Journal of Conservative Dentistry
Home About us Editorial Board Instructions Submission Subscribe Advertise Contact e-Alerts Login 
Users Online: 64
Print this page  Email this page Bookmark this page Small font sizeDefault font sizeIncrease font size
 

 
Table of Contents   
INVITED REVIEW  
Year : 2010  |  Volume : 13  |  Issue : 4  |  Page : 256-264
Root canal irrigants


Journal of Conservative Dentistry Editor (2005-2007), Department of Conservative dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur - 116, Chennai, Tamil Nadu, India

Click here for correspondence address and email

Date of Submission13-Sep-2010
Date of Decision13-Sep-2010
Date of Acceptance14-Sep-2010
Date of Web Publication29-Nov-2010
 

   Abstract 

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were 'root canal irrigants' and 'endodontic irrigants.' The reference lists of each article were manually checked for additional articles of relevance.

Keywords: Root canal irrigants; endodotic irrigants; NaOCl; EDTA; MTAD; CHX; E faecalis

How to cite this article:
Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent 2010;13:256-64

How to cite this URL:
Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent [serial online] 2010 [cited 2023 Dec 1];13:256-64. Available from: https://www.jcd.org.in/text.asp?2010/13/4/256/73378

   Introduction Top


Bacteria have long been recognized as the primary etiologic factors in the development of pulp and periapical lesions. [1],[2],[3] Successful root canal therapy depends on thorough chemomechanical debridement of pulpal tissue, dentin debris, and infective microorganisms. Irrigants can augment mechanical debridement by flushing out debris, dissolving tissue, and disinfecting the root canal system. Chemical debridement is especially needed for teeth with complex internal anatomy such as fins or other irregularities that might be missed by instrumentation. [4] For this review article we performed a Medline search for all English-language articles published till July 2010. We used the keywords 'root canal irrigants' and 'endodontic irrigants.'


   Ideal Requirements of Root Canal Irrigants Top
[5]

  1. Broad antimicrobial spectrum
  2. High efficacy against anaerobic and facultative microorganisms organized in biofilms
  3. Ability to dissolve necrotic pulp tissue remnants
  4. Ability to inactivate endotoxin
  5. Ability to prevent the formation of a smear layer during instrumentation or to dissolve the latter once it has formed.
  6. Systemically nontoxic when they come in contact with vital tissues, noncaustic to periodontal tissues, and with little potential to cause an anaphylactic reaction.



   Classification Top





   Sodium Hypochlorite Top


History

Sodium Hypochlorite (NaOCl) has an extensive history in medicine and dentistry and continues to be popular even today. During World War I, the chemist Henry Drysdale Dakin and the surgeon Alexis Carrel extended the use of buffered 0.5% NaOCl solution to the irrigation of infected wounds. [6]

Mechanism of action

Pιcora et al. [7] reported that NaOCl exhibits a dynamic balance as is shown by the reaction:

NaOCl + H2O ↔ NaOH + HOCl ↔ Na + + OH + H + + OCl

The chemical reactions between organic tissue [7],[8] and NaOCl are shown in Schemes 1-3:



NaOCl acts as an organic and fat solvent, degrading fatty acids and transforming them into fatty acid salts (soap) and glycerol (alcohol), which reduces the surface tension of the solution [Scheme 1]. [9]



NaOCl neutralizes amino acids forming water and salt [Scheme 2]. With the exit of hydroxyl ions, there is a reduction of pH.



When hypochlorous acid, a substance present in NaOCl solution, comes in contact with organic tissue it acts as a solvent and releases chlorine, which combines with the protein amino group to form chloramines [Scheme 3]. Hypochlorous acid (HOCl ) and hypochlorite ions (OCl ) lead to amino acid degradation and hydrolysis. [9] The chloramination reaction between chlorine and the amino group (NH) forms chloramines that interfere in cell metabolism. Chlorine (a strong oxidant) has an antimicrobial action, inhibiting bacterial enzymes and leading to an irreversible oxidation of SH groups (sulphydryl group) of essential bacterial enzymes. [9]

Thus, the saponification, amino acid neutralization, and chloramination reactions that occur in the presence of microorganisms and organic tissue lead to the antimicrobial effect and tissue dissolution process. [9]

Antimicrobial property - Concentration and time

The most effective irrigation regimen is reported to be 5.25% at 40 min; [10] irrigation with 1.3% and 2.5% NaOCl for this same time interval is ineffective in removing E faecalis from infected dentin cylinders. [11] NaOCl was moderately effective against bacteria but less effective against endotoxins in root canal infection. [12]

Effect on biofilm [13]

  1. Complete dissolution of cells with absence of visual evidence
  2. Bacterial cells are disrupted and separated from the biofilm and are nonviable
  3. Bacterial cells remain adherent within the biofilm but are nonviable
  4. Bacterial cells are disrupted and separated from the biofilm but are viable
  5. Bacterial cells remain adherent within the biofilm and are still viable. [14]
Increasing the efficacy of NaOCl

1. Altering the pH:

a. The antibacterial properties and tissue-dissolving properties of 5.25% NaOCl decrease when it is diluted. [14],[15],[16] When NaOCl is added to water, the following reaction takes place:

In aqueous solution, hypochlorous acid partially dissociates into the anion hypochlorite (OCl ):



The 'available' chlorine is the sum of the HOCl and OCl concentrations in the solution. [17] Available chlorine might be defined as a measurement of oxidizing capacity and is expressed in terms of the amount of elemental chlorine. HOCl is considered to be a stronger oxidant than the hypochlorite ion. The HOCl molecule is responsible for the strong chlorinating and oxidizing action on tissue and microorganisms. HOCl dissociation [Equation 2] depends on pH, with the clinical equilibrium between HOCl and OCl being maintained as HOCl is consumed through its germicidal function. [18] Baker [19] gave the relationship between HOCl, OCl , and pH. At pH 10, basically all chlorine is in the OCl form; the reverse occurs at a pH of 4.5, when all chlorine is in the form of HOCl. The disinfecting properties decrease with higher pH, paralleling the concentration of dissociated HOCl. Bloomfield and Miles [17] confirmed that hypochlorites at a lower pH possess greater antimicrobial activity. Andrews and Orton [19] reported that HOCl was responsible for the destruction of microorganisms. Morris [20] found that OCl ion possesses approximately 1/80 th of the germicidal potency of HOCl in killing Escherechia coli.

Reactive chlorine in aqueous solution at body temperature can take two forms: hypochlorite (OCl ) or hypochlorous acid (HOCl). The concentration of these can be expressed as available chlorine by determining the electrochemical equivalent amount of elemental chlorine, [21] according to the following equations:

Therefore, 1 mol of hypochlorite contains 1 mol of available chlorine. The state of available chlorine is dependant on the pH of the solution. Above a pH of 7.6, the predominant form is hypochlorite and below this value it is hypochlorous acid. [22] Both forms are extremely reactive oxidizing agents. Pure hypochlorite solutions, as are used in endodontics, have a pH of 12, [23] and thus the entire available chlorine is in the form of OCl . However, at identical levels of available chlorine, HOCl is more bactericidal than hypochlorite. [24]

2. Temperature

A rise in temperature by 25°C increased NaOCl efficacy by a factor of 100 (25). The capacity of a 1% NaOCl at 45°C to dissolve human dental pulps was found to be equal to that of a 5.25% solution at 20°C. [26]

3. Ultrasonic

The use of ultrasonic agitation increased the effectiveness of 5% NaOCl in the apical third of the canal wall. [26] Passive ultrasonic irrigation with a nickel-titanium tip produced superior tissue-dissolving effects as compared to sonic irrigant activation. [27]

Influence on mechanical properties

NaOCl is an efficient organic solvent that causes dentin degeneration because of the dissolution of collagen by the breakdown of the bonds between carbon atoms and disorganization of the proteic primary structure. [28] The reduction of the bond strength seen between adhesive systems and dentin walls may be because of the removal of collagen fibrils from the dentin surface by NaOCl, impeding the formation of a consistent hybrid layer. [29]

Influence of NaOCl on NiTi

Busslinger and Barbakow [30] evaluated corrosion of endodontic files caused by NaOCl solutions of different concentrations from 0.5% to 5.5%. These authors concluded that the quantities of ions released by the corrosion process into the NaOCl solutions were insignificant. Consequently, no significant corrosion of NiTi files in these solutions was detected. Fabiola et al. [31] suggests that exposure to 5.25% NaOCl solution affects neither resistance to flexural fatigue nor torsional resistance of NiTi K3 endodontic files.

