Expert consensus on irrigation and intracanal medication in root canal therapy

doi:10.1038/s41368-024-00280-5

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International Journal of Oral Science ›› 2024, Vol. 16 ›› Issue (0) : 23. DOI: 10.1038/s41368-024-00280-5

Expert consensus on irrigation and intracanal medication in root canal therapy

Xiaoying Zou^1,2, Xin Zheng³, Yuhong Liang⁴, Chengfei Zhang⁵, Bing Fan⁶, Jingping Liang⁷, Junqi Ling⁸, Zhuan Bian⁶, Qing Yu⁹, Benxiang Hou¹⁰, Zhi Chen⁶, Xi Wei⁸, Lihong Qiu¹¹, Wenxia Chen¹², Wenxi He¹³, Xin Xu³, Liuyan Meng⁶, Chen Zhang¹⁴, Liming Chen¹⁵, Shuli Deng¹⁶, Yayan Lei¹⁷, Xiaoli Xie¹⁸, Xiaoyan Wang¹, Jinhua Yu¹⁹, Jin Zhao²⁰, Song Shen², Xuedong Zhou³, Lin Yue¹

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1. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China;
2. Center of Stomatology, Peking University Hospital, Beijing, China;
3. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China;
4. Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China;
5. Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China;
6. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China;
7. Department of Endodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China;
8. Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China;
9. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xián, China;
10. Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China;
11. Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China;
12. College & Hospital of Stomatology, Guangxi Medical University, Nanning, China;
13. Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China;
14. Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China;
15. Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China;
16. Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China;
17. Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China;
18. Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China;
19. Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China;
20. Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

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Abstract

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.

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Xiaoying Zou, Xin Zheng, Yuhong Liang, Chengfei Zhang, Bing Fan, Jingping Liang, Junqi Ling, Zhuan Bian, Qing Yu, Benxiang Hou, Zhi Chen, Xi Wei, Lihong Qiu, Wenxia Chen, Wenxi He, Xin Xu, Liuyan Meng, Chen Zhang, Liming Chen, Shuli Deng, Yayan Lei, Xiaoli Xie, Xiaoyan Wang, Jinhua Yu, Jin Zhao, Song Shen, Xuedong Zhou, …Lin Yue. Expert consensus on irrigation and intracanal medication in root canal therapy. International Journal of Oral Science, 2024, 16(0): 23 https://doi.org/10.1038/s41368-024-00280-5

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