A compendium of the most common root canal irrigants

Femiano Felice, Femiano Rossella, Festa Vincenzo Maria, Perillo Letizia, Rullo Rosario


This article reviews the most recent papers on root canal irrigants and summarize the chemistry, biology and procedures for safe and efficient root canal irrigation. A PubMed and PMC search for papers by using the keywords ‘root canal irrigants’ and ‘endodontic irrigants’ and the reference lists of each article were manually checked for additional articles of relevance.


Canalar Solutions;Endodontium; Irrigants; Root Canal; Smear Layer


Kandaswamy D, Venkateshbabu N. Root canal irrigants. Journal of Conservative Dentistry. 2010;13(4):256-64.

Love R, Jenkinson H. Invasion of dentinal tubules by oral bacteria. Critical Reviews in Oral Biology & Medicine. 2002;13(2):171-83.

Young G, Parashos P, Messer H. The principles of techniques for cleaning root canals. Australian Dental Journal. 2007;52(s1):S52-S63.

Basrani B. Irrigation in endodontic treatment. The Alpha omegan. 2010;104(1-2):18-25.

Jaju S, Jaju PP. Newer root canal irrigants in horizon: a review. International journal of dentistry. 2011;2011.

Waltimo T, Sen B, Meurman JH, Ørstavik D, Haapasalo M. Yeasts in apical periodontitis. Critical Reviews in Oral Biology & Medicine. 2003;14(2):128-37.

Upadya MH, Kishen A. Influence of bacterial growth modes on the susceptibility to light‐activated disinfection. International Endodontic Journal. 2010;43(11):978-87.

Chávez de Paz L, Dahlén G, Molander A, Möller Å, Bergenholtz G. Bacteria recovered from teeth with apical periodontitis after antimicrobial endodontic treatment. International Endodontic Journal. 2003;36(7):500-8.

Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis Its Role in Root Canal Treatment Failure and Current Concepts in Retreatment. Journal of endodontics. 2006;32(2):93-8.

HALAâKOVÁ Z, Kukletova M. Rinsing of the root canal. Scripta Medica (BRNO). 2003;76(1):49-54.

Karunakaran J, Kumar SS, Kumar M, Chandrasekhar S, Namitha D. The effects of various irrigating solutions on intra-radicular dentinal surface: An SEM analysis. Journal of pharmacy & bioallied sciences. 2012;4(Suppl 2):S125.

Scelza MrFZ, Pierro V, Scelza P, Pereira M. Effect of three different time periods of irrigation with EDTA-T, EDTA, and citric acid on smear layer removal. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2004;98(4):499-503.

Cameron J. The use of ultrasonics in the removal of the smear layer: a scanning electron microscope study. Journal of Endodontics. 1983;9(7):289-92.

Pashley D, Michelich V, Kehl T. Dentin permeability: effects of smear layer removal. The Journal of prosthetic dentistry. 1981;46(5):531-7.

Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;94(6):658-66.

Adigüzel Ö, Yiğit-Özer S, Kaya S, Uysal İ, Ganidağli-Ayaz S, Akkuş Z. Effectiveness of ethylenediaminetetraacetic acid (EDTA) and MTAD on debris and smear layer removal using a self-adjusting file. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(6):803-8.

Haapasalo M, Ørstavik D. In vitro infection and of dentinal tubules. Journal of Dental Research. 1987;66(8):1375-9.

Costerton JW, Geesey G, Cheng K. How bacteria stick. Scientific American. 1978;238(1):86-95.

McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. Journal of Endodontics. 1975;1(7):238-42.

Saber SE-D, Hashem AAR. Efficacy of different final irrigation activation techniques on smear layer removal. Journal of Endodontics. 2011;37(9):1272-5.

Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. Journal of endodontics. 1997;23(12):725-7.

Vijaykumar S, Gunashekhar M, Himagiri S. In vitro effectiveness of different endodontic irrigants on the reduction of Enterococcus faecalis in root canals. J Clin Exp Dent.2010;2:e169-72.

Zehnder M. Root canal irrigants. Journal of Endodontics. 2006;32(5):389-98.

Spencer H, Ike V, Brennan P. Review: the use of sodium hypochlorite in endodontics—potential complications and their management. British dental journal. 2007;202(9):555-9.

da Silva JM, Silveira A, Santos E, Prado L, Pessoa OF. Efficacy of sodium hypochlorite, ethylenediaminetetraacetic acid, citric acid and phosphoric acid in calcium hydroxide removal from the root canal: a microscopic cleanliness evaluation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(6):820-4.

