Comparative Effectiveness of Triphala and Conventional Root Canal Irrigants in Primary Teeth: A Systematic Review

The present systematic review aimed to evaluate the effectiveness of Triphala, a traditional Ayurvedic herbal formulation, as a root canal irrigant in primary teeth compared to conventional irrigants such as sodium hypochlorite, chlorhexidine, and saline. A comprehensive electronic search was conducted across multiple databases, including PubMed, MEDLINE, Embase, Scopus, and Cochrane Library, and supplemented by grey literature. Studies published in English between January 2000 and February 2025 were considered. Five studies met the inclusion criteria, comprising randomized controlled trials, in vitro, and ex vivo studies, all of which were conducted in India. The findings revealed that Triphala possesses significant antimicrobial activity against endodontic pathogens such as Enterococcus faecalis and Candida albicans, though sodium hypochlorite consistently showed greater microbial reduction. One study reported comparable long-term clinical and radiographic success between Triphala and chlorhexidine over a 12-month period. Variability in concentration, formulation, and methodology contributed to differences in efficacy across studies. Triphala demonstrated a favorable safety profile and biocompatibility, supporting its potential as an alternative or adjunctive irrigant in pediatric endodontics. However, current evidence is limited by geographic concentration and methodological heterogeneity. Further high-quality multicenter trials are warranted to validate its clinical applicability and promote its broader integration into pediatric dental practice.