The advancement in irrigation solution within the field of endodontics, A Review

Main Article Content

Fatima Fahad
Raghad A Al-Hashimi
https://orcid.org/0000-0002-8752-9139
Munther J Hussain

Abstract

The purpose of endodontic treatment is to eliminate all germs, microbial by-products, and vital tissues from the root canal system. Root canals can be mechanically and chemically used for this purpose. The needs and details of the irrigation solutions are described in this article. Because of its wide range of antibacterial activities and its ability to dissolve organic tissues, sodium hypochlorite is suggested as the main irrigation. On the contrary, chelation solutions are recommended as supplemental treatments to either eliminate the smear layer or prevent it from forming on the dentin surface. Data: Only articles that were published electronically were searched within the review. Sources: ‘Google Scholar’ and "Pub-med" websites were used to search data, The most papers related to the topic were chosen, specifically original articles , including only articles from 1999 to 2023.Journal papers that weren't published in a highly regarded publication, irrelevant studies, editorials, personal viewpoints, and social media sources were all disqualified from consideration. 98 articles were retained after the filtering procedure. In conclusion, this article reviews many types of new irrigations that may be used in endodontic practice in the future.                              

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How to Cite
1.
Fahad F, Al-Hashimi RA, Hussain MJ. The advancement in irrigation solution within the field of endodontics, A Review. J Bagh Coll Dent [Internet]. 2024 Mar. 15 [cited 2024 Apr. 30];36(1):54-69. Available from: https://jbcd.uobaghdad.edu.iq/index.php/jbcd/article/view/3591
Section
Review Articles
Author Biographies

Fatima Fahad , Ministry of health, Baghdad, Iraq

Ministry of health, Baghdad, Iraq

Raghad A Al-Hashimi , Department of Conservative Dentistry, Faculty of Dentistry, University of Baghdad, Bab-Almoadham, P.O. Box 1417, Baghdad, Iraq.

Department of Conservative Dentistry, Faculty of Dentistry, University of Baghdad, Bab-Almoadham, P.O. Box 1417, Baghdad, Iraq.

Munther J Hussain , Faculty of life science and Medicine Kings college london, UK

Faculty of life science and Medicine Kings college london, UK

How to Cite

1.
Fahad F, Al-Hashimi RA, Hussain MJ. The advancement in irrigation solution within the field of endodontics, A Review. J Bagh Coll Dent [Internet]. 2024 Mar. 15 [cited 2024 Apr. 30];36(1):54-69. Available from: https://jbcd.uobaghdad.edu.iq/index.php/jbcd/article/view/3591

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References

Boutsioukis C, Arias-Moliz MT, Chávez de Paz l. A critical analysis of research methods and experimental models to study irrigations and irrigation systems. Int. Endod. J 2022; 47:191-201.

Pereira T, Dijkstra R, Petridis X, Sharma P, van de Meer W, van der Sluis, L et al. Chemical and mechanical influence of root canal irrigation on biofilm removal from lateral morphological features of simulated root canals, dentine discs and dentinal tubules. Int. Endod. J. 2021 ; 54(1): 112–129. DOI: https://doi.org/10.1111/iej.13399

Sedgley CM, Lennan SL, Appelbe OK. Survival of Enterococcus faecalis in root canals ex vivo. Int. Endod. J. 2005; 38, 735 742. crossref DOI: https://doi.org/10.1111/j.1365-2591.2005.01009.x

Ricucci D, Siqueira JF. Biofilms and apical periodontitis: Study of prevalence and association with clinical and histopathologic findings. J Endodont. 2010; 36, 1277–1288. DOI: https://doi.org/10.1016/j.joen.2010.04.007

Parolia A, Kumar H, Ramamurthy S, Madheswaran T, Davamani F, Pichika MR, et al. Effect of propolis nanoparticles against Enterococcus faecalis biofilm in the root canal. Molecules. 2021;26(3):715.. DOI: https://doi.org/10.3390/molecules26030715

Shrestha A, Shi Z, Kishen A. Nanoparticulates for Antibiofilm treatment and effect of aging on its antibacterial activity. J Endodont. 2010; 36:1030-5 DOI: https://doi.org/10.1016/j.joen.2010.02.008

Vineet A, Rajesh M, Sonali K, Mukesh PA. Contemporary Overview of Endodontic Irrigations – A Review. J Dent App. 2014;1(6):105-115.

