A comprehensive review of endodontic irrigating solutions: balancing efficacy, biocompatibility, and clinical relevance

Endodontic irrigation is an indispensable component of successful root canal treatment, serving as a critical adjunct to mechanical instrumentation in achieving disinfection, smear layer removal, and debris dissolution. This comprehensive review delves into the contemporary landscape of endodontic irrigating solutions, meticulously evaluating their efficacy in achieving these objectives while considering their biocompatibility and clinical applicability. Sodium hypochlorite (NaOCl) remains the cornerstone of irrigation protocols due to its potent antimicrobial and tissue-dissolving properties, yet its inherent cytotoxicity necessitates judicious application. Alternative irrigants, including chlorhexidine (CHX), ethylenediaminetetraacetic acid (EDTA), citric acid, and emerging agents like QMix and MTAD, offer varying degrees of efficacy and biocompatibility. This review meticulously examines the mechanisms of action, advantages, and limitations of these solutions, underscoring the significance of understanding their interactions and the imperative for ongoing research to refine irrigation protocols for enhanced clinical outcomes. Furthermore, the review explores the impact of irrigation techniques, delivery systems, and the role of novel technologies in optimizing the effectiveness of irrigating solutions.