SynthesisClinical oral investigations2023
Can natural irrigants replace sodium hypochlorite? A systematic review.
Synthesis in Clinical oral investigations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Assessment of Antimicrobial Effect of Rotary Versus Manual Filing System Using Different Irrigants in Primary Molars
Evaluation of Antimicrobial Potency of Garlic Lemon Extract Irrigant Versus Physiological Saline Irrigant Following Partial Pulpectomy in Primary Molars: A Randomized Clinical Trial
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Antibiofilm efficacy of plant extracts as root canal irrigants in endodontics: a systematic literature review.Frontiers in dental medicine · 2024Pooled it
- Clinical and biochemical effects of cryotherapy protocols on mandibular premolars with symptomatic apical periodontitis: a randomized clinical trial.Clinical oral investigations · 2026Trial
- The impact of using cold irrigation on postoperative endodontic pain and substance P level: a randomized clinical trial.Odontology · 2026Trial
- Protocols to evaluate the antibacterial and irrigation efficacy of new root canal irrigants: A systematic review of ex vivo studies.The Japanese dental science review · 2026Review
- Garlic as a novel therapeutic agent for the management of pulp infections: a systematic review.Odontology · 2026Review
- Influence of sodium hypochlorite concentration and treatment time on enamel surface morphology and shear bond strength for orthodontic attachments: an in-vitro study.BMC oral health · 2026Article
- Antifungal efficacy of Miswak extracts versus sodium hypochlorite against Candida albicans on CAD-CAM denture base: an in-vitro study.BMC complementary medicine and therapies · 2026Article
- Effectiveness of Irrigation Protocols in Endodontic Therapy: An Umbrella Review.Dentistry journal · 2025Review
- SWEEPS-Assisted Antibacterial Photodynamic Therapy Against Dual-Species Biofilms in Mandibular Molars: An In Vitro Study.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Assessment of Endocyn on Dental Pulp Stem Cells (DPSCs): A Pilot Study of Endodontic Irrigant Effects.Methods and protocols · 2025Article
- Effect of herbal irrigants on surface roughness of intraradicular dentin using quantitative method of 3D surface texture analysis.Scientific reports · 2024Article
- Efficacy of the Orifice-Level Passive Ultrasonic Activation Technique in Removing Debris from Mandibular Molars: An Ex Vivo Study.Journal of lasers in medical sciences · 2024Article
- A 980 nm Diode Laser as an Adjunctive Therapy on the Healing of Apical Periodontitis Following Endodontic Retreatment: A Randomized Controlled Clinical Trial Study.Journal of lasers in medical sciences · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextSodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored.
aimsThis systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite. SETTINGS AND DESIGN REGISTRATION: This systematic review was registered with PROSPERO (2018 CRD42018112837) METHODS AND MATERIAL: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence.
resultsTen articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success.
conclusionsThe studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.