Influence of NaOCl on bond strength

NaOCl irrigation leads to decreased bond strength between dentin and resin cements and may require a reversal agent because of its ability to affect the polymerization of the resin sealer. [32],[33] Agents such as ascorbic acid or sodium ascorbate have been shown to completely reverse this reduction in bond strength. [34]

Interaction of NaOCl and chlorhexidine

Kuruvilla et al. [35] suggested that the antimicrobial effect of 2.5% NaOCl and 0.2% chlorhexidine (CHX) used in combination was greater than that of either agent used separately. The reaction between NaOCl and CHX produces a carcinogenic product, parachloroanaline (PCA), the potential leakage of which into the surrounding tissues is a concern. The precipitate is an insoluble neutral salt formed by the acid-base reaction between NaOCl and CHX. PCA is the main product of the interaction of NaOCl and CHX, and has the molecular formula NaC 6 H 4 Cl. [36] When mixed with NaOCl, CHX molecules become hydrolyzed into smaller fragments, each forming a byproduct. The first bonds to be broken in this reaction are those between carbon and nitrogen because of the low-bond dissociation energy between these two atoms. The presence of PCA was confirmed by the Beilstein test for the presence of chlorine and the HCl solubility test for the presence of aniline. Leaching of PCA from the insoluble precipitate formed is of concern because it has been shown to be cytotoxic in rats [37] and possibly carcinogenic in humans. [38],[39],[40] This reaction coats the canal surface and significantly occludes the dentinal tubules and affects the seal of the root canal. [41]

EDTA

EDTA reacts with the calcium ions in dentine and forms soluble calcium chelates. It has been reported that EDTA decalcified dentin to a depth of 20-30 μm in 5 min. [42]

Time duration for smear layer removal

A continuous rinse with 5 ml of 17% EDTA, as a final rinse for 3 min efficiently removes the smear layer from root canal walls. [43] According to Saito et al. greater smear layer removal was found in the 1-min EDTA irrigation group than the 30-sec or 15-sec groups. [44],[45]

Effect on tooth surface strain

Irrigation with 5% NaOCl alone or alternated with 17% EDTA (used in 30-min cycles) significantly increased tooth surface strain. The alternated regimen showed significantly greater changes in tooth surface strain than NaOCl alone. Irrigation with 3% NaOCl and 17% EDTA individually or in combination did not significantly alter the tooth surface strain. [46]

EDTA with ultrasonics

A 1-min application of 17% EDTA combined with ultrasonics is efficient for smear layer and debris removal in the apical region of the root canal. [47] EDTA performed significantly better than NaCl and NaOCl in smear layer removal and dentinal tubule opening. [48]

Chlorhexidine

Chlorhexidine digluconate is widely used in disinfection because of its excellent antimicrobial activity. However, it completely lacks tissue dissolving capability. [49]

Structure and mechanism of action

CHX is a synthetic cationic bis-guanide that consists of two symmetric 4-chlorophenyl rings and two biguanide groups connected by central hexam-ethylene chains. [50] CHX is a positively charged hydrophobic and lipophilic molecule that interacts with phospholipids and lipopolysaccharides on the cell membrane of bacteria and enters the cell through some type of active or passive transport mechanism. [51] Its efficacy is because of the interaction of the positive charge of the molecule with the negatively charged phosphate groups on microbial cell walls, [52],[53] which alters the cells' osmotic equilibrium. This increases the permeability of the cell wall, allowing the CHX molecule to penetrate into the bacteria. [49] Damage to this delicate membrane is followed by leakage of intracellular constituents, particularly phosphate entities such as adenosine triphosphate and nucleic acids. As a consequence, the cytoplasm becomes congealed, with resultant reduction in leakage; thus, there is a biphasic effect on membrane permeability. CHX antimicrobial activity is pH dependant, with the optimal range being 5.5-0.7 [Figure 1]. [54]
Figure 1: Mechanism of action of CHX.

Click here to view


Antibacterial activity


Basson and Tait [55] compared the ex vivo effectiveness of calcium hydroxide, iodine potassium iodide (IKI), and CHX solution in disinfecting root canal systems that were infected with Actinomyces israelii. The root canals were exposed to either IKI, calcium hydroxide, or 2% CHX for periods of 3, 7, and 60 days. CHX was the only disinfectant that was able to eliminate A israelii. Oncag et al. [56] evaluated the antibacterial properties against Enterococcus faecalis of 5.25% NaOCl, 2% CHX, and 0.2% CHX plus 0.2% cetrimide after 5 min and 48 h. The 2% CHX and Cetrexidin® were significantly more effective against E faecalis. Two studies [57],[58] have investigated the antimicrobial activity against endodontic pathogens of three concentrations (0.2%, 1%, and 2%) of two forms of CHX (gel and liquid) and compared them with five concentrations of NaOCl (0.5%, 1%, 2.5%, 4%, and 5.25%). Both the 2% gel and 2% liquid formulations of CHX eliminated Staphylococcus aureus and Candida albicans within 15 sec, whereas the gel formulation killed E faecalis within 1 min. All of the tested irrigants eliminated Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella intermedia within 15 sec. [57],[58]

Effect of CHX on dentin

CHX has the ability to bind anionic molecules such as phosphate present in the structure of hydroxyapatite. Phosphate exists in calcium carbonate complexes in dentin. CHX can bind phosphate, which leads to release of small amounts of calcium from the root canal dentin. [60]

Interaction of CHX and EDTA

When CHX and EDTA interact, a precipitate is formed that is over 90% CHX and EDTA, with less than 1% of the potential decomposition product, p-chloroaniline. The high recovery indicates that CHX is not degraded by EDTA under normal conditions. The precipitate is most likely a salt formed by electrostatic neutralization of cationic CHX by anionic EDTA. The suspected net ionic equation is:



The clinical significance of this precipitate is largely unknown. [60]

CHX and bioflim

Spratt et al. have evaluated the effectiveness of 2.25% NaOCl, 0.2% CHX, 10% povidone iodine against monoculture biofilms of P intermedia, P miros, S intermedius, F nucleatum, and E faecalis. They reported that NaOCl was the most effective antimicrobial agent, followed by the iodine solution. [61] Clegg et al. evaluated the ex vivo effectiveness against apical dentine biofilms of three concentrations of NaOCl (6%, 3%, and 1%), 2% CHX, and Mixture of Tetracycline acid and detergents (MTAD). They reported that the 6% NaOCl and 3% NaOCl were capable of disrupting and removing the biofilm, the 1% NaOCl and the MTAD were capable of disrupting the biofilm but did not eliminate the bacteria, and the 2% CHX was not capable of disrupting the biofilm. [62]

Substantivity

White et al. evaluated the antimicrobial substantivity of a 2% CHX solution as an endodontic irrigant and reported that the substantivity lasted 72 h. [63] Khademi et al. [64] found that 5-min application of 2% CHX solution induced substantivity for up to 4 weeks. Rosenthal et al.[65] evaluated the substantivity of 2% CHX solution within the root canal system after 10 min of application and they reported that the CHX was retained in the root canal dentine in antimicrobially effective amounts for up to 12 weeks. Antimicrobial substantivity depends on the number of CHX molecules available to interact with the dentine. [49]

CHX and dentine bonding (anticollagenolytic activity)

Human dentin contains at least collagenase (MMP-8), gelatinases MMP-2 and MMP-9, and enamelysin MMP-20. [66,67] Dentine collagenolytic [68] and gelatinolytic activities [68] can be suppressed by protease inhibitors, indicating that MMP inhibition could be beneficial in the preservation of hybrid layers. This was demonstrated in an In vivo study in which the application of CHX, known to have a broad-spectrum MMP-inhibitory effect, [69] significantly improved the integrity of the hybrid layer in a 6-month clinical trial. [70] Auto-degradation of collagen matrices can occur in resin-infiltrated dentine but may be prevented by the application of a synthetic protease inhibitor such as CHX. [71] On the whole, because of its broad-spectrum MMP-inhibitory effect, CHX can significantly improve the resin-dentine bond stability.

Cytotoxicity of CHX

Cytotoxic effects of CHX on canine embryonic fibroblast and Staphylococcus aureus showed that bactericidal concentrations were lethal to canine embryonic fibroblasts while non-cytotoxic concentrations allowed survival of bacteria. [72] Ribeiro et al. [73] evaluated the genotoxicity (potential damage to DNA) of formocresol, paramonochlorophenol, calcium hydroxide, and CHX against Chinese hamster ovary cells. Results showed that none of the mentioned agents contributed to DNA damage. Thus, in the clinically used concentrations, the biocompatibility of CHX is acceptable.

Allergic reactions to CHX

Contant dermatitis is a common adverse reaction. [74] CHX may have a number of rare side effects, such as desquamative gingivitis, discoloration of the teeth and tongue, or dysgeusia. [49]

MTAD


Torabinejad et al. developed a irrigant with combined chelating and antibacterial properties. [75] MTAD is a mixture of 3% doxycycline, 4.25% citric acid, and detergent (Tween-80). [75],[76]

Antibacterial activity and smear layer removal


MTAD is composed of three constituents that are expected to act synergistically against bacteria. [75] The bactericidal effect of MTAD was inferior to 1%-6% NaOCl against E faecalis biofilms. [77] The antibacterial activity of MTAD might also be inhibited by the buffering effect of dentin and the serum albumin present in the root canal. [78] MTAD has been reported to be effective in removing smear layer. [79] In the MTAD preparation, the citric acid may serve to remove the smear layer, allowing doxycycline to enter the dentinal tubules and exert an antibacterial effect. [80] The recently revised protocol for clinical use of MTAD advises an initial irrigation for 20 min with 1.3% NaOCl, followed by a 5-min final rinse with MTAD. [80]

Bond strength

The use of MTAD as a final rinse with gutta-percha/AH Plus® resulted in a significant reduction in bond strength (1.76±1.67 Mpa) when compared with EDTA. [81] A final rinse with MTAD might have a negative effect on the bonding ability of both resin-based and calcium hydroxide-based sealers due to the precipitate formation. [82]


   Other Irrigants Top


Citric acid and EDTA-T

The use of 10% citric acid as final irrigation has shown good results in smear layer removal. [83] In vitro studies have shown their cytotoxicity, and 10% citric acid has proven to be more biocompatible than 17% EDTA-T and 17% EDTA. [84],[85].

