Correction to: Past, Present, and Future of Sodium Hypochlorite in Dermatology: A Scoping Review.

PurposeThis scoping review aimed to investigate how different storage media of extracted human teeth before and after preparation of specimens influence the outcomes of various dental materials intended for clinical application.Materials and methodsLiterature search in four databases and by manual searching was carried out on a predefined PIO as follows: Population – extracted human teeth; Intervention – different storage media; Outcome(s) – material properties.ResultsAfter screening 110 studies, 11 were included in the scoping review. Eight studies examined storage media effects before specimen preparation and three after specimen preparation. Four studies focused on enamel bonding, six on dentine, and one both on enamel and dentine. Concerning storage of extracted teeth prior to specimen preparation, cryopreservation, Chloramine T and thymol had no negative effect on bond strength to enamel. One study found Chloramine T to increase microleakage at enamel margins whereas another study found no negative effect. Storage in formalin, ethanol and thymol also had no negative effect on microleakage at enamel margins. Cryopreservation decreased bond strength to coronal dentine, but not to mid-coronal or deep dentine. Formalin, Chloramine T, ethanol and thymol had no negative effect on bond strength to dentine nor on microleakage at dentine margins. However, one study found long-term storage in Chloramine T to increase microleakage at dentine margins. Concerning storage of extracted teeth after specimen preparation, thymol significantly lowered bond strength to enamel, whereas formalin had no negative effect. Sodium hypochlorite had no negative effect on bond strength to dentine, and finally, formalin, Chloramine T, ethanol, and thymol had no negative effect on microleakage at dentine margins. Risk of bias assessment showed one high quality study, while the remaining 10 had questionable quality.ConclusionsThe effects of storage media on in-vitro dental material testing are variable and substrate-dependent, with dentine showing greater susceptibility than enamel. While distilled water and cryopreservation showed relative stability, other media like thymol and Chloramine T produced inconsistent results. Standardized protocols and further research are needed to ensure reliable and comparable outcomes.

BackgroundRoot canal treatment (RCT) requires thorough removal of the smear layer to ensure proper sealing, reduce microbial contamination, and enhance treatment success. Chelating agents such as ethylenediaminetetraacetic acid (EDTA) are widely used, but they show limitations, especially in the apical third. Maleic acid (MA), a mild organic acid with low pH, has been proposed as a promising alternative due to its superior demineralising and adhesive-enhancing properties.AimTo evaluate the role of MA in root canal therapy, with emphasis on smear layer removal, antimicrobial efficacy, dentin-related effects, and interactions with dental materials.MethodsThe review followed PRISMA-ScR 2018 guidelines and Arksey and O’Malley’s six-stage framework. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was conducted up to October 2024. Study eligibility was defined using the PICO framework: (P) human teeth, dentin slices, bacterial cultures, and dental material specimens studied; (I) maleic acid as a root canal irrigant; (C) comparisons with EDTA, sodium hypochlorite, citric acid, and newer chelators; (O) outcomes including smear layer removal, growth factor release, effects on dental materials, antimicrobial efficacy, dentin mineral content, physical and mechanical properties, and bond strength. 71 studies were included.Results7% MA was highly effective in smear layer removal, particularly in the apical third, surpassing 17% EDTA and other irrigants. MA enhanced dentin wettability, sealer penetration, and push-out bond strength, and showed superior efficacy in removing calcium hydroxide and intracanal medicaments. It also promoted growth factor release, supporting regenerative potential. While antimicrobial activity was moderate alone, it improved significantly when combined with chlorhexidine or cetrimide. However, MA reduced dentin microhardness and mineral content and negatively impacted calcium silicate–based materials such as mineral trioxide aggregate and Biodentine.Conclusion7% MA is a potent root canal irrigant with consistent superiority in apical smear layer removal and unique advantages in adhesion and regeneration. Its demineralising effects highlight the need for controlled application, with shorter conditioning times (1–3 min) optimising outcomes while minimising risks. Overall, MA represents a promising, less cytotoxic alternative to EDTA, but standardised clinical protocols and rigorous in vivo validation are essential for its safe integration into endodontic practice.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-025-07361-9.