Zou L, Shen Y, Li W, Haapasalo M. Penetration of sodium hypochlorite into dentin. J Endodont. 2010; 36:793 DOI: https://doi.org/10.1016/j.joen.2010.02.005

Shetty S, Kahler SL, Kahler B. Alkaline Material Effects on Roots of Teeth. Materials .2017;10(2):1-15 DOI: https://doi.org/10.3390/ma10121412

Ye WH, Fan B, Purcel W, Meghil MM, Cutler CHW, Bergeronc BE, et al. Anti-biofilm efficacy of root canal irrigations against in-situ Enterococcus faecalis biofilms in root canals, isthmuses and dentinal tubules. Journal of Dentistry. 2018; 79:68-76.

Zhu WC, Gyamfi J, Niu LN, Schoeffel GJ, Liu SY, Santarcangelo F, et al. Anatomy of sodium hypochlorite accidents involving facial ecchymosis - a review, J Dent .2013;41:935–948. DOI: https://doi.org/10.1016/j.jdent.2013.08.012

Gopikrishna V, Ashok P, Kumar AR, Narayanan L, Gopikrishna V, Ashok P, et al. Influence of temperature concentration on the dynamic viscosity of sodium hypochlorite in comparison with 17% EDTA and 2% chlorhexidine gluconate: An in vitro study. J Conserv Dent. 2014;17(1):57-60. DOI: https://doi.org/10.4103/0972-0707.124142

Poggio C, Ceci M, Beltrami R, Colombo M, Dagna A. Viscosity of endodontic irrigants: Influence of temperature. Dent Res J. 2015; 12(5): 425–430. DOI: https://doi.org/10.4103/1735-3327.166189

Bukiet F, Soler T, Guivarch M, Camps J, Tassery H, Cuisinier F, et al. Factors affecting the viscosity of sodium hypochlorite and their effect on irrigant flow. Int. Endod. J .2013 ;46(10):954-61. DOI: https://doi.org/10.1111/iej.12086

Huang TY, Gulabivala K, Ng YL. A bio-molecular film ex-vivo model to evaluate the influence of canal dimensions and irrigation variables on the efficacy of irrigation. Int. Endod. J .2008; 41:60–71. DOI: https://doi.org/10.1111/j.1365-2591.2007.01317.x

Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern Endodontic Principles Part 4: Irrigation. Dent Update. 2016; 43.1.;20-33. DOI: https://doi.org/10.12968/denu.2016.43.1.20

Palazzi F, Morra M, Mohammadi Z, Grandini S, Giardino L. Comparison of the surface tension of 5.25% sodium hypochlorite solution with three new sodium hypochlorite-based endodontic irrigations. Int. Endod. J .2012; 45:129-135. DOI: https://doi.org/10.1111/j.1365-2591.2011.01952.x

Giardino L, Morra M, Becce C, Pappen FG, Mohammadi Z, Palazzi F. Comparative wettability of different sodium hypochlorite solutions. G Ital Endod. 2012;26:57-62. DOI: https://doi.org/10.1016/j.gien.2012.06.002

Lopes HP, DeFaria AR, Alves FRF, Elias CN. Wettability of Irrigations used in Root Canal Treatment. Dentistry .2015;5(3):1-3. DOI: https://doi.org/10.4172/2161-1122.1000283

Zehnder M. Root canal irrigations. J Endodont. 2006; 32:389-98. DOI: https://doi.org/10.1016/j.joen.2005.09.014

Pascon FM, Kantovitz KR, Sacramento PA, Nobre-Dos-Santos M, Puppin-Rontani RM. Effect of sodium hypochlorite on dentine mechanical properties. A review. J Dent. 2009; 37:903-908. DOI: https://doi.org/10.1016/j.jdent.2009.07.004

