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  • Invited Review Article
    The effect of root canal irrigants on dentin: a focused review
    Priti Pragati Rath, Cynthia Kar Yung Yiu, Jukka Pekka Matinlinna, Anil Kishen, Prasanna Neelakantan
    Restor Dent Endod 2020;45(3):e39.   Published online June 30, 2020
    DOI: https://doi.org/10.5395/rde.2020.45.e39
    AbstractAbstract PDFPubReaderePub

    Despite the vast literature on the effects of root canal irrigants on the dentin characteristics, the precise effects of clinically relevant irrigation sequences remain unclear. In this review, we systematically dissect the role of different sequential irrigation approaches that are used in clinical endodontics. Using a systematic search strategy, we attempt to answer the question: ‘Which irrigating sequence has the most deleterious effects on dentin structure and properties?’ The effect of irrigants on the dentin composition and mechanical properties have been reviewed. A wide variety of concentrations, duration and techniques have been employed to characterize the effects of chemicals on dentin properties, thus making it impossible to draw guidelines or recommendations of irrigant sequences to be followed clinically. It was apparent that all the studied irrigation sequences potentially result in some deleterious effects on dentin such as decrease in the flexural strength, microhardness, modulus of elasticity and inorganic content and organic-inorganic ratio of the dentin. However, the literature still lacks comprehensive investigations to compare the deleterious effect of different irrigation sequences, using a wide variety of qualitative and quantitative methods. Such investigations are essential to make clinical recommendations and strategize efforts to minimize chemically-induced damage to dentin characteristics.

