THE BIOLOGICAL DIMENSION OF ENDODONTIC IRRIGANTS — BEYOND ANTIMICROBIAL EFFICACY

Abstract

Traditionally, endodontic irrigants have been almost exclusively judged for what they kill or solve, e.g., bacteria, biofilm, or residual pulp tissue. However, the same chemical properties that make sodium hypochlorite (NaOCl), chlorhexidine (CHX), and ethylenediaminetetraacetic acid (EDTA) effective disinfectants, alone or in association, also determine how these solutions interact with periapical tissues, dentin integrity, dentin-embedded growth factors, and the stem cells. These factors are particularly relevant not only for conventional root canal treatment but also to regenerative endodontics, wherein the irrigant must eliminate infection while preserving the viability and function of cells involved in tissue repair. (1) Thus, when selecting endodontic irrigants, biocompatibility can no longer be considered a secondary issue; rather, it must be weighed alongside antimicrobial efficacy.