Scelza et al evaluated the inflammatory response of 17% EDTA, 17% EDTA-T, and 10% citric acid in bony defect created in rat jaws and they concluded that 10% citric acid showed less aggressive in inflammatory response. [86] The use of 25% citric acid was found to be ineffective in eradication of biofilms of E faecalis after 1, 5, and 10 min of exposure. [87]

Maleic acid

Maleic acid is a mild organic acid used as an acid conditioner in adhesive dentistry. [89] Ballal et al. reported that final irrigation with 7% maleic acid for 1 min was more efficient than 17% EDTA in the removal of smear layer from the apical third of the root canal system. [89]

HEBP

HEBP (1-hydroxyethylidene- 1, 1-bisphosphonate), also known as etidronic acid or etidronate, has been proposed as a potential alternative to EDTA or citric acid because this agent shows no short-term reactivity with NaOCl. [90] HEBP is nontoxic and has been systematically applied to treat bone diseases. [91] The demineralization kinetics promoted by both 9% HEBP and 18% HEBP were significantly slower than those of 17% EDTA. [92] De-Deus et al. reported that the soft chelating irrigation protocol (18% HEBP) optimized the bonding quality (3.1-6.1 MPa) of Resilon/Epiphany® . [93]

Chlorine dioxide

Chlorine dioxide (ClO 2 ) is chemically similar to chlorine or hypochlorite, the familiar household bleach. An In vitro study compared organic tissue dissolution capacity of NaOCl and ClO 2 . It was concluded that ClO 2 and NaOCl are equally efficient for dissolving organic tissue. [94] ClO 2 produces little or no trihalomethanes. [95] A study showed that trihalomethane is an animal carcinogen and a suspected human carcinogen. [96] ClO 2 might therefore be a better dental irrigant than NaOCl. [97]

Silver diamine fluoride

A 3.8% w/v silver diamine fluoride (Ag[NH 3 ] 2 F) solution has been developed for intracanal irrigation. This represents a 1:10 dilution of the original 38% Ag(NH 3 ) 2 F solution used for root canal infection. [98] The study on the antibacterial effect of 3.8% Ag(NH3 ) 2 F against a E faecalis biofilm model concluded that Ag(NH3 ) 2 F has potential for use as an antimicrobial root canal irrigant or interappointment medicament to reduce bacterial loads. [99] E faecalis was completely killed by Ag(NH 3 ) 2 F after exposure to these agents for 60 min. The silver deposits were found to occlude tubular orifices after removal of the smear layer.

Tetraclean®

Tetraclean is a mixture of doxycycline hyclate (at a lower concentration than in MTAD), an acid, and a detergent. [100],[101] It is able to eliminate microorganisms and smear layer in dentinal tubules of infected root canals with a final 5-min rinse. Comparison of antimicrobial efficacy of 5.25% NaOCl, MTAD, and Tetraclean® against E faecalis biofilm showed that only 5.25% NaOCl could consistently disgregate and remove the biofilm at every time interval. However, treatment with Tetraclean® caused a high degree of biofilm disgregation in every considered time interval (5, 30, and 60 min at 20°C) as compared with MTAD. [102]

Triclosan and Gantrez®

Triclosan is a broad spectrum antimicrobial agent, active against gram-positive and gram-negative bacteria as well as some fungi and viruses. [103],[104] Nudera et al. [105] evaluated the minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of triclosan and triclosan with Gantrez® against P intermedia, F nucleatum, A naeslundii, P gingivalis, and E faecalis. The MBC of triclosan ranged from 12-94 μg/ml. The MBC of triclosan with Gantrez® ranged from <0.3-10.4 μg/ml. The addition of Gantrez® enhanced the bactericidal activity of triclosan. Both triclosan and triclosan with Gantrez® demonstrated bactericidal activity against the five specific endodontic pathogens.

Herbal

Triphala

Triphala
consists of dried and powdered fruits of three medicinal plants Terminalia bellerica, Terminalia chebula, and Emblica officinalis. [106] Triphala achieved 100% killing of E faecalis at 6 min. This may be attributed to its formulation, which contains three different medicinal plants in equal proportions; in such formulations, different compounds may help enhance the potency of the active compounds, producing an additive or synergistic effect. [107] Triphala contains fruits that are rich in citric acid, which may aid in removal of the smear layer. The major advantages of using herbal alternatives are easy availability, cost-effectiveness, longer shelf life, low toxicity, and lack of microbial resistance. [108]

Green tea

Green tea polyphenols, the traditional drink of Japan and China is prepared from the young shoots of the tea plant Camellia sinensis. [109] Green tea polyphenols showed statistically significant antibacterial activity against E faecalis biofilm formed on tooth substrate. It takes 6 min to achieve 100% killing of E faecalis. [107]

Morinda citrifolia

Morinda citrifolia (MCJ) has a broad range of therapeutic effects, including antibacterial, antiviral, antifungal, antitumor, antihelmintic, analgesic, hypotensive, anti-inflammatory, and immune-enhancing effects. [110],[111],[112],[113] MCJ contains the antibacterial compounds L-asperuloside and alizarin [113] . Murray et al. [113] proved that, as an intracanal irrigant to remove the smearlayer, the efficacy of 6% MJC was similar to that of 6% NaOCl in conjunction with EDTA. The use of MCJ as an irrigant might be advantageous because it is a biocompatible antioxidant [113] and not likely to cause severe injuries to patients as might occur through NaOCl accidents.


   Conclusion Top


During instrumentation canals should be irrigated using copious amounts of the NaOCl solution. Once the shaping procedure is completed, canals can be thoroughly rinsed using aqueous EDTA or citric acid. Generally each canal is rinsed for at least 1 min using 5 to 10 ml of the chelator irrigant. After the smear layer removal procedure, a final rinse with an antiseptic solution appears beneficial. Chlorhexidine appears to be the most promising agent for use as a final irrigant in this situation. It has an affinity for dental hard tissues and, once bound to a surface, it has prolonged antimicrobial activity, a phenomenon called substantivity. After the introduction of MTAD irrigant, newer irrigating regimen followed was initial rinse with 1.3 % NaOCl for 20 min and followed by final rinse with MTAD for 5 min. Future research on irrigants needs to focus on finding a single irrigant that has tissue dissolving capacity, smear layer removal property, and antibacterial efficacy.

 
   References Top

1.Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965;20:340-9.  Back to cited text no. 1
    
2.Baumgartner JC, Falkler WA. Bacteria in the apical 5 mm of infected root canals. J Endod 1991;17:380-3.  Back to cited text no. 2
    
3.Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997;30:297-306.  Back to cited text no. 3
    
4.Baker NA, Eleazer PD, Averbach RE, Seltzer S. Scanning electron microscopic study of the efficacy of various irrigation solutions. J Endod 1975;4:127-35.  Back to cited text no. 4
    
5.Zehnder M. Root Canal Irrigants. J Endod 2006;32:389-98.  Back to cited text no. 5
    
6.Dakin HD. On the use of certain antiseptic substances in treatment of wounds. Br Med J 1915;2:318-20.  Back to cited text no. 6
    
7.Pecora JD, Sousa-Neto MD, Estrela C. Soluηυes irrigadoras auxiliares do preparo do canal radicular. In: Estrela C, Figueiredo JA. editors. Endodontia - Princνpios biolσgicos e mecβnicos. Sγo Paulo: Artes Mιdicas; 1999. p. 552-69.  Back to cited text no. 7
    
8.Spanσ JC, Barbin EL, Santos TC, Guimarγes LF, Pιcora JD. Solvent action of sodium hypochlorite on bovine pulp and physico-chemical properties of resulting liquid. Braz Dent J 2001;12:154-7.  Back to cited text no. 8
    
9.Esterla C, Cyntia RA. Esterla, Barbin EL. Mechanism of action of sodium hypochlorite. Braz Dent J 2002;13:113-7.  Back to cited text no. 9
    
10.Siqueira J, Rocas I, Favieri A, Lima K. Chemomechanical reduction of the bacterial population in the root canal alter instrumentation and irrigation with 1 %, 2.5 %, and 5.25 % sodium hypoclorite. J Endod 2000;26:331-4.  Back to cited text no. 10
    
11.Retamozo B, Shabahang S, Johnson N. Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis. J Endod 2010;36:520-3.  Back to cited text no. 11
    
12.Martinho FC, Gomes BP. Quantification of endotoxins and cultivable bacteria in root canal infection before and after chemomechanical preparation with 2.5% sodium hypochlorite. J Endod 2008;34:268-72.  Back to cited text no. 12
    
13.Bryce G, Donnell DO, Ready D. Contemporary root canal irrigants are able to disrupt and eradicate single- and dual-species biofilms. J Endod 2009;35:1243-8.  Back to cited text no. 13
    
14.Harrison JW, Hand RE. The effect of dilution and organic matter on the antibacterial property of 5.25% sodium hypochlorite. J Endod 1981;7:128-32.  Back to cited text no. 14
    
15.Hand RE, Smith ML, Harrison, JW. Analysis of the effect of dilution on the necrotic tissue dissolution property of sodium hypochlorite. J Endod 1978;2:60-4.  Back to cited text no. 15
    
16.Abou-Rass M, Oblesby SW. The effects of temperature, concentration, and tissue type on the solvent ability of sodium hypochlorite. J Endod 1981;8:376-7.  Back to cited text no. 16
    
17.Bloomfield SF, Miles G. The relationship between residual chlorine and disinfection capacity of sodium hypochlorite and sodium dichlorisocyanurate solutions in the presence of E. coli and milk. Microbios 1979;10:33-43.  Back to cited text no. 17
    
18.Baker RJ. Types and significance of chlorine residuals. J Am Water Works Assoc 1959;51:1185-90.  Back to cited text no. 18
    