Cunha C, Barcelos R, Primo L. Soluções irrigadoras e materiais obturadores utilizados na terapia endodôntica de dentes decíduos. Pesq Bras Odontoped Clin Integr. 2005;5(1):75-83.

Estrela C, Estrela CR, Barbin EL, Spanó JCE, Marchesan MA, Pécora JD. Mechanism of action of sodium hypochlorite. Brazilian Dental Journal. 2002;13(2):113-7.

Mohammadi Z, Shahriari S. Residual antibacterial activity of chlorhexidine and MTAD in human root dentin in vitro. Journal of Oral Science. 2008;50(1):63-7.

Gómez-López VM. Decontamination of fresh and minimally processed produce: Wiley Online Library; 2012.

Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. Journal of Endodontics. 2005;31(9):669-71.

Sevimay S, Oğan-Hasçiçek C, Tarımcı N. Evaluation of surface tensions and cleansing ability of sodium hypochlorite and chlorhexidine solutions at different concentrations and temperatures. Balkan Journal of Stomatology. 2010;14(2):72-8.

Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. Journal of Endodontics. 2006;32(11):1091-3.

Mohammadi Z, Mombeinipour A, Giardino L, Shahriari S. Residual antibacterial activity of a new modified sodium hypochlorite-based endodontic irrigation solution. Med Oral Patol Oral Cir Bucal. 2011;16(4):588-92.

Kennedy J, Hussey D. The antimicrobial effects of root canal irrigation and medication. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2007;103(4):560-9.

Torabinejad M, Walton RE. Principles and practice of endodontics: Saunders Philadelphia; 2002.

Torabinejad M. Root Canal Irrigants and Disinfectants. Endodontics: Colleagues for Excellence. 2011:2-7.

Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. Minimum Contact Time and Concentration of Sodium Hypochlorite Required to Eliminate Enterococcus faecalis. Journal of Endodontics. 2010;36(3):520-3.

Fidalgo TKdS, Barcelos R, Portela MB, Soares RMdA, Gleiser R. Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus. Brazilian oral research. 2010;24(4):406-12.

Gomes-Filho JE, Aurélio KG, Costa MMTdM, Bernabé PFE. Comparison of the biocompatibility of different root canal irrigants. Journal of Applied Oral Science. 2008;16(2):137-44.

Sena N, Gomes B, Vianna M, Berber V, Zaia A, Ferraz C, et al. In vitro antimicrobial activity of sodium hypochlorite and chlorhexidine against selected single‐species biofilms. International endodontic journal. 2006;39(11):878-85.

Siqueira Jr JF, Guimarães-Pinto T, Rôças IN. Effects of chemomechanical preparation with 2.5% sodium hypochlorite and intracanal medication with calcium hydroxide on cultivable bacteria in infected root canals. Journal of endodontics. 2007;33(7):800-5.

Siqueira Jr JF, Rôças IN, Santos SR, Lima KC, Magalhães FA, de Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. Journal of Endodontics. 2002;28(3):181-4.

Harrison J. Irrigation of the root canal system. Dental Clinics of North America. 1984;28(4):797.

Rödig T, Vogel S, Zapf A, Hülsmann M. Efficacy of different irrigants in the removal of calcium hydroxide from root canals. International Endodontic Journal. 2010;43(6):519-27.

Moorer W, Wesselink P. Factors promoting the tissue dissolving capability of sodium hypochlorite. International Endodontic Journal. 1982;15(4):187-96.

Baumgartner JC, Cuenin PR. Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. Journal of Endodontics. 1992;18(12):605-12.

Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. Journal of endodontics. 2010;36(9):1558-62.

de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. Efficacy of Different Irrigation and Activation Systems on the Penetration of Sodium Hypochlorite into Simulated Lateral Canals and up to Working Length: An< i> In Vitro Study. Journal of endodontics. 2010;36(7):1216-21.

Spratt D, Pratten J, Wilson M, Gulabivala K. An in vitro evaluation of the antimicrobial efficacy of irrigants on biofilms of root canal isolates. International Endodontic Journal. 2001;34(4):300-7.

Al-Jadaa A, Paqué F, Attin T, Zehnder M. Acoustic hypochlorite activation in simulated curved canals. Journal of endodontics. 2009;35(10):1408-11.

Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. Journal of Endodontics. 2005;31(11):817-20.

Newberry BM, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. The Antimicrobial Effect of Biopure MTAD on Eight Strains of Enterococcus faecalis: An In Vitro Investigation. Journal of endodontics. 2007;33(11):1352-4.

