While advancements in mechanical instrumentation have significantly improved the shaping of root canals, research consistently shows that up to 35% of the canal surface remains untouched by endodontic files.
In these untouched areas—where necrotic tissue and biofilm may persist—the role of chemical irrigation becomes essential.
This comprehensive narrative review, published in 2023, explores the evolving role of NaOCl in chemical preparation, shedding light on the multiple factors that influence its efficacy: concentration (ranging from 0.5% to 8.25%), temperature, volume of solution used, and exposure time.
The paper highlights how modifying these parameters can optimize the disinfection potential while minimizing undesirable effects
Among the key innovations discussed are methods for enhancing NaOCl activity, including preheating the solution, ultrasonic and sonic activation, laser-assisted agitation, and the use of continuous chelation with soft chelators like HEDP.
These strategies aim to improve organic tissue dissolution, disrupt biofilm matrices more efficiently, and promote deeper penetration into complex canal anatomies.
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Importantly, the article also examines the limitations and risks associated with sodium hypochlorite use
These include cytotoxicity, adverse interactions with dentin (leading to changes in flexural strength and elasticity), and the risk of accidental extrusion beyond the apex—particularly in cases with inadequate irrigation control.
This state-of-the-art review bridges clinical experience with current scientific evidence, helping dental professionals better understand how to adapt irrigation protocols for improved outcomes.
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It underscores the need for a balanced approach—maximizing antibacterial performance while protecting periapical tissues and preserving dentinal structure.
📄 We invite dentists around the world to read the Full article in PDF format and explore the latest updates on optimizing sodium hypochlorite irrigation.
Discover practical recommendations and evidence-based strategies to enhance your endodontic practice.
