Medicinal treatment of root canals in endodontics: problems of using modern agents

INTRODUCTION: Medicinal treatment of root canals (RC) in the endodontic treatment is an important aspect of therapeutic dentistry. Antiseptic solutions help clean RC from smear layer components, pathogenic microorganisms and their toxins, and also ensure high adhesion of materials to tooth tissues. A quality medicinal irrigation permits to prevent the development of inflammation in the apical periodontium after endodontic treatment. AIM: Based on current literature, to analyze the problems of using modern agents for medicinal treatment of RC in endodontics. Articles from 2013–2023 in Russian and English from eLibrary, Medline/PubMed, Google Scholar electronic databases were analyzed. The paper presents a review of studies concerning the choice of irrigant for medicinal treatment of RC in terms of different concentration of solutions and exposure time. The main problem in the use of antiseptics is their evident toxic effect on the human organism at the concentration required for a quality treatment of RC. The irrigation technique should be practically ideal to avoid severe complications of periodontal damage, which is achieved by a specialist over time. To increase the effectiveness of removing the smear layer, it is optimal to use combinations of antiseptics: 3% sodium hypochlorite and 17% EDTA, 3% sodium hypochlorite and 10% citric acid, 3% sodium hypochlorite and 3% hydrogen peroxide CONCLUSION: Despite the variety of antiseptics for medicinal treatment of the dental RC, there is currently no preparation meeting all the requirement to these agents. Most effective remain sodium hypochlorite solutions both in a pure form and in a combination with ethylenediaminetetraacetic acid, hydrogen peroxide or citric acid. Activation of antiseptic solutions in the CR system using sound, ultrasound, laser radiation increases the effectiveness of medicinal treatment.