Abstract
Introduction: In the context of endodontic treatments, irrigation is one of the most important aspects of the biomechanical preparation of the root canal. The arsenal of irrigation solutions designed for endodontic treatment and commercially available is broad. The choice of the correct solution depends on the combination of the properties of the solution associated with the effects to be obtained with irrigation, according to the clinical condition. Objective: It was to carry out a systematic review of the different endodontic irrigation methods, as well as to show the different clinical indications for use, comparing the effectiveness, biocompatibility, and influence on the dentin surface of irrigation solutions. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 115 articles were found, 50 articles were evaluated in full and 41 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=57.8%<50%. It was concluded that irrigation plays a fundamental role in the success of endodontic treatment. Although hypochlorite is the most important irrigating solution, no irrigant can perform all of the tasks required by irrigation. A detailed understanding of the mode of action of various solutions is important for optimal irrigation. New developments such as mechanical devices will help promote safe and effective irrigation. Within the limitations of this study, the use of the selfadjusting file system with the combination of EDTA and NaOCl improved Ca(OH)2 removal. The passive ultrasonic irrigation and the self-adjusting file system were more effective in removing Ca(OH)2 from the lateral grooves in the apical parts of the root canal than the EndoVac and conventional syringe irrigation systems.