Souza EM, Quadros RPJ, Silva EJNL, De-Deus G., Belladonna FG, Filho EMM. Volume and/or Time of NaOCl Influences the Fracture Strength of Endodontically Treated Bovine Teeth. Braz Dent J 2019;30(1): 31-35. DOI: https://doi.org/10.1590/0103-6440201902076

Rath PP, Yiu C KY, Matinlinna JP, Kishen A, Neelakantan P. The effect of root canal irrigations on dentin: a focused review Restor Dent Endod. 2020; 45(3): 39. DOI: https://doi.org/10.5395/rde.2020.45.e39

Sim TP, Knowles JC., Ng YL. Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int. Endod. J .2001; 34:120–32. DOI: https://doi.org/10.1046/j.1365-2591.2001.00357.x

Gu L, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of Contemporary Irrigation Agitation Techniques and Devices. J Endodont. 2009; 35:791-804. DOI: https://doi.org/10.1016/j.joen.2009.03.010

Abraham S, Raj JD, Venugopal M. Endodontic Irrigations: A Comprehensive Review. J Pharm Sci Res. 2015; 7(1):5-9.

Ismail S, Adyanthaya A, Sreelakshmi N. Intracanal irrigations in pediatric endodontics: A review. Inter J Appl Den Sci .2017; 3(4): 246-251.

Tartari T, Bachmann L, Maliza AGA, Andrade FB, Duarte MAH, Bramante CM. Tissue dissolution and modification in Dentin composition by different sodium hypochlorite concentrations. J Appl Oral Sci. 2016; 24(3):291-298. DOI: https://doi.org/10.1590/1678-775720150524

Hülsmann M, Heckendorff M, Lennon Á. Chelating agents in root canal treatment: mode of action and indications for their use .Int. Endod J. 2003 ;36 (12): 810-830 . DOI: https://doi.org/10.1111/j.1365-2591.2003.00754.x

Mohammadi Z, Shalavi S, Yaripour Sh, Kinoshita J, Manabe A, Kobayashi et al. Smear Layer Removing Ability of Root Canal Irrigation Solutions: A Review. The Journal of Contemporary Dent Practice. 2019;20(3):395-402. DOI: https://doi.org/10.5005/jp-journals-10024-2528

Chia MS, Parolia A, Lim BS, Jayaraman J, de Moraes Porto IC. Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies. Restor Dent Endod. 2020; 45(3):28. DOI: https://doi.org/10.5395/rde.2020.45.e28

Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigation, QMiX. Int. Endod J. 2012; 45(4):363-71 DOI: https://doi.org/10.1111/j.1365-2591.2011.01985.x

Aniketh TN, Idris M, Geeta IB, Nandakishore KJ, Sahu GK, Arul PT, et al. Root canal irrigants and irrigation techniques: A review. Journal of Evolution of Medical and Dental Sciences. Nat Rev Cancer. 2014; 4(3):133-139.

Gusiyska A, Gyulbenkiyan Е, Vassileva R, Dyulgerova E, Mironova J. Effective Root Canal Irrigation- A Key Factor of Endodontic Treatment-Review of The Literature. Inter J Rec Sci Res 2016; 7(4):9962-9970.

Dube K, Jain P. Electrolyzed Saline An Alternative to Sodium Hypochlorite for Root Canal Irrigation. MPR. 2018; 91(3): 322-327 DOI: https://doi.org/10.15386/cjmed-863

Baysan A, Lynch E. The use of ozone in dentistry and medicine. Prim Dent J. 2005;12(2):47–52. DOI: https://doi.org/10.1308/1355761053695158

Takeda FH, Harashima T, Kimura Y, Matsumoto K. A Comparative Study of the Removal of Smear Layer by Three Endodontic Irrigations and Two Types of Laser. Int. Endod. J. 1999; 32 (1):32–39. DOI: https://doi.org/10.1046/j.1365-2591.1999.00182.x

Walsh LJ, George R. Activation of Alkaline Irrigation Fluids in Endodontic. Materials 2017;10(10): 1214 . DOI: https://doi.org/10.3390/ma10101214

