A Systematic Review of the Comparative Efficacy of Lactobacillus Probiotics and Sodium Hypochlorite as Intracanal Irrigants Against Enterococcus faecalis

Irrigation plays a pivotal role in the success of root canal treatments. The development of innovative, less hazardous irrigating solutions is necessary because of the inherent limitations of the gold standard, sodium hypochlorite. Since probiotics have proven to be effective in treating common oral diseases such as periodontitis and dental caries, they have gained attention in the field of endodontics as well. The present systematic review aims to assess the efficacy of Lactobacillus probiotics against compared to that of sodium hypochlorite. A thorough search of five databases, PubMed, Scopus, EBSCOhost, ScienceDirect, and BVS (Biblioteca Virtual en Salud, or Virtual Health Library), from January 2000 to January 2024 yielded 135 articles after a preliminary search. Three research publications that satisfied the strict inclusion and exclusion criteria were charted after the removal of duplicates and careful examination of the full-text articles. The Quality Assessment Tool for In Vitro Studies (QUIN Tool) was used to assess the quality of the study, aiming to identify any risk of bias. All three publications had a low risk of bias and demonstrated that Lactobacillus species were effective against and proved to be a safer alternative to sodium hypochlorite as an intracanal irrigant. However, more clinical trials are required to determine the best probiotic combinations, appropriate probiotic carriers, and ideal dosage and frequency of administration before using probiotics as intracanal irrigants in clinical trials.