Effect of Root Canal Irrigants on the Mechanical Properties of Endodontically Treated Teeth: A Scoping Review

Introduction: The article has the medical importance in presenting ozone therapy, its application and benefits as a new irrigant in endodontic treatment. Objective: To analyze the literature on ozone, sodium hypochlorite, ethyleneaminotetraacetic acid and chlorhexidine. Methodology: A literature review was carried out by searching the Pubmed, Scopus an Google Scholar databases using the keywords: “ozone”, “therapy”, “dentistry”, “endodontics”, “sodium hypochlorite” “EDTA” “chlorhexidine”. Results: Ozone has a powerful antioxidant capacity and outstanding antimicrobial properties and its toxicity, when properly administered, can be beneficial. Sodium hypochlorite helps to dissolve organic tissue giving cleanliness and disinfection of the root canal, high concentrations of NaOCl can irritate periapical tissues. Chlorhexidine is one of the main irrigants used in endodontic treatment, it is less cytotoxic to periapical tissues than NaOCl. EDTA benefits endodontic treatment by improving the seal of the obturation material. It is recommended in lower concentrations for clinical use to avoid cytotoxicity. Conclusions: Ozone as a disinfectant and antioxidant agent, will have efficacy when handled with caution due to its intrinsic toxicity. Sodium hypochlorite stands out for its potent antibacterial activity, although its use in high concentrations can cause irritation. EDTA improves the seal of the filling material and demineralizes dentin, although it should be used in adequate concentrations to avoid excessive erosion. Chlorhexidine shows less cytotoxicity and greater regeneration compared to sodium hypochlorite.

Aim: This review seeks to obtain enough scientific evidence to provide knowledge regarding the effectiveness of using sodium hypochlorite (NaOCl) at various temperatures, i.e., warm, cold, and room temperature NaOCl, on posttreatment pain. Methods: Online databases were used to identify studies published till 2024, in which 551 studies were obtained during the initial search. After the screening, 7 studies were selected regarding the use of NaOCl at various temperatures, i.e., warm NaOCl, cold NaOCl, and room temperature NaOCl as endodontic irrigants, compared for the effect of posttreatment pain. Results: Upon reviewing 6 studies on the use of warm NaOCl as an irrigant, 4 studies (66.67%) showed an increase in posttreatment pain, whereas 3 out of 4 studies (75%) on using cold NaOCl showed a decrease in posttreatment pain. Conclusion: Overall, most of the studies that were included in this review suggested that using warm NaOCl increased posttreatment pain, using cold NaOCl reduced the posttreatment pain, whereas room temperature showed varied outcomes. Thus, according to the results, it can be concluded that using warm NaOCl as a root canal irrigant may increase posttreatment pain, whereas the use of cold NaOCl may decrease posttreatment pain.

The effect of textiles and their management on healthcare-associated infections: A scoping review.

Research methods assessing sodium hypochlorite cytotoxicity: A scoping review

Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.

This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation. Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings. From the initial 1916 studies, and by adding 2 cross-references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%-17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2-240 min (NaOCl) and 1-1440 min (EDTA) being evaluated. Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration- and time-dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes. Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration- and time-dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations.