Oliveira LLL, Eslava AT. Treatment of Paget’s Disease of Bone Reumatol Clin. 2012;8(4):220–224 DOI: https://doi.org/10.1016/j.reumae.2011.06.006

Tartari T, Duarte Junior AP, Silva Junior JO, Klautau EB. Etidronate from medicine to endodontics: effects of different irrigation regimes on root dentin roughness J Appl Oral Sci. 2013; 21(5): 409–415 . DOI: https://doi.org/10.1590/1679-775720130201

Afkhami F, Akbari S, Chiniforush N. Entrococcus faecalis Elimination in Root Canals Using Silver Nanoparticles, Photodynamic Therapy, Diode Laser, or Laser-activated Nanoparticles: An in Vitro Study. J Endodont. 2017;43(2):279-282. DOI: https://doi.org/10.1016/j.joen.2016.08.029

Ahangari Z, Naseria M, Vatandoosta F. Propolis: Chemical Composition and Its Applications in Endodontics. Iran Endod J. 2018 ; 13(3): 285–292.

Bouchelaghem S. Propolis characterization and antimicrobial activities against Staphylococcus aureus and Candida albicans: A review Saudi J Biol Sci. 2022 ; 29(4): 1936–1946. DOI: https://doi.org/10.1016/j.sjbs.2021.11.063

Abbasi AJ, Mohammadi F, Bayat M, Gema SM, Ghadirian H, Seifi H, et al. Applications of Propolis in Dentistry: A Review Ethiop J Health Sci. 2018; 28(4): 505–512. DOI: https://doi.org/10.4314/ejhs.v28i4.16

Kim D, Kim E. Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part II. in vivo studies Restor Dent Endod. 2015; 40(2): 97–103. DOI: https://doi.org/10.5395/rde.2015.40.2.97

del Carpio-Perochena A, Kishen A, Felitti R, Bhagirath AY, Medapati MR, Lai C, et al. Antibacterial properties of chitosan nanoparticles and propolis associated with calcium hydroxide against single-and multispecies biofilms: an in vitro and in situ study. J Endodont. 2017;43(8):1332-6., DOI: https://doi.org/10.1016/j.joen.2017.03.017

Shrivastava R, Rai VK, Kumar A, Sinha S, Tripathi P, Gupta K. et al. An in vitro Comparison of Endodontic Medicaments Propolis and Calcium Hydroxide alone and in Combination with Ciprofloxacin and Moxifloxacin against Enterococcus Faecalis. J Contemp Dent Pract. 2015 ;16(5):394-9. DOI: https://doi.org/10.5005/jp-journals-10024-1696

Almadi KH, Ahmed MA, Ghazal T, Jouhar R, Alkahtany MF, Abduljabbar T, et al. Antimicrobial Efficacy of Propolis in Comparison to Chlorhexidine against Enterococcus faecalis: A Systematic Review and Meta-Analysis. Appl. Sci. 2021; 11(8): 3469. DOI: https://doi.org/10.3390/app11083469

Al-Ogaidi IAZ. Improving Oral Intake of Essential Oil Blends Using A Novel Formulation of Biodegradable Chitosan/Lecithin Iraqi J Sci. 2021; 62(9): 2906-2914. DOI: https://doi.org/10.24996/ijs.2021.62.9.7

Silva PV, Guedes DFC, Nakadi FV, Pe´cora JD, Cruz-Filho AM. Chitosan: a new solution for removal of smear layer after root canal instrumentation. Int. Endod. J. 2012;46(4):332-338 DOI: https://doi.org/10.1111/j.1365-2591.2012.02119.x

Antunes PV, Flamini LE, Chaves JF, Silva RG, Cruz Filho AM. Comparative effects of final canal irrigation with chitosan and EDTA.. J Appl Oral Sci. 2020; 28(2): 20190005. DOI: https://doi.org/10.1590/1678-7757-2019-0005

Simanjuntak PA, Djauharie N, Nursasongko B. antibacterial effectiveness of 2% chitosan and 2% chlorhexidine against enterococcus faecalis. Inter J Appl Pharm. 2019; 11(1): 0975-7058.

