Evaluation of various root canal irrigation methods in primary teeth: a systematic review

Although effective irrigation methods are crucial for pulpectomy in primary teeth (PT), no consensus exists on the best technique. This study guides clinicians in making evidence-based choices for irrigation techniques in PT.

This study reviewed in vitro and in vivo research on PT using an extensive electronic search up to April 2024. The QUIN and RoB 2 tools were used to assess bias, and no meta-analysis was conducted in this study.

Eleven in vitro studies evaluated outcomes such as microorganism reduction, smear layer (SL) removal, and apical extrusion of debris. Some methods significantly reduced bacteria and improved SL removal compared to conventional techniques. Six in vivo studies on primary root canal treatment reported that certain methods reduced postoperative pain (PP), improved obturation quality, and enhanced antibacterial effects. The risk assessment tools identified most studies with low risk of bias.

In vitro studies suggest that activating irrigants in PT canals, especially with laser activation, effectively reduces Enterococcus faecalis and removes SLs, particularly in the apical third. Endovac caused less debris extrusion. Clinical studies indicated that sonic activation and side-vent syringes reduce PP, but more data is needed on the antibacterial effects of these techniques.