sarkis Onofre R, Bacchi A, Pereira G . Effect of Root Canal Irrigants on the Mechanical Properties of Endodontically Treated Teeth: A Scoping Review. J Endod. 2020; 46(5):596-604.e3. DOI: 10.1016/j.joen.2020.01.017. View

Carda C, Peydro A . Ultrastructural patterns of human dentinal tubules, odontoblasts processes and nerve fibres. Tissue Cell. 2006; 38(2):141-50. DOI: 10.1016/j.tice.2006.01.002. View

Valenzuela A, Overall C . The matrix metalloproteinase gelatinase A in human dentine. Arch Oral Biol. 2000; 45(9):757-65. DOI: 10.1016/s0003-9969(00)00052-2. View

Baldasso F, Roleto L, da Silva V, Morgental R, Kopper P . Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Braz Oral Res. 2017; 31:e40. DOI: 10.1590/1807-3107BOR-2017.vol31.0040. View

10.

Aranda-Garcia A, Kuga M, Chavez-Andrade G, Kalatzis-Sousa N, Duarte M, Faria G . Effect of final irrigation protocols on microhardness and erosion of root canal dentin. Microsc Res Tech. 2013; 76(10):1079-83. DOI: 10.1002/jemt.22268. View

11.

Sim T, Knowles J, Ng Y, Shelton J, Gulabivala K . Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J. 2001; 34(2):120-32. DOI: 10.1046/j.1365-2591.2001.00357.x. View

12.

Kara Tuncer A, Tuncer S, Siso S . Effect of QMix irrigant on the microhardness of root canal dentine. Aust Dent J. 2014; 60(2):163-8. DOI: 10.1111/adj.12242. View

13.

Di Renzo M, Ellis T, Sacher E, Stangel I . A photoacoustic FTIRS study of the chemical modifications of human dentin surfaces: II. Deproteination. Biomaterials. 2001; 22(8):793-7. DOI: 10.1016/s0142-9612(00)00239-8. View

14.

Qian W, Shen Y, Haapasalo M . Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod. 2011; 37(10):1437-41. DOI: 10.1016/j.joen.2011.06.005. View

15.

Zou L, Shen Y, Li W, Haapasalo M . Penetration of sodium hypochlorite into dentin. J Endod. 2010; 36(5):793-6. DOI: 10.1016/j.joen.2010.02.005. View

16.

Paque F, Boessler C, Zehnder M . Accumulated hard tissue debris levels in mesial roots of mandibular molars after sequential irrigation steps. Int Endod J. 2010; 44(2):148-53. DOI: 10.1111/j.1365-2591.2010.01823.x. View

17.

Prado M, Gusman H, Gomes B, Simao R . Scanning electron microscopic investigation of the effectiveness of phosphoric acid in smear layer removal when compared with EDTA and citric acid. J Endod. 2011; 37(2):255-8. DOI: 10.1016/j.joen.2010.11.011. View

18.

Eldeniz A, Erdemir A, Belli S . Effect of EDTA and citric acid solutions on the microhardness and the roughness of human root canal dentin. J Endod. 2005; 31(2):107-10. DOI: 10.1097/01.don.0000136212.53475.ad. View

19.

Gu L, Huang X, Griffin B, Bergeron B, Pashley D, Niu L . Primum non nocere - The effects of sodium hypochlorite on dentin as used in endodontics. Acta Biomater. 2017; 61:144-156. DOI: 10.1016/j.actbio.2017.08.008. View

20.

Lottanti S, Gautschi H, Sener B, Zehnder M . Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J. 2009; 42(4):335-43. DOI: 10.1111/j.1365-2591.2008.01514.x. View