    Citations

    Citations to this article as recorded by  
    • A Comparative Evaluation of the Antimicrobial Properties of 50% Grape Seed Extract, N-acetyl Cysteine and 5.25% Sodium Hypochlorite against Enterococcus faecalis (ATCC 19433) – An In vitro Study
      Nikita Vishweshwar Kurtkoti, Madhura Vivek Pawar, Vaishnavi Ketan Mathawala, Shraddha Mahadeo Shirsat
      Advances in Human Biology.2025; 15(2): 237.     CrossRef
    • Comparative Evaluation of Pulp Dissolution and Smear Layer Removal Properties of Various Herbal Extracts: An in vitro Study
      Suleman Abbas Khan, Harshal Gaidhane, Saumya Navit, Meenakshi Upadhyay, Sujeet Shriram Pal, Nishi Grover
      Advances in Human Biology.2025;[Epub]     CrossRef
    • Exploring a new Portland cement-free calcium silicate cement —Part 1: Synthesis of dicalcium and tricalcium silicate
      Tomomi ITOH, Kohei SHINTANI, Takashi HORIGUCHI, Norihiro SASAMOTO, Katsushi OKUYAMA, Yukimichi TAMAKI, Takeshi SUWABE, Satoshi YOKOSE, Satoshi KAWANO
      Dental Materials Journal.2025; 44(2): 140.     CrossRef
    • Effect of phthalocyanine, methylene blue and toluidine blue photosensitizers on the adhesive interface of fiber posts: a confocal laser microscopy study
      Tuba Gök, Gamze Er Karaoglu, Hulde Korucu
      Lasers in Medical Science.2025;[Epub]     CrossRef
    • Antimicrobial effect of 2.5% sodium hypochlorite irradiated with the 445 Nm diode laser against bacterial biofilms in root canal - in vitro pilot study
      Ivan Katalinić, Antonija Pranjić, Ana Budimir, Lucija Kanižaj, Ivona Bago, Valentina Rajić
      Lasers in Medical Science.2025;[Epub]     CrossRef
    • When oral health affects overall health: biofilms, dental infections, and emerging antimicrobial strategies
      Ahmed Adel Abdelaziz, Ahmed S. Doghish, Akram N. Salah, Reda M. Mansour, Yasser M. Moustafa, Sherif S. Abdel Mageed, Hebatallah Ahmed Mohamed Moustafa, Walaa A. El-Dakroury, Sama A. Doghish, Osama A. Mohammed, Mustafa Ahmed Abdel-Reheim, Shaimaa O. Abbass
      Infection.2025;[Epub]     CrossRef
    • Enhanced Bond Strength and Adhesive Interface of Resin‐Based Sealer to Root Dentin Using a Novel Single Multifunctional Endodontic Irrigant Solution
      Paulo Oliveira Silva, Julia Godoi Lopes, Iago Ramirez, Helena Cristina de Assis, Vinícius Leite Rosa‐e‐Silva, Gustavo Alexandre de Castro‐Vasconcelos, Antonio Miranda da Cruz‐Filho, Renato Roperto, Manoel Damião de Sousa‐Neto, Benedetta Ghezzi, Fabiane Ca
      Australian Endodontic Journal.2025;[Epub]     CrossRef
    • Enhanced Cleaning, Enhanced Healing: A Systematic Review of Advances in Endodontic Irrigation
      Shubhi Gupta, Karunakaran Venkataraman Jeyaraman, M. Deepthi, Rohan Shinkre, Neha Singh, Sagar Shah
      Journal of Pharmacy and Bioallied Sciences.2025; 17(Suppl 2): S1845.     CrossRef
    • Dual- or single rinse? The tubular sealer penetration of endodontic chelating agents
      Beliz Ozel, Tuba Ayhan, Figen Kaptan, Fikrettin Sahin, Meriç Karapınar-Kazandağ, Ajinkya M. Pawar
      PLOS ONE.2024; 19(6): e0303377.     CrossRef
    • Mechanical properties of simulated dentin caries treated with metal cations and l-ascorbic acid 2-phosphate
      Mohammad Ali Saghiri, Julia Vakhnovetsky, Amir Abdolmaleki, Elham Samadi, Fatereh Samadi, Salvatore Napoli, Michael Conte, Steven M. Morgano
      Odontology.2024; 112(2): 489.     CrossRef
    • The advancement in irrigation solution within the field of endodontics, A Review
      Fatima Fahad , Raghad A Al-Hashimi , Munther J Hussain
      Journal of Baghdad College of Dentistry.2024; 36(1): 54.     CrossRef
    • Comparative evaluation of effect of modified triple antibiotic paste and calcium hydroxide as intracanal medicament on microhardness of root dentin: An in vitro study
      Aparna Palekar, Piyush Mantri, Minal Awinashe, Basawaraj Biradar, Mukund Singh
      Endodontology.2024;[Epub]     CrossRef
    • Effect of herbal irrigants on surface roughness of intraradicular dentin using quantitative method of 3D surface texture analysis
      Sabah M. Sobhy, Heba Abdelfatah, Hanaa M. Elgamily, Nesreen Y. Mohammed
      Scientific Reports.2024;[Epub]     CrossRef
    • Effect of different root canal irrigants on surface roughness and microhardness of Biodentine combined with triple antibiotic paste: An in vitro study