19.Andrews FW, Orton KS. Disinfectant action of hypochlorous acid. Zentralbl Bakteriol Orig A 1904;35:645-51, 811-5.  Back to cited text no. 19
    
20.Morris JC. Future of chlorination. J Am Water Works Assoc 1966;58:1475-82.  Back to cited text no. 20
    
21.Dychdala GR. Chlorine and chlorine compounds. In: Block SS, editor. Disinfection, sterilization and preservation. Philadelphia: Lea and Febiger; 1991. p. 131-51.  Back to cited text no. 21
    
22.Smith RM, Martell AE. Critical stability constants. New York: Plenum Press; 1976.  Back to cited text no. 22
    
23.Frais S, Ng YL, Gulabivala K. Some factors affecting the concentration of available chlorine in commercial sources of sodium hypochlorite. Int Endod J 2001;34:206-15.  Back to cited text no. 23
    
24.Bloomfield SF, Miles GA. The antibacterial properties of sodium dichloroisocyanurate and sodium hypochlorite formulations. J Appl Bacteriol 1979;46:65-73.  Back to cited text no. 24
    
25.Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005;31:669-71.  Back to cited text no. 25
    
26.Paragliola R, Franco V, Fabiani C. Final Rinse Optimization: Influence of Different Agitation Protocols. J Endod 2010;36:282-5.  Back to cited text no. 26
    
27.Jadaa AA, Paquι F, Attin T. Acoustic hypochlorite activation in simulated curved canals.J Endod 2009;35:1408-11.  Back to cited text no. 27
    
28.Ishizuka T, Kataoka H, Yoshioka T, Suda H, Iwasaki N, Takahashi H, et al. Effect of NaOCl treatment on bonding to root canal dentin using a new evaluation method. Dent Mater J 2001;20:24-33.  Back to cited text no. 28
    
29.Nikaido T, Takano Y, Sasafuchi Y, Burrow MF, Tagami J. Bond strengths to endodontically-treated teeth. Am J Dent 1999;12:177-80.  Back to cited text no. 29
    
30.Busslinger BS, Barbakow F. Effects of sodium hypochlorite on nickel-titanium Lightspeed instruments. Int Endod J 1998;31:2904.  Back to cited text no. 30
    
31.Barbosa FO, Gomes JA, Araϊjo MC. Influence of sodium hypochlorite on mechanical properties of k3 nickel-titanium rotary instruments. J Endod 2007;33:982-5.  Back to cited text no. 31
    
32.Morris MD, Lee KW, Agee KA, Bouillaguet S, Pashley DH. Effect of sodium hypochlorite and RC prep on bond strengths pf resin cement on endodontic surfaces.J Endod 2001;27:753-7.  Back to cited text no. 32
    
33.Ari H, Yasar E, Belli S. Effects of NaOCl on bond strengths of resin cements to root canal dentin. J Endod 2003;29:248-51.  Back to cited text no. 33
    
34.Lai SC, Mak YF, Cheung GS, Osorio R, Toledano M, Carvalho RM, et al. Reversal of compromised bonding to oxidized etched dentin. J Dent Res 2001;80:1919-24.  Back to cited text no. 34
    
35.Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. J Endod 1998;24:472-6.  Back to cited text no. 35
    
36.Basrani BR, Manek S, Sodhi RN, Fillery E, Manzur A. Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod 2007;33:966-9.  Back to cited text no. 36
    
37.Chhabra RS, Huff JE, Haseman JK, Elwell MR, Peters AC. Carcinogenicity of p-chloroanaline in rats and mice. Food Chem Toxicol 1991;29:119-24.  Back to cited text no. 37
    
38.International Agency for Research on Cancer: IARC Monography on the Evaluation of Carcinogenic Risks to Human. Vol. 86. Lyon, France: World Health Organisation; 2006. p.1-25.  Back to cited text no. 38
    
39.Barbin LE, Saquy PC, Guedes DF, Sousa-Neto MD, Estrela C, Pιcora JD. Determination of para-chloroaniline and reactive oxygen species in chlorhexidine and chlorhexidine associated with calcium hydroxide. J Endod 2008;34:1508-14.  Back to cited text no. 39
    
40.Shashikala K, Sudhakaran S. Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine. J Endod 2010;36:1154-7.  Back to cited text no. 40
    
41.Bui TB, Baumgartner CJ, Mitchell CJ. Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin. J Endod 2008;34:181-5.  Back to cited text no. 41
    
42.Von Der Fehr FR, Nygaard Φstby B. Effect of EDTAC and sulfuric acid on root canal dentine. Oral Surg Oral Med Oral Pathol 1963;16:199-205.  Back to cited text no. 42
    
43.Mello I, Kammerer BA, Yoshimoto D. Influence of Final Rinse Technique on Ability of Ethylenediaminetetraacetic acid of removing smear layer. J Endod 2010;36:512-4.  Back to cited text no. 43
    
44.Saito K, Webb TD, Imamura GM, Goodell GG. Effect of Shortened Irrigation Times with 17% Ethylene diamine tetra-acetic acid on smear layer removal after rotary canal instrumentation. J Endod 2008;34:1011-4.  Back to cited text no. 44
    
45.Sudha R, Sukumaran VR, Ranganathan J, Bharadwaj N. Comparative evaluation of the effect of two different concentrations of EDTA at two different PH and time periods on root dentin. J cons dent 2006;9:36-42.  Back to cited text no. 45
    
46.Rajasingham R, Ng YL, Knowles JC, Gulabivala K. The effect of sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, individually and in alternation, on tooth surface strain. Int Endod J 2010;43:31-40 31  Back to cited text no. 46
    
47.Kuah HG, Lui JN, Tseng PS, Chen NN. The Effect of EDTA with and without Ultrasonics on Removal of the Smear Layer. J Endod 2009;35:393-6.  Back to cited text no. 47
    
48.Gu XH, Mao CY, Kern M. Effect of Different Irrigation on Smear Layer Removal after Post Space Preparation. J Endod 2009;35:583-6.  Back to cited text no. 48
    
49.Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J 2009;42:288-302.  Back to cited text no. 49
    
50.Greenstein G, Berman C, Jaffin R. Chlorhexidine: An adjunct to periodontal therapy. J Periodontol 1986;57:370-6.  Back to cited text no. 50
    
51.Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J 2007;52:S64-82.  Back to cited text no. 51
    
52.Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L, et al. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine In vitro. Int Endod J 2003a;36:267-75.  Back to cited text no. 52
    
53.Gomes BP, Sato E, Ferraz CC, Teixeira FB, Zaia AA, Souza- Filho FJ. Evaluation of time required for recontamination of coronally sealed canals medicated with calcium hydroxide and chlorhexidine. Int Endod J 2003b;36:604-9.  Back to cited text no. 53
    
54.Siqueira JF, Paiva SS, Rocas IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod2007;33:541-7.  Back to cited text no. 54
    
55.Basson NJ, Tait CM. Effectiveness of three root canal medicaments to eliminate Actinomyces israelii from infected dentinal tubules In vitro. SAD J 2001;56:499-501.  Back to cited text no. 55
    
56.Oncag O, Hosgor M, Hilmioglu S, Zekioglu O, Eronat C, Burhanoglu D. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J 2003;36:423-32.  Back to cited text no. 56
    
57.Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J 2001;34:424-8.  Back to cited text no. 57
    
58.Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CC, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:79-84.  Back to cited text no. 58
    
59.Sayin TC, Cehreli ZC, Deniz D, Akcay A, Tuncel B, Dagli F, et al. Time dependant decalcifying effects of endodontic irrigants with antibacterial properties. J Endod 2009;35:280-3.  Back to cited text no. 59
    
60.Rasimick BJ, Nekich M, Hladek MM, Musikant BL, Deutsch AS. Interaction between chlorhexidine digluconate and EDTA. J Endod 2008;34:1521-3.  Back to cited text no. 60
    
61.Spratt DA, Pratten J, Wilson M, Gulabivala K .An In vitro evaluation of the antimicrobial efficacy of irrigants on biofilms of root canal isolates. Int Endod J 2001;34:300-7.   Back to cited text no. 61
    
62.Clegg MS, Vertucci FJ, Walker C, Belanger M, Britto LR. The effect of exposure to irrigant solutions on apical dentine biofilms In vitro. J Endod 2006;32:434-7.  Back to cited text no. 62
    
63.White RR, Hays GL, Janer LR. Residual antimicrobial activity after canal irrigation with chlorhexidine. J Endodod 1997;23:229-31.  Back to cited text no. 63
    
64.Khademi AA, Mohammadi Z, Havaee A. Evaluation of the antibacterial substantivity of several intra-canal agents. Aust Endod J 2006;32:112-5.  Back to cited text no. 64
    
65.Rosenthal S, Spangberg L, Safavi KE. Chlorhexidine substantivity in root canal dentine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:488-92.  Back to cited text no. 65
    
66.Martin-De Las Heras S, Valenzuela A, Overall CM. The matrix metalloproteinase gelatinase A in human dentine. Arch Oral Biol 2000;45:757-65.  Back to cited text no. 66
    
67.Sulkala M, Tervahartiala T, Sorsa T, Larmas M, Salo T, et al. Matrix metalloproteinase-8 (MMP-8) is the major collagenase in human dentin. Arch Oral Biol 2007;52:121-7.  Back to cited text no. 67
    
68.Pashley DH, Tay FR, Yiu C, Hashimoto M, Breschi L, Carvalho RM, et al. Collagen degradation by host-derived enzymes during aging. J Dent Res 2004;83:216-21.  Back to cited text no. 68
    