For over a century, dilute sodium hypochlorite (NaOCl), historically recognized as the antiseptic component of bleach, has been well established in wound care, primarily owing to its broad antimicrobial activity and ability to penetrate soft tissue and necrotic debris. NaOCl has been increasingly utilized and studied in clinical dermatology owing to its broad ranging antimicrobial, skin healing, and more recently described anti-inflammatory properties. This scoping review (Open Science Network; osf.io/6hyru) synthesizes current evidence of NaOCl's applications in skin care, highlighting mechanistic insights, clinical trends, and knowledge gaps. A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov was conducted from inception through November 2024. This review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 6959 deduplicated records, 222 studies published between 1915 and 2024 were identified for final inclusion. Four key clinical themes for NaOCl use emerged upon analysis of these publications: antimicrobial properties (n = 57), wound care (n = 64), eczematous skin disease (n = 78), and noneczematous inflammatory skin conditions (n = 23). NaOCl exhibits broad-spectrum activity against various organisms, notably Staphylococcus aureus and Pseudomonas aeruginosa, contributing to its effectiveness in treating chronically infected burns, ulcers, and other wounds. Limited studies also suggest NaOCl's potential role in modulating critical processes that support wound repair. In addition, the anti-inflammatory effects of NaOCl have supported its utility in treating eczematous and noneczematous skin disorders. Current literature provides broad and extensive evidence supporting NaOCl's role in wound-healing, antimicrobial, and anti-inflammatory activity. However, considerable heterogeneity exists in recommended concentrations, preparation methods, and usage instructions across studies. There is a need for more randomized controlled trials and standardized protocols to better define the efficacy, safety, and optimal use of NaOCl in dermatologic practice.

Carbapenemase-producing Enterobacterales (CPE) pose a global health crisis. Their resistance to conventional antimicrobials and many disinfectants increases the healthcare costs of treatment and risk mitigation. Hospital water systems are reservoirs for CPE, necessitating targeted infection prevention and control (IPC) strategies. To review and consolidate current evidence of disinfection strategies for CPE in hospital water systems, focusing on practical application, challenges and IPC integration. A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, encompassing studies from 1st December 2014 to 31st December 2024. Of 1188 records screened, 22 met the inclusion criteria. Thematic analysis categorized findings into chemical, physical and integrative strategies. Sodium hypochlorite and hydrogen peroxide reduced contamination temporarily, but were poorly effective against biofilms, while acetic acid showed consistent efficacy with regular use. Quaternary ammonium compounds proved effective but required standardized protocols. Physical interventions, such as steam cleaning and drain covers, reduced contamination, and plumbing modifications minimized biofilm formation. Resource-intensive measures, such as removing contaminated sinks or adopting water-free environments, were also effective. Integrative approaches combining chemical disinfection, infrastructural upgrades and enhanced sink protocols demonstrated the most sustained outcomes, with novel technologies such as ultraviolet light and biofilm-targeting foams showing great promise. Effective CPE control in hospital water systems requires multi-disciplinary action addressing biofilm-protected reservoirs. Regular application of proven disinfectants, tailored to specific contexts, coupled with infrastructural upgrades and comprehensively implemented IPC strategies, offers the most promising outcomes. Novel technologies and updated guidelines are essential to standardizing practices and mitigating the broader threat of antimicrobial resistance.

BackgroundThis scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory.MethodsPubMed, Scopus, Web of Science, and Google scholar search engines/databases were searched up to February 2022 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and identifying relevant studies.ResultsOut of 193 studies, 15 fulfilled the inclusion criteria and were processed for data extraction. Thirteen in vitro studies assessed antibacterial/antibiofilm efficacy of NAC, and reported good and promising efficacy: NAC was found as efficacious as the comparators (chlorhexidine, sodium hypochlorite, calcium hydroxide), or even showed higher efficacy. Regarding the anti-inflammatory efficacy of NAC, one in vitro study found it equivalent to, while one clinical trial revealed it more efficacious than calcium hydroxide.ConclusionsThere is accumulating evidence on the anti-microbial and anti-inflammatory efficacy of NAC in context of endodontics. However, further clinical trials with robust methodology and objective and reliable clinical, biological and microbial outcomes are warranted to translate its use for clinical practice on humans.