Wong J, Zou T, Lee AH, Zhang C. The potential translational applications of nanoparticles in endodontics. Inter Nanomed. 2021 Mar 9:2087-106. DOI: https://doi.org/10.2147/IJN.S293518

Dragland IS, Wellendorf H, Kopperud H, Stenhagen I, Valen H. Investigation on the antimicrobial activity of chitosan-modified zinc oxide-eugenol cement. Biomat investig dent. 2019 Dec 20;6(1):99-106.. DOI: https://doi.org/10.1080/26415275.2019.1697621

Yan D, Li Y, Liu Y, Li N, Zhang X, Yan C. Antimicrobial properties of chitosan and chitosan derivatives in the treatment of enteric infections. Molecules. 2021 Nov 25;26(23):7136.. DOI: https://doi.org/10.3390/molecules26237136

Kravanja G, Primožič M, Knez Ž, Leitgeb M. Academic Editor Chitosan-Based (Nano)Materials for Novel Biomedical Applications. Molecules. 2019; 24(10): 1960 DOI: https://doi.org/10.3390/molecules24101960

Simanjuntak PA, Djauharie NI, Nursasongko B. Antibacterial effectiveness of 2% chitosan and 2% chlorhexidine against enterococcus faecalis in biofilm (Laboratory experiment). Int J Appl Pharm. 2019 Apr 1;11(01):44-8.. DOI: https://doi.org/10.22159/ijap.2019.v11s1.163

Siqueira JF, Rocas IN . Present status and future directions: Microbiology of endodontic infections. Int Endod J. 2022; 55 (3): 512-530.

Cardoso FGD , Martinho FC , Ferreira ND , do Prado RF , Manhães-Júnior LRC, Rocco MA , et al , Correlation Between Volume of Root Canal, Cultivable Bacteria, Bacterial Complexes and Endotoxins in Primary Infection. Braz Dent J, 2019. 30(2): 117-122. DOI: https://doi.org/10.1590/0103-6440201902239

Gomes, B, Herrera DR. Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res, 2018; 32(1):69.

Barbosa-Ribeiro M., Arruda-Vasconcelos R., Louzada LM., Lima AR., Marciano M, de Almeida JFA, et al. Microbiological Investigation in Teeth with Persistent/Secondary Endodontic Infection in Different Stages of Root Canal Retreatment. Eur Endod J, 2020. 5(3): 219-225. DOI: https://doi.org/10.14744/eej.2020.73626

Wong J ,Manoil D, Näsman P, Belibasakis G N, Neelakanta P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges.Front. Oral. Health. 2021; 2(25): 672887. DOI: https://doi.org/10.3389/froh.2021.672887

Siqueira Jr JF, Rôças IN. Present status and future directions: Microbiology of endodontic infections. Int Endod J, 2022. 55 Suppl 3: p. 512-530. DOI: https://doi.org/10.1111/iej.13677

Sheng X, Yu J, Liu H, Wang Z, Deng S, Shen Y. Dual effectiveness of a novel all-in-one endodontic irrigating solution in antibiofilm activity and smear layer removal. Front Bioeng Biotechnol. 2023; 11(1):1254927. DOI: https://doi.org/10.3389/fbioe.2023.1254927

Bicego-Pereira EC, Barbosa-Ribeiro M, de-Jesus-Soares A, Zaia AA, Ferraz CC, Almeida JF, et al. Evaluation of the presence of microorganisms from root canal of teeth submitted to retreatment due to prosthetic reasons and without evidence of apical periodontitis. Clin Oral Investig .2020 ;24(9):3243-325 DOI: https://doi.org/10.1007/s00784-020-03200-z

Zargar N, Abadi MRH, Sabeti M, Yadegari Z, Baghban AA, Dianat O. Antimicrobial efficacy of clindamycin and triple antibiotic paste as root canal medicaments on tubular infection: An in vitro study. Aust Endod J. 2019. 45(1).86-91. DOI: https://doi.org/10.1111/aej.12288

