A critical analysis of research methods and experimental models to study irrigants and irrigation systems

Christos Boutsioukis*, Maria Teresa Arias-Moliz, Luis E. Chávez de Paz

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-computed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.

Original languageEnglish
Pages (from-to)295-329
Number of pages35
JournalInternational Endodontic Journal
Volume55
Issue numberS2
DOIs
Publication statusE-pub ahead of print - 16 Feb 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society

Keywords

  • biofilm
  • debris
  • extrusion
  • irrigant
  • penetration
  • pulp tissue
  • smear layer

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