Natural irrigation solutions in endodontics

One primary objective in the root canal treatments is to ensure chemomechanical removal of the microorganisms and organic/inorganic tissue residues from the infected root canals. Studies in the literature report that due to the structure of the root canals, mechanical instrumentation alone could not perform a satisfying cleaning in the canal. In ex vivo and clinical studies, some areas have remained unreached and infected, thus irrigation has played a key role in the achievement of root canal treatments (1,2). Irrigation is a process performed to make the mechanical preparation easier through lubrication by wetting the root canals with liquids of different types and concentrations, and to ensure the disinfection of the root canals by removing the organic/ inorganic debris, infected pulp tissue, microorganisms, soft and hard tissue residues from the root canals both physically and chemically. An irrigation solution of optimal quality that can completely clean the root canals alone is not still available, and although there are new developments in the relevant field of research, a solution much closer to the ideal quality has not been developed yet. Having many of the properties expected from root canal irrigation solutions, sodium hypochlorite (NaOCI) is the most ideal and the most widely used agent among all washing irrigation agents developed in recent years. NaOCl can be used at different concentrations but is commonly used in root canal treatments at concentrations from 0.5% to 6%. Besides its excellent properties such as high antimicrobial activity, satisfying tissue dissolving, accessibility, and a relatively lower cost, NaOCI also has certain disadvantages like failing to remove the smear layer alone, causing a bad smell, emphysema, possible allergic reactions, and toxic effect on the surrounding tissues. Recently, it has been discovered that it has a detrimental impact on dentin elasticity and bending resistance, as well (3,4). Another irrigation solution, chlorhexidine gluconate (CHX), is reported to show a bactericidal effect by causing coagulation of intracellular components at high concentrations, while it has shown a bacteriostatic effect at low concentrations (4,5). For DOI: 10.4274/gulhane.galenos.2020.902 REVIEW