Abdulkareem A , Abdulbaqi H , Gul S, Milward M , Chasib N, Alhashimi R. Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview Antibiotics. 2022; 11(1): 9; DOI: https://doi.org/10.3390/antibiotics11010009

Iandolo A, Pisano M, Buonavoglia A, Giordano F, Amato A, Abdellatif D. Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review. Clin Pract, 2023.13(5):1059-1072. DOI: https://doi.org/10.3390/clinpract13050094

Jhamb S, Singla R, Kaur A, Sharma J, Bhushan J. An in vitro determination of antibacterial effect of silver nanoparticles gel as an intracanal medicament in combination with other medicaments against Enterococcus fecalis. J Conserv Dent. 2019;22(5): 479–482. DOI: https://doi.org/10.4103/JCD.JCD_113_20

Donnermeyer D, Averkorn C, Bürklein S , Schäfer E. Cleaning Efficiency of Different Irrigation Techniques in Simulated Severely Curved Complex Root Canal Systems. J Endodont. 2023; 49 (11): 1548-1552.

Shihab DM, Mahdee AF. Root and Root Canal Morphology: Study Methods and Classifications. J Bagh Coll Dent .2021;33 (4): 11-19. DOI: https://doi.org/10.26477/jbcd.v33i4.3014

Gomes B, Herrera DR, Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res, 2018. 32(1): 69. DOI: https://doi.org/10.1590/1807-3107bor-2018.vol32.0069

Boutsioukis C, Arias‐Moliz MT. Present status and future directions – irrigations and irrigation methods Int Endod J. 2022 ; 55(3): 588–6122022 . DOI: https://doi.org/10.1111/iej.13739

Khorasani M, Nabavi S , Hamedi A, Jafarzadeh H. Endodontic Treatment of C-shaped Mandibular Premolars: A Case Report and Review of Literature. Iran Endod J, 2021;16(4):244-253.

Khawaja S, Alharbi N, Chaudhry J, Khamis AH, El Abed R, Ghoneima A, et al. The C-shaped root canal systems in mandibular second molars in an Emirati population. Sci Rep. 2021;11:23863. DOI: https://doi.org/10.1038/s41598-021-03329-1

Donnermeyer D, Averkorn C , Bürklein S, Schäfer E . Cleaning Efficiency of Different Irrigation Techniques in Simulated Severely Curved Complex Root Canal Systems. J Endodont. 2023;49 (11):1548-1552. DOI: https://doi.org/10.1016/j.joen.2023.08.006

Yin X, Jeffrey WW, Chang, Wang Q, Zhang C. Three‑dimensional morphologic classifications and analysis of canal isthmuses in permanent molars. Surgical and Radiologic Anatomy .2021; 43:1793–1799. DOI: https://doi.org/10.1007/s00276-021-02796-5

Ye WH, Fan B, Purcel W, Meghil MM, Cutler CHW, Bergeronc BE, et al. Anti-biofilm efficacy of root canal irrigations against in-situ Enterococcus faecalis biofilms in root canals, isthmuses and dentinal tubules. J Dent. 2018; 79:68-76. DOI: https://doi.org/10.1016/j.jdent.2018.10.002

Jaber ZA, Al-Huwaizi FH. Evaluation of the cleaning efficiency of the isthmus using different rotary instrumentation techniques (In vitro study) .j Bagh Coll Dent 2015; 27(2):43-7. DOI: https://doi.org/10.12816/0015293

Iliescu AA, Iliescu MG, Nistor CC, Marinescu IR. The relevance of root canal isthmuses in endodontic rehabilitation, Romanian J Oral Rehabil. 2023;15(1):219

Ahmed HMA, Neelakantan P, Dummer PMH, A new system for classifying accessory canal morphology. Int Endod J.2018;51(2):164-176. DOI: https://doi.org/10.1111/iej.12800

Xu T, Fan W, Tay FR, Fan B. Micro–computed tomographic evaluation of the prevalence, distribution, and morphologic features of accessory canals in chinese permanent teeth. J Endodont. 2019;45(8):994-9.. DOI: https://doi.org/10.1016/j.joen.2019.04.001

