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Review | Open Access

Expert consensus on irrigation and intracanal medication in root canal therapy

Xiaoying Zou1,2, 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( )
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
Center of Stomatology, Peking University Hospital, Beijing, China
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
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
Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
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
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
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
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
Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China
Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
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
Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China
Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

These authors contributed equally: Xiaoying Zou, Xin Zheng

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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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International Journal of Oral Science
Volume 16 Issue 1,
March 2024
Article number: 23
DOI: 10.1038/s41368-024-00280-5

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Cite this article:
Zou X, Zheng X, Liang Y, et al. Expert consensus on irrigation and intracanal medication in root canal therapy. International Journal of Oral Science, 2024, 16(1): 23. https://doi.org/10.1038/s41368-024-00280-5

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Received: 05 November 2023
Revised: 22 December 2023
Accepted: 03 January 2024
Published: 01 March 2024
© The Author(s) 2024

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