69.Gendron R, Grenier D, Sorsa T, Mayrand D. Inhibition of the activities of matrix metalloproteinases 2, 8, and 9 by chlorhexidine. Clin Diagn Lab Immunol 1999;6:437-9.  Back to cited text no. 69
    
70.Hebling J, Pashley DH, Tjδderhane L, Tay FR. Chlorhexidine arrests subclinical degradation of dentin hybrid layers In vivo. J Dent Res 2005;84:741-6.  Back to cited text no. 70
    
71.Carrilho MR, Geraldeli S, Tay F, de Goes MF, Carvalho RM, Tjδderhane L, et al. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res 2007b;86:529-33.  Back to cited text no. 71
    
72.Sanchez IR, Nusbaum KE, Swaim SF, Hale AS, Henderson RA, McGuire JA. Chlorhexidine diacetate and povidone-iodine cytotoxicity to canine embryonic fibroblasts and Staphylococcus aureus. Vet Surg 1988;17:182-5.  Back to cited text no. 72
    
73.Ribeiro DA, Scolastici C, Almeida PL, Marques PL, Marques ME, Salvadori MF. Genotoxicity of antimicrobial endodontic compounds by single cell gel (comet) assay in Chinese hamster ovary (CHO) cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:637-40.  Back to cited text no. 73
    
74.Krautheim AB, German TH, Bircher AJ. Chlorhexidine anaphylaxis: Case report and review of the literature. Contact Dermatitis 2004;50:113-6.  Back to cited text no. 74
    
75.Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, et al. A new solution for the removal of smear layer. J Endod 2003:29;170-5.  Back to cited text no. 75
    
76.Mamatha Y, Ballal S, Gopikrishna V, Kandaswamy D. Comparison of sodium hypochlorite and edta irrigants with an indigenous solution as an alternative to mtad. J cons dent 2006;9:48-52  Back to cited text no. 76
    
77.Haapasalo M, Qian W, Portenier I, Waltimo T. Effects of dentin on the antimicrobial properties of endodontic medicaments. J Endod 2007;33:917-25.  Back to cited text no. 77
    
78.Dunavant TR, Regan JD, Glickmann GN, Solomon GS, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod 2006;32:527-31.  Back to cited text no. 78
    
79.Torabinejad M, Shabahang S, Aprecio R, Ketting JD. The antimicrobial effect of MTAD and NaOCl. J Endod 2003;29:576-9.  Back to cited text no. 79
    
80.Torabinejad M, ChoY, Khademi AA, Bakland LK, Shabahang S. The effect of various concentrations of sodium hypochlorite on the ability of MTAD to remove the smear layer. J Endod 2003;29:233-9.  Back to cited text no. 80
    
81.Hashem AA, Ghoneim AG, Lufty RA, Fouda MY. The effect of different irrigating solutions on bond strength of two root canal filling systems. J Endod 2009;35:537-40.  Back to cited text no. 81
    
82.Gopikrishna V, Venkateshbabu N, Datta K, Kandaswamy D. Evaluation of the effect of MTAD in comparison with EDTA when employed as the final rinse on the shear bond strength of three endodontic sealers to dentine. Aust Endod J 2010.[In Press].  Back to cited text no. 82
    
83.Smith J, Wayman B. An evaluation of the antimicrobial effect of citric acid as root canal irrigants. J Endod 1986;12:54-8  Back to cited text no. 83
    
84.Sceiza MF, Daniel RL, Santos EM, Jaeger MM. Cytotoxic effects of 10% citric acid and EDTA-T used as root canal irrigants: An In vitro Analysis. J Endod 2001;7:741-3.  Back to cited text no. 84
    
85.Malheiros CF, Marques MM, Gavini G. In vitro evaluation of the cytotoxic effects of acid solutions used as canal irrigants. J Endod 2005;31:746-8.   Back to cited text no. 85
    
86. Scelza MF, Pierro VS, Chagas MA, Silva LE, Scelza P. Evaluation of inflammatory response of EDTA, EDTA-T, and citric acid in animal model. J Endod 2010;36:515-9.  Back to cited text no. 86
    
87.Moliz MT, Luque CM, Garcνa ME, Baca P. Enterococcus faecalis Biofilms eradication by root canal irrigants. J Endod 2009;35:711-4.  Back to cited text no. 87
    
88.Wieczowski G, Davis EL, Joynt RB. Microleakage in various bonding agent composite resin systems. Oper Dent 1992;Suppl 5:62-7.  Back to cited text no. 88
    
89.Ballal NV, Kandian S, Mala K, Bhat KS. Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: A Scanning Electron Microscopic Study. J Endod 2009;35:1573-6.  Back to cited text no. 89
    
90.Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod 2005;31:817-20.  Back to cited text no. 90
    
91.Russell RG, Rogers MJ. Bisphosphonates: From the laboratory to the clinic and back again. Bone 1999;25:97-106.  Back to cited text no. 91
    
92.De-Deus G, Zehnder M, Reis C, Fidel S, Fidel RA. Longitudinal co-site optical microscopy study on the chelating ability of etidronate and edta using a comparative single-tooth model. J Endod 2008;34:71-5.  Back to cited text no. 92
    
93.De-Deus G, Namen F, Galan J, Zehnder M. Soft chelating irrigation protocol optimizes bonding quality of resilon/epiphany root fillings. J Endod 2008;34:703-5.  Back to cited text no. 93
    
94.Cobankara FK, Ozkan HB, Terlemez A. Comparison of Organic Tissue Dissolution Capacities of Sodium Hypochlorite and Chlorine Dioxide. J Endod 2010;36:272-4.  Back to cited text no. 94
    
95.Hua G, Reckhow DA. Comparison of disinfection byproduct formation from chlorine and alternative disinfectants. Water Res 2007;41:1667-78.  Back to cited text no. 95
    
96.Lιvesque B, Ayotte P, Tardif R, Ferron L, Gingras S, Schlouch E, et al. Cancer risk associated with household exposure to chloroform. J Toxicol Environ Health A 2002;65:489-502.  Back to cited text no. 96
    
97.Nishikiori R, Nomura Y, Sawajiri M, Masuki K, Hirata I, Okazaki M. Influence of chlorine dioxide on cell death and cell cycle of human gingival fibroblasts. J Dent 2008;36:993-8.  Back to cited text no. 97
    
98.Eto JN, Niu W, Takeda FH, Kimura Y, Matsumoto K. Morphological and atomic analytical changes of root canal wall dentin after treatment with thirty-eight percent Ag(NH 3 ) 2 F solution and CO 2 laser. J Clin Laser Med Surg 1999;17:19-24.  Back to cited text no. 98
    
99.Hiraishi N, Yiu CK, King NM, Tagami J, Tay FR. Antimicrobial Efficacy of 3.8% silver diamine fluoride and its effect on root dentin. J Endod 2010;36:1026-9.  Back to cited text no. 99
    
100.Torabinejad M, Khademi AA, Babagoli J. A new solution for the removal of the smear layer. J Endod 2003;29:170-5.  Back to cited text no. 100
    
101.Giardino L, Ambu E, Becce C, Rimondini L, Moora M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod 2006;32:1091-3.  Back to cited text no. 101
    
102.Giardino L, Ambu E, Savoldi E, Rimondini R, Cassanelli C, Debbia EA. Comparative evaluation of antimicrobial efficacy of sodium hypochlorite, mtad, and tetraclean against Enterococcus faecalis biofilm. J Endod 2007;33:852-5.  Back to cited text no. 102
    
103.McDonnell G, Russell AD. Antiseptics and disinfectants: Activity, action, and resistance. Clin Microbiol Rev 1999;12:147-79.  Back to cited text no. 103
    
104.Zambon JJ, Reynolds HS, Dunford RG, Bonta CY. Effect of a triclosan/copolymer/ fluoride dentifrice on the oral microflora. Am J Dent 1990;3:S27-34.  Back to cited text no. 104
    
105.Nudera WJ, Fayad MI, Johnson BR, Zhu M, Wenckus CS, BeGole EA, et al. Antimicrobial effect of triclosan and triclosan with gantrez on five common endodontic pathogens. J Endod 2007;33:1239-42.  Back to cited text no. 105
    
106.Jagetia GC, Baliga MS, Malagi KJ, Kamath SM. The evaluation of the radioprotective effect of Triphala (an Ayurvedic rejuvenating drug) in the mice exposed to radiation. Phytomedicine 2002;9:99-108.  Back to cited text no. 106
    
107.Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and Green Tea Polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis Biofilm Formed on Tooth Substrate: An In vitro Study. J Endod 2010;36:83-6.  Back to cited text no. 107
    
108.Hamilton-Miller JM. Anti-cariogenic properties of tea (Camellia sinensis). J Med Microbiol 2001;50:299-302.  Back to cited text no. 108
    
109.Younos C, Rolland A, Fleurentin J, Lanhers MC, Misslin R, Mortier F. Analgesic and behavioural effects of Morinda citrifolia. Planta Med 1990;56:430-4.  Back to cited text no. 109
    
110.Wang MY, Su C. Cancer preventive effect of Morinda citrifolia (Noni). Ann N Y Acad Sci 2001;952:161-8.  Back to cited text no. 110
    
111.Li RW, Myers SP, Leach DN, Lin GD, Leach G. A cross-cultural study: Anti-inflammatory activity of Australian and Chinese plants. J Ethnopharmacol 2003;85:25-32.  Back to cited text no. 111
    
