Evaluation of the efficacy of root canal disinfection methods

Antiseptic treatment of root canals is a critical stage in endodontic therapy, determining its success and long-term prognosis. The quality of this stage directly affects the degree of microbial contamination of the root canal system and, consequently, the likelihood of developing inflammatory complications in the future. Due to the wide range of existing techniques, the continuous emergence of new technologies, and the lack of a unified treatment standard, a comparative analysis of the effectiveness of various approaches remains a relevant objective for defining optimal clinical protocols. This study provides a comprehensive evaluation of different approaches to root canal antisepsis based on an analysis of current scientific literature. Traditional methods of chemical irrigation using antiseptic solutions from various groups (including chlorine-containing agents, oxidizers, nitrofuran compounds, and proteolytic enzymes) were examined in detail. In addition, modern physical methods, such as laser technologies and red light photodynamic therapy, were analyzed. Based on comparative analysis, the most effective antiseptic techniques were identified. It was established that maximum irrigation efficacy is achieved through the combined use of sodium hypochlorite and EDTA solutions, which provide both pronounced antimicrobial action and complete removal of the smear layer with exposure of dentinal tubules. A significant further increase in antiseptic potential is observed with ultrasonic activation of the washing fluid, which facilitates the penetration of solutions into hard-to-reach areas of the root canal system. It was found that in cases of long-term chronic inflammatory processes in periapical tissues with frequent exacerbations, comprehensive antiseptic treatment can be achieved through additional methods, namely, the use of laser radiation and red light photodynamic therapy.