Objective: Root canal irrigation plays a critical role in achieving effective chemomechanical disinfection during endodontic therapy. Conventional syringe irrigation, typically using sodium hypochlorite, ethylenediaminetetraacetic acid, and chlorhexidine, is limited by its delivery method and often fails to adequately penetrate complex canal anatomies, compromising disinfection. Advancements such as ultrasonic and multisonic irrigation systems aim to address these limitations. This scoping review compares the clinical effectiveness of ultrasonic irrigation techniques with conventional syringe irrigation, focusing exclusively on in vivo studies conducted within the oral environment. Methods: A comprehensive scoping review was conducted using PubMed, Scopus, Dentistry & Oral Sciences Source, and Google Scholar. Peer-reviewed, full-text articles published in English between 2015 and 2025 were screened by four independent reviewers based on predefined inclusion and exclusion criteria. Eligible studies were thematically analyzed. Results: Of 312 records screened, eleven studies met the inclusion criteria. Ultrasonic irrigation was associated with improved clinical outcomes, particularly greater reductions in bacterial load and endotoxins; however, findings regarding its effect on postoperative pain were inconsistent, with some studies reporting a benefit while others observed no significant difference. These outcomes were attributed to mechanisms such as acoustic streaming and cavitation, which enhance irrigant penetration, promote fluid dynamics, and facilitate debridement in anatomically complex regions. Conclusions: Ultrasonic irrigation appears to hold promise for enhancing the efficacy and efficiency of root canal treatment. Existing in vivo studies suggest potential clinical advantages over conventional syringe irrigation, underscoring the need for further high-quality clinical research to more definitively establish its benefits.

ObjectivesTo summarize the current scientific evidence on the implications of root canal treatment (RCT) in patients receiving antiresorptive therapy and to outline best practices for managing such cases to prevent MRONJ.Materials and methodsA search strategy across PubMed, Web of Science and Scopus was performed. Clinical studies and reports on RCTs in patients on antiresorptive therapy were screened by two independent reviewers. Data on patient factors (sex, age, disease, treatment, outcome) and tooth-related aspects (procedure, diagnosis, anesthesia, irrigation, obturation, antibiotics) were extracted.ResultsOf the 514 studies identified, 15 articles (133 patients) met inclusion criteria. One prospective study included 65 patients and 96 RCTs; the remaining patients were reported in case reports or series and in two retrospective studies. Endodontic protocols varied largely across studies. The most common indications for RCT were pulpitis (n = 62) and periapical lesions with acute endodontic diseases (n = 119). All patients were undergoing antiresorptive therapy with oral or intravenous bisphosphonates for the management of osteoporosis or oncologic conditions. RCT was performed in all cases using conventional protocols that included local anesthesia (in some cases without vasoconstrictors), mechanical instrumentation, chemical irrigation (most commonly with sodium hypochlorite) and root canal obturation. Five studies reported antibiotic use. The cases of MRONJ (n = 7, 5.3%; mean treatment duration was 49 months) appeared only in oncological patients.ConclusionsRCT appears to be a safe procedure for patients receiving bisphosphonates. Cases in which RCT appeared to act as a trigger for MRONJ are rare and ambiguous and seem primarily associated with procedural errors or high-risk patients. Although some recommendations for endodontic practice to prevent MRONJ have been proposed, there is a clear need for further research in this area.Clinical relevanceDentists can safely perform RCT in patients undergoing bisphosphonate therapy. Some clinical recommendations based on the available literature are provided.

This scoping review aimed to investigate whether sodium ascorbate can recover the bond strength of resin composite restorations to sodium hypochlorite (NaOCl)-treated dentin. The protocol of this study, available online (https://osf.io/psj3v/), followed the Joana Briggs Institute guidelines. The PRISMA Extension for Scoping Reviews was used to reporting. In vitro studies evaluating the effect of sodium ascorbate on NaOCl-treated dentin and resin composite restorations, regardless of the adhesive material used, were included without time restriction. The search and study screening were conducted in Embase, PubMed, Scopus, and Web of Science by two independent researchers. A descriptive analysis was performed and the PRILE 2021 guidelines were used to assess the risk bias of the included studies. The initial search yielded 941 studies, of which only 7 studies were included. The findings revealed that extracted third molars were the most used samples, and there was a significant variation in the NaOCl concentration employed. In general, sodium ascorbate effectively restored the compromised bond strength in dentin treated with different NaOCl concentrations. Furthermore, regarding the failure mode, the most prevalent observed was mixed failure. This scoping review showed that sodium ascorbate appears to effectively recover the bond strength of resin composite restorations to dentin treated with NaOCl. However, it is important to note the limited number of studies and the heterogeneity observed.