112.Wang MY, West BJ, Jensen CJ, Nowicki D, Su C, Palu AK, et al. Morinda citrifolia (Noni): A literature review and recent advances in Noni research. Acta Pharmacol Sin 2002;23:1127-41.  Back to cited text no. 112
    
113.Murray PE, Farber RM, Namerow KM, Kuttler S, Godoy FG. Evaluation of Morinda citrifolia as an endodontic irrigant. J Endod 2008;34:66-70.  Back to cited text no. 113
    

Top
Correspondence Address:
Deivanayagam Kandaswamy
Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur - 116, Chennai, Tami Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0707.73378

Rights and Permissions


    Figures

  [Figure 1]

This article has been cited by
1 Comparison of dentinal tubular penetration of Intra-canal heated and Pre-heated sodium hypochlorite through different agitation techniques
Swati Jain, Pallav Patni, Pradeep Jain, Swadhin Raghuwanshi, Sanket Hans Pandey, Shubham Tripathi, Ankita Soni
Journal of Endodontics. 2023;
[Pubmed] | [DOI]
2 The potential of reuterin derived from Indonesian strain of Lactobacillus reuteri against endodontic pathogen biofilms in vitro and ex vivo
Armelia Sari Widyarman, Louise Anastasya Halim, Jesslyn, Heidi Amanda Irma, Mario Richi, Muhammad Ihsan Rizal
The Saudi Dental Journal. 2023;
[Pubmed] | [DOI]
3 PEG–PLGA nanoparticles for encapsulating ciprofloxacin
Natsorn Watcharadulyarat, Monthira Rattanatayarom, Nisarat Ruangsawasdi, Nisa Patikarnmonthon
Scientific Reports. 2023; 13(1)
[Pubmed] | [DOI]
4 Comparison of Different Dentin Deproteinizing Agents on Bond Strength and Microleakage of Universal Adhesive to Dentin
Fatih Bedir, Gül Yildiz Telatar
Journal of Advanced Oral Research. 2023; : 2320206823
[Pubmed] | [DOI]
5 Irrigation in Endodontics: Polyhexanide Is a Promising Antibacterial Polymer in Root Canal Treatment
Zurab Khabadze, Yulia Generalova, Alena Kulikova, Irina Podoprigora, Saida Abdulkerimova, Yusup Bakaev, Mariya Makeeva, Marina Dashtieva, Mariya Balashova, Fakhri Gadzhiev, Oleg Mordanov, Adam Umarov, Taric Khaddad, Andrei Zoryan, Amina Karnaeva, Yakup Rakhmanov
Dentistry Journal. 2023; 11(3): 65
[Pubmed] | [DOI]
6 The Interaction of Two Widely Used Endodontic Irrigants, Chlorhexidine and Sodium Hypochlorite, and Its Impact on the Disinfection Protocol during Root Canal Treatment
Dirk-Joachim Drews, Anh Duc Nguyen, Antje Diederich, Christian Ralf Gernhardt
Antibiotics. 2023; 12(3): 589
[Pubmed] | [DOI]
7 Sealing Efficiency of BeeFill 2in1 Filling Technique and Cold Lateral Compaction Technique
Ning Zhang, Jiuyu Ge
Journal of Biomaterials and Tissue Engineering. 2023; 13(3): 482
[Pubmed] | [DOI]
8 Assessment of Penetrability for Different Endodontic Irrigation Activating Techniques Using Cone-Beam Computed Tomography and Periapical Digital Radiography—An In Vitro Study
Manal M. Abdelhafeez, Afnan S. Alharbi, Swati Srivastava, Rehab Abdelaziz, Elzahraa Eldwakhly, Rahaf A. Almohareb, Fahda N. Algahtani, Mai Soliman
Applied Sciences. 2023; 13(13): 7436
[Pubmed] | [DOI]
9 Dental Surface Conditioning Techniques to Increase the Micromechanical Retention to Fiberglass Posts: A Literature Review
Paulina Leticia Moreno-Sánchez, Maricela Ramírez-Álvarez, Alfredo del Rosario Ayala-Ham, Erika de Lourdes Silva-Benítez, Miguel Ángel Casillas-Santana, Diana Leyva del Rio, León Francisco Espinosa-Cristóbal, Erik Lizárraga-Verdugo, Mariana Melisa Avendaño-Félix, Jesús Eduardo Soto-Sainz
Applied Sciences. 2023; 13(14): 8083
[Pubmed] | [DOI]
10 Antimicrobial Therapeutic Strategies for Enterococcus faecalis In Dental Infections - Past, Present and Future
Lokitha R., Namitha Nandakumar, Harish K., Arulmozhi P., Aarthi Jayakumar, Anbarasi K., Benedict Paul C.
Anti-Infective Agents. 2023; 21(3)
[Pubmed] | [DOI]
11 Evaluation of Root Canal Cleanliness on Using a Novel Irrigation Device with an Ultrasonic Activation Technique: An Ex Vivo Study
Keerthika Rajamanickam, Kavalipurapu Venkata Teja, Sindhu Ramesh, Sahil Choudhari, Mariangela Cernera, Niccolo Giuseppe Armogida, Mohammed Mustafa, Gianrico Spagnuolo
Applied Sciences. 2023; 13(2): 796
[Pubmed] | [DOI]
12 Irrigants and irrigation activation systems in Endodontics
Brenda P. F. A. Gomes, Emelly Aveiro, Anil Kishen
Brazilian Dental Journal. 2023; 34(4): 1
[Pubmed] | [DOI]
13 Factors influencing the occurrence and progress of sodium hypochlorite accident: A narrative and update review
AR Vivekananda Pai
Journal of Conservative Dentistry. 2023; 26(1): 3
[Pubmed] | [DOI]
14 Prior Restorative Procedures to Endodontic Treatment
Mário A Moreira, Virgínia R Silveira, Veronica O Alcantara, Frederico B Sousa, Bruno C Sousa
Cureus. 2023;
[Pubmed] | [DOI]
15 Comparative analysis of root canal irrigation in endodontic treatment of apical periodontitis in patients with root canal systems contaminated with Candida albicans
M. N. Medzhidov, T. A. Abakarov, G. N. Amirov, M. M. Medzhidov, M. G. Magomedova, R. M. Gareeva
Endodontics Today. 2023; 21(1): 49
[Pubmed] | [DOI]
16 Comparative evaluation of antimicrobial efficacy of nanosilver solution, Azadirachta indica, sodium hypochlorite, and normal saline as root canal irrigants in primary teeth
Zoya Tanvir, Zohra Jabin, Nidhi Agarwal, Ashish Anand, Nandita Waikhom
Journal of Indian Society of Pedodontics and Preventive Dentistry. 2023; 41(1): 76
[Pubmed] | [DOI]
17 Evaluation of Postoperative Pain with Endoactivator and Conventional Syringe Irrigation in Single Rooted Teeth
. Sidharath, Sheharyar Akhtar Khokhar, Samia Ejaz, . Madiha, Aziz Ali Khowaja, Rajesh Kumar
Pakistan Journal of Health Sciences. 2023; : 149
[Pubmed] | [DOI]
18 The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study)
Ayat ADHAM, Ahmed ALI
Cumhuriyet Dental Journal. 2023; 26(2): 112
[Pubmed] | [DOI]
19 Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination
Neha K Urkande, Nikhil Mankar, Pradnya P Nikhade, Manoj Chandak
Cureus. 2023;
[Pubmed] | [DOI]
20 Comparative Evaluation of Antimicrobial Efficacy of Etidronic Acid and Propolis against E. faecalis in Primary Teeth: An In Vivo Study
Veena Arali, Harika Rapala, Atluri N Supraja, Charan T Vemagiri, Mounika Kallakuri, Gannamani LGSP Kumar
Journal of South Asian Association of Pediatric Dentistry. 2023; 6(2): 51
[Pubmed] | [DOI]
21 Effect of Passion Fruit Juice in Removal of Smear Layer in Root Canal of Ex Vivo Human Teeth: A Scanning Electron Microscopic Study
Kayalvizhi Gurusamy, Sanguida Adimoulame, Prathima Gajula Shivashankarappa, Kavitha Muthukrishnan, Vinothini Venkatachalamoorthi, Ezhumalai Govindan
International Journal of Clinical Pediatric Dentistry. 2023; 16(S2): S190
[Pubmed] | [DOI]
22 A Comparative Evaluation of Pulp Tissue Dissolving Ability of Three Different Pulp Dissolving Agents With 5.25% Sodium Hypochlorite: An In-Vitro Study
Ganesh Kalandar, Manoj Ramugade, Kishor Sapkale, Abrar Sayed, Sapna Sonkurla
International Journal of Orofacial Research. 2023; 7(2): 42
[Pubmed] | [DOI]
23 Comparison of ultrasonic versus side-vented needle irrigation for reductions in bacterial growth and postoperative pain: A randomized controlled trial
Revathi Palanisamy, Subha Anirudhan, RJaya Shree Roja, Minu Koshy
Journal of Conservative Dentistry and Endodontics. 2023; 26(6): 616
[Pubmed] | [DOI]
24 Evaluation of Free Available Chlorine of Sodium Hypochlorite When Admixed with 0.2% Chitosan: A Preliminary Study
Rupali Karale, Nithin K Shetty, Prashanth Bytarahosalli Rajachar, Mythreyee S Vidhya, Vinay Kumar Govindaraju
