Evidence map›Paper›PMID 39302543›Full record

SynthesisOdontology2025

Smear layer removal and antimicrobial efficacy of chitosan as a root canal irrigant: a systematic review of in-vitro studies.

Karthikeyan Anbalagan, Amit Jena, Saumyakanta Mohanty, Rashmirekha Mallick, Govind Shashirekha, Priyanka Sarangi

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Odontology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Karthikeyan AnbalaganDepartment of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University, Cuttack, Odisha, India. karthiknbds@gmail.com.ORCID http://orcid.org/0000-0002-3478-9658
Amit JenaDepartment of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University, Cuttack, Odisha, India.ORCID http://orcid.org/0000-0002-4522-6519
Saumyakanta MohantyDepartment of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University, Cuttack, Odisha, India.
Rashmirekha MallickDepartment of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University, Cuttack, Odisha, India.
Govind ShashirekhaDepartment of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to Be) University, Bhubaneswar, Odisha, India.
Priyanka SarangiDepartment of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College & Hospital, Utkal University, Cuttack, Odisha, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This systematic review was designed to answer the following question: Does chitosan provide better smear layer removal and antimicrobial efficacy than other root canal irrigants? A literature search was done using electronic databases PubMed, Scopus, Web of Science, Cochrane Library, EBSCO host, Grey Literature Report, and Open Grey from inception to June 18, 2024. The reference lists of included articles were also hand-searched. Two reviewers independently assessed the studies' eligibility based on the inclusion and exclusion criteria and performed data extraction. Two reviewers independently evaluated the risk of bias in the selected studies. The search retrieved 2330 studies. After analysis, 36 studies fulfilled the eligibility criteria and were included, with 19 involving smear layer removal, 16 involving antibacterial efficacy, and 1 involving both. The overall risk of bias of the included studies was medium. Chitosan removed the smear layer more effectively than citric acid and acetic acid, similar to MTAD and Qmix, with conflicting results against EDTA. In addition, chitosan demonstrated comparable antibacterial efficacy to chlorhexidine, propolis, and photodynamic therapy but was less effective than sodium hypochlorite. Based on available evidence, it was found that chitosan provided better smear layer removal and antimicrobial efficacy than most root canal irrigants compared in this systematic review. There was substantial heterogeneity in the methodology of included studies. As a result, this review highly recommends further research using standardized methods to assess the effectiveness of chitosan as a root canal irrigant in in-vitro studies to validate its clinical use.

Indexed as

ChitosanRoot Canal IrrigantsSmear LayerAnti-Infective AgentsCitric AcidHumansIn Vitro TechniquesAnti-Infective AgentsChitosanCitric AcidRoot Canal IrrigantsAntibacterialAntimicrobialChitosanChitosan nanoparticleRoot canal irrigantsSmear layer

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.