Is continuous soft chelation protocol more efficacious than conventional irrigation protocol in removing the smear...

Area of Science:

• Endodontics
• Dental Materials Science

Background:

• Smear layer removal is critical for successful endodontic treatment.
• Conventional irrigation methods have limitations in effectively removing the smear layer.

Purpose of the Study:

• To systematically review and compare the effectiveness of continuous soft chelation versus conventional irrigation in removing the smear layer during endodontic treatment.

Main Methods:

• Systematic literature search conducted on PubMed/MEDLINE, Google Scholar, and Cochrane from 2000-2024.
• Included in vitro studies comparing continuous and conventional chelation for smear layer removal.
• Nine studies met the inclusion criteria following PRISMA guidelines.

Main Results:

• Continuous chelation demonstrated superior smear layer removal in four studies; one study favored conventional irrigation, and four found similar outcomes.
• Etidronic acid, a soft chelator, was frequently used, often with sodium hypochlorite (NaOCl).
• Low-certainty evidence suggests continuous soft chelation is more effective, potentially creating a versatile irrigation solution.

Conclusions:

• Continuous soft chelation presents a promising alternative for smear layer removal in endodontics.
• Additional research is necessary to validate these findings and resolve methodological heterogeneity.
• Combining weak chelators with NaOCl may offer a multifunctional irrigation solution.