The Journal of Contemporary Dental Practice. 2022; 22(10): 1171
[Pubmed] | [DOI]
25 Assessment of Bacterial Load Using 3.8% SDF as an Irrigant in Pulpectomized Primary Molars: A Randomized Controlled Trial
Dimple Padawe, Vilas Takate, Viral Maru, Sayali Mali, Shilpa Naik, Kishor Sarjeraodighe
International Journal of Clinical Pediatric Dentistry. 2022; 15(S1): S47
[Pubmed] | [DOI]
26 Perplexity and Repercussions in Maldiagnosis of an Extraoral Draining Sinus by a Physician and its Dental Management: A Case Report
Seerat Sidhu, Abi M Thomas, Ruchika Kundra
International Journal of Clinical Pediatric Dentistry. 2022; 15(1): 115
[Pubmed] | [DOI]
27 Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia
Rizwan Jouhar, Muhammad Adeel Ahmed, Hussain Abdulmuttalib Ali Almomen, Abdullah Amin Jawad BuHulayqah, Mohammed Yousef Ahmed Alkashi, Ahmed Adel A. Al-Quraini, Naseer Ahmed
International Journal of Environmental Research and Public Health. 2022; 19(11): 6601
[Pubmed] | [DOI]
28 A comparative evaluation of antimicrobial efficacy of novel surfactant-based endodontic irrigant Regimen's on Enterococcus faecalis
Manikandan Ravinanthanan, MithraN Hegde, Veena Shetty, Suchetha Kumari, FahdNasser Al Qahtani
Contemporary Clinical Dentistry. 2022; 13(3): 205
[Pubmed] | [DOI]
29 Cold plasma: a good Enterococcus faecalis inhibitor –an in vitro tooth root canal pilot study
Gustavo Obando-Pereda, Rufo Figueroa-Banda, Luis Ponce-Soto
Journal of Dental Health, Oral Disorders & Therapy. 2022; 13(1): 117
[Pubmed] | [DOI]
30 The Lipid Composition of the in situ pellicle
M. Reich, C. Hannig, M. Hannig, K. Kümmerer, A. Kensche
Archives of Oral Biology. 2022; : 105493
[Pubmed] | [DOI]
31 Effect of chlorhexidine digluconate on antimicrobial activity, cell viability and physicochemical properties of three endodontic sealers
Vasileios Kapralos, Pia Titterud Sunde, Josette Camilleri, Else Morisbak, Andreas Koutroulis, Dag Ørstavik, Håkon Valen
Dental Materials. 2022;
[Pubmed] | [DOI]
32 Efficacy of Salvadora persica Root Extract as an Endodontic Irrigant- An In-vitro evaluation
Fahd Aljarbou, Abdurahman A Niazy, Rhodanne Nicole A. Lambarte, Ramzi A. Mothana, Abdulaziz Binrayes, Mohammad Al-Obaida, Hadi M. Alamri
Journal of Herbal Medicine. 2022; : 100564
[Pubmed] | [DOI]
33 EFFECT OF ALEXIDINE DIHYDROCHLORIDE ON THE BOND STRENGTH OF RESIN-BASED SEALER TO DENTIN
Emine ODABASI TEZER, Meltem DARTAR ÖZTAN
Atatürk Üniversitesi Dis Hekimligi Fakültesi Dergisi. 2022; : 1
[Pubmed] | [DOI]
34 Genetic, Cellular and Molecular Aspects involved in Apical Periodontitis
Igor Bassi Ferreira Petean, Alice Corrêa Silva-Sousa, Tamara Justiniano Cronenbold, Jardel Francisco Mazzi-Chaves, Lea Assed Bezerra da Silva, Raquel Assed Bezerra Segato, Guilherme Assed Piedade de Castro, Erika Calvano Kuchler, Francisco Wanderley Garcia Paula-Silva, Manoel Damião Sousa-Neto
Brazilian Dental Journal. 2022; 33(4): 1
[Pubmed] | [DOI]
35 Comparison of fracture resistance of mandibular central incisors following the use of two different spreaders during lateral condensation obturation technique- An in vitro study
Khushboo Gupta
IP Indian Journal of Conservative and Endodontics. 2022; 7(3): 130
[Pubmed] | [DOI]
36 The Potential of Phenothiazines against Endodontic Pathogens: A Focus on Enterococcus-Candida Dual-Species Biofilm
Nicole de Mello Fiallos, Ana Luiza Ribeiro Aguiar, Bruno Nascimento da Silva, Mariana Lara Mendes Pergentino, Marcos Fábio Gadelha Rocha, José Júlio Costa Sidrim, Débora Castelo Branco de Souza Collares Maia, Rossana de Aguiar Cordeiro
Antibiotics. 2022; 11(11): 1562
[Pubmed] | [DOI]
37 Antimicrobial Efficacy of Silver Diamine Fluoride against Enterococcus faecalis: A Systematic Review of In Vitro Studies
Juzer Shabbir, Zohaib Khurshid, Muhammad Sohail Zafar, Waqas Ahmed Farooqui, Eisha Imran, Shariq Najeeb, Sompop Bencharit, Heng Bo J
BioMed Research International. 2022; 2022: 1
[Pubmed] | [DOI]
38 Offener Apex – endodontische Versorgung von unreifen Zähnen
Richard Steffen
ZWR - Das Deutsche Zahnärzteblatt. 2021; 130(10): 470
[Pubmed] | [DOI]
39 CYCLIC FATIGUE RESISTANCE OF ROTATE, EDGEFILE PLATINUM, AND K3XF FILES EXPOSED TO INTRACANAL TEMPERATURE IN AN S-SHAPED CANAL
Salih DÜZGÜN, Hüseyin Sinan TOPÇUOGLU, Hakan ARSLAN, Sezer DEMIRBUGA
Atatürk Üniversitesi Dis Hekimligi Fakültesi Dergisi. 2021; : 1
[Pubmed] | [DOI]
40 Antimicrobial Efficacy of Octenidine Hydrochloride, Green Tea, Sodium Hypochlorite and Chlorhexidine Gluconate as Retreatment Endodontic Irrigant Against E. faecalis, Candida & Mixed Culture – In-Vitro Study
Reetika S. Khandelwal, Shivkumar P. Mantri, Bonny Paul, Kavita A. Dube, Gargi Mishra, Vrinda R. Dhirawani
Journal of Evolution of Medical and Dental Sciences. 2021; 10(32): 2629
[Pubmed] | [DOI]
41 Use of electromagnetic stimulation on an Enterococcus faecalis biofilm on root canal treated teeth in vitro
Beatriz H. D. Panariello, Justin K. Kindler, Kenneth J. Spolnik, Ygal Ehrlich, George J. Eckert, Simone Duarte
Scientific Reports. 2021; 11(1)
[Pubmed] | [DOI]
42 EFFICACY OF VARIOUS LASER-ASSISTED IRRIGATION ACTIVATION TECHNIQUES ON CALCIUM HYDROXIDE REMOVAL
Ezgi DOGANAY YILDIZ, Fatma DURNA YURTSEVEN, Dilek HANÇERLIOGULLARI
Atatürk Üniversitesi Dis Hekimligi Fakültesi Dergisi. 2021; : 1
[Pubmed] | [DOI]
43 Influence of Propolis, Ozone and Photodynamic therapy in root canal disinfection on resin bond strength to radicular dentin
Khalid Almadi, Mazen Alkahtany, Yousef Alamam, Fahad Alaql, Abdulaziz Alaqil, Meshari Almutairi, Saud Mohammed Bin Thafrah
Photodiagnosis and Photodynamic Therapy. 2021; 33: 102131
[Pubmed] | [DOI]
44 Chlorhexidine and Sodium Hypochlorite Provide Similar Antimicrobial Effect in Root Canal Disinfection
Xiaoyan Zhou, Shanika Nanayakkara
Journal of Evidence Based Dental Practice. 2021; 21(3): 101577
[Pubmed] | [DOI]
45 Carbon Nanotubes for Improved Performances of Endodontic Sealer
Andreea Marica, Luminita Fritea, Florin Banica, Cosmin Sinescu, Ciprian Iovan, Iosif Hulka, Gerlinde Rusu, Simona Cavalu
Materials. 2021; 14(15): 4248
[Pubmed] | [DOI]
46 Comparative Evaluation of Antimicrobial Efficacy of Three Different Endodontic Irrigants against Candida albicans: An In Vitro Study
Ravi Vaiyapuri, Jambai S Sivakumar, Chittrarasu Mathimaraiselvan, Anjaneya Shiva Prasad, Saravana Priyan Soundappan, Arun Karthika Pandian
Journal of Operative Dentistry & Endodontics. 2021; 6(1): 45
[Pubmed] | [DOI]
47 Comparative Evaluation of Cytotoxicity of Neem Leaf Extract, 2% Chlorhexidine, Nigella sativa Extract and 3% Sodium Hypochlorite
Shilpa Bhandi, Madhuram Krishnamurthy, Vignesh Guptha Raju, A Shafie Ahamed, KE Selvendran, Hamed Ahmed Ali Alshawkani, Omaima Ahmed Hassam Allayl, Manar Ali Ibrahim Alhomood, Mohammed Ali Ali Sumayli
World Journal of Dentistry. 2021; 13(1): 46
[Pubmed] | [DOI]
48 Assessment of irrigant flow and apical pressure in simulated canals of single-rooted teeth with different root canal tapers and apical preparation sizes: An ex vivo study
ImmadiLaxmi Sujith, KavalipurapuVenkata Teja, Sindhu Ramesh
Journal of Conservative Dentistry. 2021; 24(4): 314
[Pubmed] | [DOI]
49 Evaluation of morinda citrifolia ethanolic extract versus morinda citrifolia fresh fruit juice for tissue response and systemic toxicity in animal model
KavalipurapuVenkata Teja, Sindhu Ramesh, Karthik Ganesh, KaligotlaApoorva Vasundhara
Indian Journal of Dental Research. 2021; 32(4): 423
[Pubmed] | [DOI]
