The most efficient root canal irrigation solution is NaOCl, a potent disinfectant with advantageous properties, including tissue solubility, proteolytic impacts on microorganisms, and bactericidal effects on bacterial endodontic biofilms. NaOCl is most frequently utilized as a root canal detergent in endodontic procedures at concentrations between 0.5 and 5.25%. A systematic literature review from 2000 to 2023 was performed using PubMed, Medline, and ScienceDirect databases. 10 studies were reviewed to determine the effects of different concentrations of sodium hypochlorite (NaOCl) on root canal disinfection and patient outcomes. The higher doses of NaOCl were more effective in lowering bacterial counts, but there were no significant changes in patient outcomes, such as healing rates or discomfort levels. NaOCl demonstrated effective antibacterial activity against various bacteria, including Enterococcus faecalis, Actinomyces naeslundii, Candida albicans, and Streptococcus aureus. It was found that applying NaOCl as an irrigant, combined with appropriate irrigation protocols and sufficient exchange of the solution, is crucial for achieving optimal antibacterial efficacy. Additional studies are warranted to investigate further the effects of NaOCl concentration and its interaction with other irrigants on the outcomes of root canal treatment.
