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Da tradição à inovação: irrigantes all-in-one em endodontia – revisão sistemática
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O tratamento endodôntico exige uma irrigação eficaz para a remoção da smear layer e redução bacteriana intracanalar. Os protocolos convencionais com NaOCl e EDTA apresentam limitações associadas à complexidade operatória e a possíveis efeitos adversos na estrutura dentinária. O objetivo desta revisão sistemática foi avaliar a eficácia dos novos irrigantes all-in-one (Triton All-in-One®, Dual Rinse HEDP® e QMix 2in1) na remoção da smear layer e na redução bacteriana, em comparação com os protocolos convencionais. A pesquisa foi conduzida segundo as diretrizes PRISMA nas bases de dados PubMed, Europe PMC e LILACS, abrangendo o período entre 2020 e 2025. A seleção dos estudos foi realizada de forma independente por dois revisores. Foram incluídos estudos in vitro, ex vivo ou clínicos em dentes humanos monorradiculares, excluindo-se dentição animal ou decídua, canais curvos ou artificiais, revisões de literatura e estudos sem grupo controlo. No total, 12 estudos cumpriram os critérios de elegibilidade e foram incluídos na análise qualitativa. Os dados laboratoriais indicam que as soluções all-in-one apresentam capacidade de remoção de smear layer e ação antimicrobiana comparáveis ou superiores aos protocolos tradicionais, destacando se a preservação das propriedades mecânicas da dentina, embora com variações dependentes do tempo de aplicação. Em conclusão, as evidências laboratoriais sugerem que os irrigantes all-in-one representam uma alternativa promissora; contudo, a escassez de dados in vivo torna imperativo o desenvolvimento de mais estudos clínicos para confirmar a sua eficácia. Esta abordagem propicia uma potencial simplificação operatória, reduzindo o risco de acidentes durante o tratamento endodôntico não cirúrgico.
Endodontic treatment requires effective irrigation for smear layer removal and intraradicular bacterial reduction. Conventional protocols using NaOCl and EDTA present limitations related to operative complexity and potential adverse effects on dentin. The aim of this systematic review was to evaluate the efficacy of all-in-one irrigants (Triton All-in-One®, Dual Rinse HEDP®, and QMix 2in1) in smear layer removal and intraradicular bacterial reduction compared to conventional protocols. The search was conducted in accordance with PRISMA guidelines across PubMed, Europe PMC, and LILACS databases for studies published between 2020 and 2025. Study selection was performed independently by two reviewers. In vitro, ex vivo or clinical studies on intact human single-rooted teeth were included, while animal or primary dentition, curved or artificial canals, literature reviews, and studies without a control group were excluded. In total, 12 studies met the eligibility criteria and were included in the qualitative analysis. Laboratory data indicate that all-in-one solutions exhibit smear layer removal and antimicrobial efficacy comparable or superior to traditional protocols, notably preserving dentin mechanical properties, though variations occurred based on application time. In conclusion, laboratory evidence suggests that all-in-one irrigants are a promising alternative to traditional protocols; however, the scarcity of in vivo data mandates further clinical trials to confirm their clinical efficacy and safety. This approach offers a potential simplification of the irrigation procedure, leading to a reduced risk of accidents during non-surgical endodontic treatment.
Endodontic treatment requires effective irrigation for smear layer removal and intraradicular bacterial reduction. Conventional protocols using NaOCl and EDTA present limitations related to operative complexity and potential adverse effects on dentin. The aim of this systematic review was to evaluate the efficacy of all-in-one irrigants (Triton All-in-One®, Dual Rinse HEDP®, and QMix 2in1) in smear layer removal and intraradicular bacterial reduction compared to conventional protocols. The search was conducted in accordance with PRISMA guidelines across PubMed, Europe PMC, and LILACS databases for studies published between 2020 and 2025. Study selection was performed independently by two reviewers. In vitro, ex vivo or clinical studies on intact human single-rooted teeth were included, while animal or primary dentition, curved or artificial canals, literature reviews, and studies without a control group were excluded. In total, 12 studies met the eligibility criteria and were included in the qualitative analysis. Laboratory data indicate that all-in-one solutions exhibit smear layer removal and antimicrobial efficacy comparable or superior to traditional protocols, notably preserving dentin mechanical properties, though variations occurred based on application time. In conclusion, laboratory evidence suggests that all-in-one irrigants are a promising alternative to traditional protocols; however, the scarcity of in vivo data mandates further clinical trials to confirm their clinical efficacy and safety. This approach offers a potential simplification of the irrigation procedure, leading to a reduced risk of accidents during non-surgical endodontic treatment.
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Palavras-chave
Endodontia Irrigação do canal radicular Irrigantes all-in-one Smear layer Redução bacteriana Endodontics Root canal irrigation All-in-one irrigants Bacterial reduction