Mohmmed SA, Vianna ME, Penny MR , Hilton ST, Mordan NJ , Knowles JC. Investigations into in situ Enterococcus faecalis biofilm removal by passive and active sodium hypochlorite irrigation delivered into the lateral canal of a simulated root canal model. Int Endod J.2018 ;51(6):649-662. DOI: https://doi.org/10.1111/iej.12880

Siqueira JuniorJ F, Neves RôçasI D, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res. 2018;32(1): 65. DOI: https://doi.org/10.1590/1807-3107bor-2018.vol32.0065

Al-Nazhan S , Al-Sulaiman A , Al-Rasheed F, Alnajjar F , Al-Abdulwahab B , Al-Badah A .Microorganism penetration in dentinal tubules of instrumented and retreated root canal walls. In vitro SEM study. Restor Dent Endod, 2014. 39(4): 258-64. DOI: https://doi.org/10.5395/rde.2014.39.4.258

Galler KM, Grubmüller V, Schlichting R, Widbiller M, Eidt A, Schuller C, et al., Penetration depth of irrigations into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J. 2019; 52(8): 1210-1217 DOI: https://doi.org/10.1111/iej.13108

Susila A , Minu J. Activated Irrigation vs. Conventional non-activated Irrigation in Endodontics – A Systematic Review Eur Endod J. 2019; 4(3): 96–110. DOI: https://doi.org/10.14744/eej.2019.80774

Mukhlif T , Al-Hashimi RA. The Effect of Adding Poloxamer Surfactant on the Penetration Depth of NaOCl and NaOH into Dentinal Tubules. J Res Med Dent Sci. 2021;9(1):200-209.

Jihad R, Al-Huwaizi H. Antimicrobial Evaluation for Novel Solution of Iron Oxide Nanoparticles Functionalized with Glycine and Coated by Chitosan as Root Canal Final Irrigation. Systematic Review Pharmacy. 2020; 11(6):633-642.

Aydin ZU, Akpinar KE, Hepokur C, Altunba D. Evaluation of cytotoxicity of Qmix, ethylene diamintetraacetic acid and chlorhexidine on human osteoblast cell line. Cumhuriyet Dental Journal. 2018; 21(3):202-208. DOI: https://doi.org/10.7126/cumudj.438506

Jaiswal N , Sinha DJ , Singh UP , Singh K, Jandial U, Goel S. Evaluation of antibacterial efficacy of Chitosan, Chlorhexidine, Propolis and Sodium hypochlorite on Enterococcus faecalis biofilm : An in vitro study. J Clin Exp Dent. 2017; 19(9):1066-1074. DOI: https://doi.org/10.4317/jced.53777

Abidin T, Susilo D, Gani B. The effectiveness of nano-chitosan high molecular 0.2% as irrigation agent against Enterococcus faecalis with passive ultrasonic irrigation . J Conserv Dent. 2022; 25(1):37-41. DOI: https://doi.org/10.4103/jcd.jcd_437_21

Abu Al-timan JA, Al-Huwaizi H , Abed H. Evaluating the effect of adding Chitosan nanoparticles on the disinfection properties of Glyde material: An in vitro study Res J Pharm Tech .2020;13(1):255 DOI: https://doi.org/10.5958/0974-360X.2020.00051.7

Singh A, Hou WC., Lin TF. Combined impact of silver nanoparticles and chlorine on the cell integrity and toxin release of Microcystis aeruginosa. Chemosphere 2021; 272 :129825. DOI: https://doi.org/10.1016/j.chemosphere.2021.129825

Adham AH, Ali AH. 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). Cumhuriyet Dental Journal. 2023; 26(2): 112 - 120. DOI: https://doi.org/10.7126/cumudj.1231568

Fahad F, Al‑Hashimi RA, Hussien ZR. Antibacterial Efficacy andCytotoxicity ofIncorporating Nanoparticles intoSodium Hypochlorite asIrrigation Solution. BioNanoScience 2023; 13:1-12. DOI: https://doi.org/10.1007/s12668-023-01260-5

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