A Review - Irrigation in Endodontics

Abstract

The goal of endodontic therapy is the removal of all vital or necrotic tissue,
microorganisms, and microbial by-products from the root canal system. This may be achieved through
chemomechanical debridement of root canal. In this review article, the specifics of the pulpal
microenvironment and the resulting requirements for irrigating solutions are spelled out. Sodium
hypochlorite solutions are recommended as the main irrigants. This is because of their broad antimicrobial
spectrum as well as their unique capacity to dissolve necrotic tissue remnants. Chemical and toxicological
concerns related to their use are discussed, including different approaches to enhance local efficacy without
increasing the caustic potential. In addition, chelating solutions are recommended as adjunct irrigants to
prevent the formation of a smear layer and/or remove it before filling the root canal system. Along with
traditional irigants, newer irrigants are also studied for potential replacement of sodium hypochloride. This
article reviews the potential irrigants with their advantages and limitations with their future in endodontic
irrigation. Based on the actions and interactions of currently available solutions, a clinical irrigating regimen
is proposed. Furthermore, some technical aspects of irrigating the root canal system are discussed, and
recent trends are critically inspected.