Paredes-Vieyra J, Enríquez FJJ, Lasso CC. Ability of four irrigating solutions to remove debris after root-canal instrumentation. Root. 2012;1:26-9.

Nikaido H. Molecular basis of bacterial outer membrane permeability revisited. Microbiology and Molecular Biology Reviews. 2003;67(4):593-656.

Putzer P, Hoy L, Günay H. Highly concentrated EDTA gel improves cleaning efficiency of root canal preparation in vitro. Clinical oral investigations. 2008;12(4):319-24.

Grande NM, Plotino G, Falanga A, Pomponi M, Somma F. Interaction between EDTA and sodium hypochlorite: a nuclear magnetic resonance analysis. Journal of Endodontics. 2006;32(5):460-4.

Saito K, Webb TD, Imamura GM, Goodell GG. Effect of shortened irrigation times with 17% ethylene diamine tetra-acetic acid on smear layer removal after rotary canal instrumentation. Journal of endodontics. 2008;34(8):1011-4.

Hariharan V, Nandlal B, Srilatha K. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: A scanning electron microscopy study. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2010;28(4):271-7.

Balaji T, Sajjan G. Effect Of Various Root Canal Irrigants On Removal Of Smear Layer And Debris–Scanning Electron Microscopic Study. Journal of Conservative Dentistry. 2002;5(03):131.

Dakshita J, Ashish A. Recent concepts on root canal chelation. Endodontic Practice Today. 2011;5(3).

Shabahang S, Torabinejad M. Effect of MTAD on Enterococcus faecalis Contaminated Root Canals of Extracted Human Teeth. Journal of Endodontics. 2003;29(9):576-9.

Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endodontic Topics. 2005;10(1):77-102.

Dineshkumar MK, Vinothkumar TS, Arathi G, Shanthisree P, Kandaswamy D. Effect of ethylene diamine tetra-acetic acid, MTAD™, and HEBP as a final rinse on the microhardness of root dentin. Journal of conservative dentistry: JCD. 2012;15(2):170.

Zehnder M, Schicht O, Sener B, Schmidlin P. Reducing surface tension in endodontic chelator solutions has no effect on their ability to remove calcium from instrumented root canals. Journal of endodontics. 2005;31(8):590-2.

De-Deus G, Zehnder M, Reis C, Fidel S, Fidel RAS, Galan Jr J, et al. Longitudinal co-site optical microscopy study on the chelating ability of etidronate and EDTA using a comparative single-tooth model. Journal of endodontics. 2008;34(1):71-5.

Ballal NV, Kandian S, Mala K, Bhat KS, Acharya S. Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: a scanning electron microscopic study. Journal of endodontics. 2009;35(11):1573-6.

Takeda F, Harashima T, Kimura Y, Matsumoto K. A comparative study of the removal of smear layer by three endodontic irrigants and two types of laser. International Endodontic Journal. 1999;32(1):32-9.

Chandak M, Bodhankar A, Pattanaik N. Chemical interaction of 7 % MA with 2 % CHX and 5 % Naocl – an in vitro study. Journal of Dental and Medical Sciences (IOSR-JDMS) 2013;8(6):79-82

Prabhu S, Rahim N, Bhat K, Mathew J. Comparison of removal of endodontic smear layer using NaOCl, EDTA, and different concentrations of maleic acid–A SEM study. Endodontology. 2003;15(1):20-5.

Ballal NV, Mala K, Bhat KS. Evaluation of decalcifying effect of maleic acid and EDTA on root canal dentin using energy dispersive spectrometer. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(2):e78-e84.

Zamany A, Safavi K, Spångberg LS. The effect of chlorhexidine as an endodontic disinfectant. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2003;96(5):578-81.

Bansal R, Jain A, Mittal S, Kumar T, Jindal N, Kaur D. A Comparison Of The Antibacterial Efficiency Of MTAD (Mixture Of Tetracycline, Citric Acid And Detergent), 2.5% Sodium Hypochlorite And 2% Chlorhexidine Root Canal Irrigants Against Enterococcus Faecalis In Root Canals Of Single Rooted Mandibular Premolars-An In Vitro Study. J Dent Med Sci. 2013;5(3):47-53.

Ryan S. Chlorhexidine as a canal irrigant: a review. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995). 2010;31(5):338-42; quiz 43, 64.

Shahriari S, Mohammadi Z, Mokhtari MM, Yousefi R. Effect of hydrogen peroxide on the antibacterial substantivity of chlorhexidine. International journal of dentistry. 2011;2010.

Faria G, Celes M, De Rossi A, Silva LAB, Silva JS, Rossi MA. Evaluation of chlorhexidine toxicity injected in the paw of mice and added to cultured l929 fibroblasts. Journal of Endodontics. 2007;33(6):715-22.

Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. Journal of Endodontics. 1998;24(7):472-6.

Basrani BR, Manek S, Sodhi RN, Fillery E, Manzur A. Interaction between sodium hypochlorite and chlorhexidine gluconate. Journal of Endodontics. 2007;33(8):966-9.

Vianna M, Horz H, Gomes B, Conrads G. In vivo evaluation of microbial reduction after chemo‐mechanical preparation of human root canals containing necrotic pulp tissue. International endodontic journal. 2006;39(6):484-92.

Sayin TC, Cehreli ZC, Deniz D, Akcay A, Tuncel B, Dagli F, et al. Time-dependent decalcifying effects of endodontic irrigants with antibacterial properties. Journal of endodontics. 2009;35(2):280-3.

Rasimick BJ, Nekich M, Hladek MM, Musikant BL, Deutsch AS. Interaction between chlorhexidine digluconate and EDTA. Journal of Endodontics. 2008;34(12):1521-3.

Ordinola‐Zapata R, Bramante C, Cavenago B, Graeff M, Gomes de Moraes I, Marciano M, et al. Antimicrobial effect of endodontic solutions used as final irrigants on a dentine biofilm model. International Endodontic Journal. 2012;45(2):162-8.

Brudzynski K, Lannigan R. Mechanism of honey bacteriostatic action against MRSA and VRE involves hydroxyl radicals generated from honey’s hydrogen peroxide. Frontiers in microbiology. 2012;3:36.

Steinberg D, Heling I, Daniel I, Ginsburg I. Antibacterial synergistic effect of chlorhexidine and hydrogen peroxide against Streptococcus sobrinus, Streptococcus faecalis and Staphylococcus aureus. Journal of oral rehabilitation. 1999;26(2):151-6.

Mohammadi Z, Giardino L, Palazzi F, Shalavi S. The Effect of Ascorbic Acid on the Substantivity of Tetraclean in Sodium Hypochlorite-Treated Bovine Dentin. Journal of Dentistry (Tehran, Iran). 2012;9(3):230.

Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, et al. A new solution for the removal of the smear layer. Journal of Endodontics. 2003;29(3):170-5.

Giardino L, Pecora G, Ambu E, Savoldi E, editors. A new irrigant in the treatment of apical periodontitis: from research to clinic. 12th Biennial Congress European Society of Endodontology, Dublin; 2005.

Beltz RE, Torabinejad M, Pouresmail M. Quantitative analysis of the solubilizing action of MTAD, sodium hypochlorite, and EDTA on bovine pulp and dentin. Journal of endodontics. 2003;29(5):334-7.

De-Deus G, Reis C, Fidel S, Fidel R, Paciornik S. Dentin demineralization when subjected to BioPure MTAD: a longitudinal and quantitative assessment. Journal of endodontics. 2007;33(11):1364-8.

Kho P, Baumgartner JC. A Comparison of the Antimicrobial Efficacy of NaOCl/Biopure MTAD versus NaOCl/EDTA against Enterococcus faecalis. Journal of endodontics. 2006;32(7):652-5.

Torabinejad M, Shabahang S, Aprecio RM, Kettering JD. The antimicrobial effect of MTAD: an in vitro investigation. Journal of Endodontics. 2003;29(6):400-3.

Zhang W, Torabinejad M, Li Y. Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method. Journal of Endodontics. 2003;29(10):654-7.

Saghiri MA, Delvarani A, Mehrvarzfar P, Nikoo M, Lotfi M, Karamifar K. The impact of pH on cytotoxic effects of three root canal irrigants.The Saudi Dental Journal.2011;23(3):149-52.

Mohammadi Z, Giardino L, Shahriari S. Effect of dentin treatment time with tetraclean on its residual antibacterial activity. Journal of the California Dental Association. 2010;38(12):853-6.

Torabinejad M, Cho Y, Khademi AA, Bakland LK, Shabahang S. The effect of various concentrations of sodium hypochlorite on the ability of MTAD to remove the smear layer. Journal of Endodontics. 2003;29(4):233-9.

Mittal R, Singla M, Garg A, Gupta S, Dahiya V. Comparative evaluation of the antimicrobial efficacy of MTAD, oxytetracycline, sodium hypochlorite and chlorhexidine against Enterococcus faecalis: An ex-vivo study. Saudi Endodontic Journal. 2012;2(2):70.

Singla MG, Garg A, Gupta S. MTAD in endodontics: an update review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(3):e70-e6.

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