Antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis in endodontics: A systematic review

Aim: The aim of this systematic review was to investigate the in vitro antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis during root canal treatment. Methods: An electronic databases (PubMed, ScienceDirect, Google Scholar, CENTRAL, Health Advance) was performed (last updated was 1st April 2019). The reference lists of the included studies were hand-searched. Randomized in vitro studies that compared sodium hypochlorite gel to solution as a root canal irrigant were included. No limitation on publication date. Results: Out of 20741 articles, only two studies with 116 human teeth were included in this review. The studies showed 50% high risk of bias, and 50% medium risk of bias for the included studies. Both sodium hypochlorite gel and solution had some bacterial growth inhibition over E. faecalis. The heterogeneity in methodology of the included studies and the lack of high evidence led to contradictory results. However, sodium hypochlorite solution was better in enhancing the antibacterial effect according to the robust study. Conclusion: There is insufficient reliable evidence about the antibacterial effect of sodium hypochlorite gel on enterococcus faecalis. Although the robust study included in this review revealed that sodium hypochlorite gel is less efficient than the solution as a root canal irrigant, further studies are needed to consider the most effective type, concentration, duration and treatment protocols in enhancing the antibacterial effect of sodium hypochlorite. How to cite this article: Al Nesser S, Bshara N, Adıgüzel Ö. Antibacterial effect of sodium hypochlorite gel on Enterococcus faecalis in endodontics: A systematic review. Int Dent Res 2020;10(1):22-29. https://doi.org/10.5577/intdentres.2020.vol10.no1.3 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.