50 Comparative Evaluation of Microhardness of Radicular Dentin by Using Different Herbal Extracts (Azadirachta indica, Morinda citrifolia, Green Tea) as Root Canal Irrigant: An In Vitro Study
Durgabhavani Gondi, Prasanthi Gonapa, Tejasree Rathod, Paramesh Yelloji, Choppa Arjun
Conservative Dentistry and Endodontic Journal. 2021; 6(1): 1
[Pubmed] | [DOI]
51 Evaluation of Antimicrobial Efficacy of Commercially Available Herbal Products as Irrigants and Medicaments in Primary Endodontic Infections: In Vivo Study
Rakesh Mittal, Goldy Rathee, Monika Tandan
World Journal of Dentistry. 2021; 11(6): 488
[Pubmed] | [DOI]
52 Azadirachta indica A. juss, Morinda citrifolia L. and Triphala as herbal endodontic irrigants: A scoping review
Archna Agnihotri, Swaty Jhamb, Urvashi Shrama, Sumidha Rohtagi
AYU (An international quarterly journal of research in Ayurveda). 2020; 41(3): 148
[Pubmed] | [DOI]
53 The Efficiency of the Er: YAG Laser and PhotonInduced Photoacoustic Streaming (PIPS) as an Activation Method in Endodontic Irrigation: A Literature Review
Quy Linh Do, Alexis Gaudin
Journal of Lasers in Medical Sciences. 2020; 11(3): 316
[Pubmed] | [DOI]
54 Is a filled lateral canal – A sign of superiority?
Kavalipurapu Venkata Teja, Sindhu Ramesh
Journal of Dental Sciences. 2020; 15(4): 562
[Pubmed] | [DOI]
55 Comprehensive biomedical applications of low temperature plasmas
Simone Duarte, Beatriz H.D. Panariello
Archives of Biochemistry and Biophysics. 2020; 693: 108560
[Pubmed] | [DOI]
56 Antimicrobial potential of irrigants based on essential oils of Cymbopogon martinii and Thymus zygis towards in vitro multispecies biofilm cultured in ex vivo root canals
Jelena Marinkovic, Dragana Mitic Culafic, Biljana Nikolic, Stefana Ðukanovic, Tatjana Markovic, Gvozden Tasic, Ana Ciric, Dejan Markovic
Archives of Oral Biology. 2020; 117: 104842
[Pubmed] | [DOI]
57 Antibacterial potency of mangosteen pericarp extracts (Garcinia mangostana L.) against Fusobacterium nucleatum
Nia Pramais Octaviani, Latief Mooduto, Achmad Sudirman
Conservative Dentistry Journal. 2020; 10(2): 44
[Pubmed] | [DOI]
58 The Effectiveness of 2.5% NaOCl Irrigation and 17% EDTA against the Sealing Ability of Resin Paste
Tamara Nitya A, Nanik Zubaidah, Moch Mudjiono
Conservative Dentistry Journal. 2020; 9(2): 105
[Pubmed] | [DOI]
59 Biomimetic Aspects of Restorative Dentistry Biomaterials
Muhammad Sohail Zafar, Faiza Amin, Muhmmad Amber Fareed, Hani Ghabbani, Samiya Riaz, Zohaib Khurshid, Naresh Kumar
Biomimetics. 2020; 5(3): 34
[Pubmed] | [DOI]
60 Mechano-chemical coupling of irrigation enhances endodontic biofilm debridement
Jialei Xu, Yuan Gao, Yajun Meng, Weiwei Wu, Chialing Tsauo, Tingwei Guo, Yangpei Cao, Dingming Huang, Xuedong Zhou, Jinzhi He
Biofouling. 2020; 36(7): 792
[Pubmed] | [DOI]
61 Detection, treatment and prevention of endodontic biofilm infections: what’s new in 2020?
Sumaya Abusrewil, Om Alkhir Alshanta, Khawlah Albashaireh, Saeed Alqahtani, Christopher J. Nile, James Alun Scott, William McLean
Critical Reviews in Microbiology. 2020; 46(2): 194
[Pubmed] | [DOI]
62 Offener Apex – endodontische Versorgung von unreifen Zähnen
Richard Steffen
Zahnmedizin up2date. 2020; 14(06): 487
[Pubmed] | [DOI]
63 Effect of autoclave sterilisation and heat activated sodium hypochlorite irrigation on the performance of nickel-titanium rotary files against cyclic fatigue
Zuha Ayad Jaber, Sattar Jabbar Abdul-Zahra Al-Hmedat, Sarmad Adel Hameed, Suhad Jabbar Hamed Al-Nasrawi, Abtesam Imhemed Aljdaimi, Julfikar Haider
Advances in Materials and Processing Technologies. 2020; : 1
[Pubmed] | [DOI]
64 Role of Irrigants in Endodontics
Kaur Prabjot
Journal of Dental Problems and Solutions. 2020; : 100
[Pubmed] | [DOI]
65 Comparison of antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of primary teeth
Suchi Agarwal, Parimala Tyagi, Ashwini Deshpande, Saurabh Yadav, Vipul Jain, KuldeepSingh Rana
Journal of Indian Society of Pedodontics and Preventive Dentistry. 2020; 38(2): 164
[Pubmed] | [DOI]
66 Toward better microbial safety of wheat sprouts: chlorophyllin-based photosensitization of seeds
Bernadeta Žudyté, Živile Lukšiené
Photochemical & Photobiological Sciences. 2019; 18(10): 2521
[Pubmed] | [DOI]
67 Daya bunuh dan daya hambat antimikrobial chlorhexidine 2% dan povidone iodine 1% sebagai medikamen saluran akar terhadap Enterococcus faecalis The ability of chlorhexidine 2% and povidone iodine 1% as root canal medicaments to kill and inhibit Enterococc
Nathania Astria, Ari Subiyanto, Latief Mooduto
Conservative Dentistry Journal. 2019; 7(1): 12
[Pubmed] | [DOI]
68 Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12-month short-term evaluation
Ahmad Abdel Hamid Elheeny
Clinical and Experimental Dental Research. 2019; 5(4): 420
[Pubmed] | [DOI]
69 Comparison of penetrating depth of chlorhexidine and chitosan into dentinal tubules with and without the effect of ultrasonic irrigation
Ganesh Arathi, Arasappan Rajakumaran, Sinha Divya, Narasimhan Malathi, Varadarajan Saranya, Deivanayagam Kandaswamy
Journal of Oral and Maxillofacial Pathology. 2019; 23(3): 389
[Pubmed] | [DOI]
70 Endodontic Irrigation Protocols: Effects on Bonding of Adhesive Systems to Coronal Enamel and Dentin
Marcos Paulo Marchiori Carvalho, Victor Hugo Carvalho Morari, Alexandre Henrique Susin, Rachel De Oliveira Rocha, Luiz Felipe Valandro, Fabio Zovico Maxnuck Soares
Journal of Esthetic and Restorative Dentistry. 2017; 29(3): 222
[Pubmed] | [DOI]
71 Antibacterial Activity of Leaf Extract of Annona muricata and Simarouba glauca on Enterococcus faecalis
Jain Mathew, Reshmi George, Robin Theruvil, Tobin C Padavil, Lincy Tomy, Anil Kurian
The Journal of Contemporary Dental Practice. 2016; 17(8): 650
[Pubmed] | [DOI]
72 Toxicological effects of pet food ingredients on canine bone marrow-derived mesenchymal stem cells and enterocyte-like cells
M. T. Ortega, B. Jeffery, J. E. Riviere, N. A. Monteiro-Riviere
Journal of Applied Toxicology. 2016; 36(2): 189
[Pubmed] | [DOI]
73 Nanodiamond–Gutta Percha Composite Biomaterials for Root Canal Therapy
Dong-Keun Lee, Sue Vin Kim, Adelheid Nerisa Limansubroto, Albert Yen, Akrivoula Soundia, Cun-Yu Wang, Wenyuan Shi, Christine Hong, Sotirios Tetradis, Yong Kim, No-Hee Park, Mo K. Kang, Dean Ho
ACS Nano. 2015; 9(11): 11490
[Pubmed] | [DOI]
74 Comparing the efficacy of hyper-pure chlorine-dioxide with other oral antiseptics on oral pathogen microorganisms and biofilm in vitro
Anna Herczegh,Milán Gyurkovics,Hayk Agababyan,Ágoston Ghidán,Zsolt Lohinai
Acta Microbiologica et Immunologica Hungarica. 2013; 60(3): 359
[Pubmed] | [DOI]
75 Update on endodontic irrigating solutions
Bettina Basrani,Markus Haapasalo
Endodontic Topics. 2012; 27(1): 74
[Pubmed] | [DOI]
76 Comparison of the Effect of Various Irrigants on Apically Extruded Debris after Root Canal Preparation
Masoud Parirokh,Shahrzad Jalali,Ali Akbar Haghdoost,Paul Vincent Abbott
Journal of Endodontics. 2012; 38(2): 196
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
 
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  
 


    Abstract
    Introduction
    Ideal Requiremen...
    Classification
    Sodium Hypochlorite
    Other Irrigants
    Conclusion
    References
    Article Figures

 Article Access Statistics
    Viewed49004    
    Printed1512    
    Emailed0    
    PDF Downloaded4384    
    Comments [Add]    
    Cited by others 76    

Recommend this journal