      Rahul Halkai, S. Syed Ishaq, Kiran R. Halkai, Syeda Uzma Mahveen
      Journal of Conservative Dentistry and Endodontics.2024; 27(5): 508.     CrossRef
    • Bacteria debridement efficacy of two sonic root canal irrigant activation systems
      Chang Zeng, Pei Hu, Colin P. Egan, Brian E. Bergeron, Franklin Tay, Jingzhi Ma
      Journal of Dentistry.2024; 140: 104770.     CrossRef
    • Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review
      Joana A. Marques, Rui I. Falacho, João Miguel Santos, João Carlos Ramos, Paulo J. Palma
      Journal of Esthetic and Restorative Dentistry.2024; 36(4): 606.     CrossRef
    • Effect of ultrasonic and Er,Cr:YSGG laser-activated irrigation protocol on dual-species root canal biofilm removal: An in vitro study
      Venkata Divya Durga Datla, Lakshman Varma Uppalapati, Hema Prakash Kumari Pilli, Jyothi Mandava, Sirisha Kantheti, Sri Naagaja Krishnaveni Komireddy, Vedamani Chandolu
      Journal of Conservative Dentistry and Endodontics.2024; 27(6): 613.     CrossRef
    • Comparative Evaluation of Dental Pulp Tissue Dissolution Ability of Sapindus mukorossi and Sodium Hypochlorite
      Sriram Kaliamoorthy, Sreeram Rayar, Shanmugapriya SundarRaj, Sugantha Priya Sayeeram, V.V. Premkumar, Sapna C Muddappa, Venkatraman Muthukumaran, Kanmani Raju, Agila Samidorai
      Cureus.2024;[Epub]     CrossRef
    • Effect of Different Irrigating Solutions on Root Canal Dentin Microhardness—A Systematic Review with Meta-Analysis
      Sunidhi Agarwal, Lora Mishra, Naomi Ranjan Singh, Rini Behera, Manoj Kumar, Ravishankar Nagaraja, Krzysztof Sokolowski, Barbara Lapinska
      Journal of Functional Biomaterials.2024; 15(5): 132.     CrossRef
    • Evaluation of Effect of Herbal Irrigant on Microhardness of Root Dentin: An in vitro Study
      Anuya Ravindra Koparde, Anupam Sandeep Sharma, Aniket Jadhav, Aishwarya Handa, Abhijit Bajirao Jadhav, Madhura A. Jadhav
      Journal of the International Clinical Dental Research Organization.2024; 16(2): 170.     CrossRef
    • Impact of calcium hydroxide and 2-hydroxyisocaproic acid on the microhardness of root dentine: an in vitro study
      Nandini T. Niranjan, Protim Ghosh Dastidar, Raghavendra Penukonda, Galvin Sim Siang Lin, Roopa Babannavar, Arun Jaysheel, Harshada Pattar
      Odontology.2024; 112(3): 711.     CrossRef
    • Endodontic irrigants from a comprehensive perspective
      Rayana Duarte Khoury, Lara Steffany de Carvalho, Mauro Felipe Rios do Nascimento, Fadi Alhussain, Amjad Abu Hasna
      World Journal of Clinical Cases.2024; 12(21): 4460.     CrossRef
    • Exploring Periostracum as an Alternative Root Canal Irrigant: Insights From Zebrafish Embryo Experiments
      Annie Sylvea Valan, Jogikalmat Krithikadatta, Ajay Guru
      Cureus.2024;[Epub]     CrossRef
    • A Systematic Review of the Comparative Efficacy of Lactobacillus Probiotics and Sodium Hypochlorite as Intracanal Irrigants Against Enterococcus faecalis
      Mrinalini Mrinalini, Alpa Gupta, Dax Abraham, Arun Kumar Duraisamy, Rajat Sharma
      Cureus.2024;[Epub]     CrossRef
    • Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin
      Adriana Katunarić, Sandra Flinčec Grgac, Dragana Gabrić, Božidar Pavelić, Ivona Bago
      Microscopy Research and Technique.2024; 87(4): 818.     CrossRef
    • Impact of antimicrobial photodynamic therapy on the bond-strength and penetration of endodontic sealers: A systematic review
      Khalid H Almadi
      Photodiagnosis and Photodynamic Therapy.2023; 41: 103249.     CrossRef
    • In Vitro Assessment of SWEEPS and Antimicrobial Photodynamic Therapy Alone or in Combination for Eradicating Enterococcus faecalis Biofilm in Root Canals
      Ali Shahi Ardakani, Shima Afrasiabi, Pegah Sarraf, Stefano Benedicenti, Luca Solimei, Nasim Chiniforush
      Pharmaceutics.2023; 15(11): 2628.     CrossRef
    • Effects of traditional and novel proteolytic agents on tissue dissolution and dentine microhardness
      Shwetha Elizabeth Jacob, Niharika Prasad, Sreya Dutta, Vasavi Kumblekar, Srikant Natarajan, Kukkila Jayaprakash, Manuel Sebastian Thomas
      Australian Endodontic Journal.2023; 49(2): 287.     CrossRef
    • Push-Out Bond Strength of EndoSeal Mineral Trioxide Aggregate and AH Plus Sealers after Using Three Different Irrigation Protocols
