Can natural irrigants replace sodium hypochlorite? A systematic review.

Autor: Susila AV; Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India. drsusila2000@yahoo.com., Sai S; Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India., Sharma N; Department of Conservative Dentistry & Endodontics, Shree Bankey Bihari Dental College and Research Centre, Masuri, NH 24, Ghaziabad, Uttar Pradesh, India., Balasubramaniam A; Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India., Veronica AK; Department of Conservative Dentistry & Endodontics, Madha Dental College & Hospital, Somangalam, Kavanoor Road, Kundrathur, Chennai, Tamil Nadu, 600069, India., Nivedhitha S; Department of Conservative Dentistry & Endodontics, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2023 May; Vol. 27 (5), pp. 1831-1849. Date of Electronic Publication: 2023 Feb 18.
DOI: 10.1007/s00784-023-04913-7
Abstrakt: Context: Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored.
Aims: This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite.
Settings and Design Registration: This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence.
Results: Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success.
Conclusions: The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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