      Shimaa Rifaat, Ahmed Rahoma, Fatimah Alkhalifa, Ghofran AlQuraini, Zahraa Alsalman, Zahraa Alwesaibi, Noha Taymour
      European Journal of Dentistry.2023; 17(01): 076.     CrossRef
    • Can natural irrigants replace sodium hypochlorite? A systematic review
      Anand Venkatraman Susila, Shamini Sai, Nikita Sharma, Arthi Balasubramaniam, Aruna Kumari Veronica, Sureshbabu Nivedhitha
      Clinical Oral Investigations.2023; 27(5): 1831.     CrossRef
    • Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment
      Chen Cai, Xuan Chen, Yang Li, Qianzhou Jiang, Yeliz Guven
      BioMed Research International.2023;[Epub]     CrossRef
    • A laboratory investigation on the effect of biguanide‐ and pyridine‐derived antiseptics on the adhesion of resin composites to dentin
      Arzu Yağmur Uçar, Türkay Kölüş, D. Alperen Bozkurt, Prasanna Neelakantan, Islam A. A. Ali, Sema Belli
      Australian Endodontic Journal.2023; 49(3): 599.     CrossRef
    • Minimally invasive management of vital teeth requiring root canal therapy
      E. Karatas, M. Hadis, W. M. Palin, M. R. Milward, S. A. Kuehne, J. Camilleri
      Scientific Reports.2023;[Epub]     CrossRef
    • Disinfection of radicular dentin using Riboflavin, Rose Bengal, Curcumin, and Porfimer sodium on extrusion bond strength of fiber post to radicular dentin
      Sami A Alturaiki, Ahmed A. Bamanie, Mohammed A. Albulowey, Abdullah A. Al Daafas, Abdullah Almalki, Ali Alqerban
      Photodiagnosis and Photodynamic Therapy.2022; 37: 102625.     CrossRef
    • Present status and future directions: Minimally invasive root canal preparation and periradicular surgery
      Prasanna Neelakantan, Vijetha Vishwanath, Silvio Taschieri, Stefano Corbella
      International Endodontic Journal.2022; 55(S4): 845.     CrossRef
    • Ex Vivo Effect of Novel Lipophosphonoxins on Root Canal Biofilm Produced by Enterococcus faecalis: Pilot Study
      Yuliya Morozova, Iva Voborná, Radovan Žižka, Kateřina Bogdanová, Renata Večeřová, Dominik Rejman, Milan Kolář, Duy Dinh Do Pham, Pavel Holík, Roman Moštěk, Matej Rosa, Lenka Pospíšilová
      Life.2022; 12(1): 129.     CrossRef
    • Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review
      Riccardo Tonini, Matteo Salvadori, Elisabetta Audino, Salvatore Sauro, Maria Luisa Garo, Stefano Salgarello
      Frontiers in Oral Health.2022;[Epub]     CrossRef
    • Evaluation of Effects of Various Irrigating Solutions on Chemical Structure of Root Canal Dentin Using FTIR, SEM, and EDS: An In Vitro Study
      Indu Padmakumar, Dharam Hinduja, Abdul Mujeeb, Raghu Kachenahalli Narasimhaiah, Ashwini Kumar Saraswathi, Mubashir Baig Mirza, Ali Robaian, Syed Nahid Basheer, Mohmed Isaqali Karobari, Giuseppe Alessandro Scardina
      Journal of Functional Biomaterials.2022; 13(4): 197.     CrossRef
    • Final irrigation protocols affect radicular dentin DMP1-CT expression, microhardness, and biochemical composition
      Cristina Retana-Lobo, Tatiana Ramírez-Mora, Fabian Murillo-Gómez, Juliane Maria Guerreiro-Tanomaru, Mario Tanomaru-Filho, Jessie Reyes-Carmona
      Clinical Oral Investigations.2022; 26(8): 5491.     CrossRef
    • Comparative Evaluation of Antimicrobial Efficacy of Herbal Formulations of Septilin and Triphala with Conventional 2% Chlorhexidine on Root Canal and Oral Commensal Bacteria using Kirby Bauer Method
      Shadab Ahmed, Kamil Shahnawaz, Tapan Kumar Mandal, Mamnoon Ghafir, Shiva Shankar Gummaluri, Gaurav Vishal
      Contemporary Clinical Dentistry.2022; 13(4): 383.     CrossRef
    • Adjunctive procedure with solvent mixtures in non-surgical endodontic retreatment: does it affect root dentin hardness?
      Inês Ferreira, Ana Cristina Braga, Maria Ascensão Lopes, Irene Pina-Vaz
      Odontology.2021; 109(4): 812.     CrossRef
    • 1,192 View
    • 33 Download
    • 41 Crossref
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    Research Article
    The top 10 most-cited articles on the management of fractured instruments: a bibliometric analysis
    Lora Mishra, Hyeon-Cheol Kim, Naomi Ranjan Singh, Priti Pragati Rath
    Restor Dent Endod 2019;44(1):e2.   Published online December 26, 2018
    DOI: https://doi.org/10.5395/rde.2019.44.e2
    AbstractAbstract PDFPubReaderePub
    Objectives

    The purpose of this research was to identify the top 10 most-cited articles on the management of fractured or broken instruments and to perform a bibliometric analysis thereof.

    Materials and Methods

    Published articles related to fractured instruments were screened from online databases, such as Web of Science, Scopus, PubMed, and ScienceDirect, and highly cited papers, with at least 50 citations since publication, were identified. The most-cited articles were selected and analysed with regard to publication title, authorship, the journal of publication, year, institution, country of origin, article type, and number of citations.

    Results

    The top 10 most-cited articles were from various journals. Most were published in the Journal of Endodontics, followed by the International Endodontic Journal, and Dental Traumatology. The leading countries were Australia, Israel, Switzerland, the USA, and Germany, and the leading institution was the University of Melbourne. The majority of articles among the top 10 articles were clinical research studies (n = 8), followed by a basic research article and a non-systematic review article.

    Conclusions

    This bibliometric analysis revealed interesting information about scientific progress in endodontics regarding fractured instruments. Overall, clinical research studies and basic research articles published in high-impact endodontic journals had the highest citation rates.

    Citations

    Citations to this article as recorded by  
    • Bibliometric analysis of the publications that list the most-cited articles in endodontics
      Oscar Alejandro Gutiérrez-Alvarez, Luis Alberto Pantoja-Villa, Benigno Miguel Calderón-Rojas
      Endodontology.2025; 37(2): 128.     CrossRef
    • A Bibliometric Analysis of the 100 Top-Cited Articles on Vertical Root Fractures
      Pillai Arun Gopinathan , Ikram UI Haq, Nawaf Alfahad, Saleh Alwatban, Abdullah Alghamdi, Amal Alamri, Kiran Iyer
      Cureus.2024;[Epub]     CrossRef
    • Predictive factors in the retrieval of endodontic instruments: the relationship between the fragment length and location
      Ricardo Portigliatti, Eugenia Pilar Consoli Lizzi, Pablo Alejandro Rodríguez
      Restorative Dentistry & Endodontics.2024;[Epub]     CrossRef
    • A bibliometric analysis of the top 100 most‐cited case reports and case series in Endodontic journals
      Venkateshbabu Nagendrababu, Jelena Jacimovic, Aleksandar Jakovljevic, Giampiero Rossi‐Fedele, Paul M. H. Dummer
      International Endodontic Journal.2022; 55(3): 185.     CrossRef
    • The Most Highly Cited Publications on Basketball Originate From English-Speaking Countries, Are Published After 2000, Are Focused on Medicine-Related Topics, and Are Level III Evidence
      Zachary D. Griffin, Jordan R. Pollock, M. Lane Moore, Kade S. McQuivey, Jaymeson R. Arthur, Anikar Chhabra
      Arthroscopy, Sports Medicine, and Rehabilitation.2022; 4(3): e891.     CrossRef
    • Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies
      Emmanuel João Nogueira Leal Silva, Karem Paula Pinto, Natasha C. Ajuz, Luciana Moura Sassone
      Restorative Dentistry & Endodontics.2021;[Epub]     CrossRef
    • Publication trends in micro‐CT endodontic research: a bibliometric analysis over a 25‐year period
      U. Aksoy, M. Küçük, M. A. Versiani, K. Orhan
      International Endodontic Journal.2021; 54(3): 343.     CrossRef
    • 442 View
    • 4 Download
    • 7 Crossref
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