Evidence Gaps

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Mean change in health-related quality of life or participant-expressed satisfaction with the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Adverse effects · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Chlorhexidine 0.2% vs Normal saline

Proportion of participants or samples with positive bacterial growth culture, up to 72 hours after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
Positive bacterial cultures at end of first appointment: 65% of samples (chlorhexidine 0.2%) vs 89% (normal saline); no further data reported.
1 study
GRADE not reported

Sodium hypochlorite 5.25% vs Normal saline

Adverse effects · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Chlorhexidine 0.2% vs Normal saline

Mean change in health-related quality of life or participant-expressed satisfaction with the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Proportion of participants or samples with positive bacterial growth culture, up to 72 hours after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

Sodium hypochlorite 5% (also 2.5%) led to lower proportion of participants or samples with positive bacterial growth… compared with sodium hypochlorite 1%; GRADE not reported.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
RR 0.22 [0.051, 0.91]
1 study · 111 participants
GRADE not reported

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Proportion of participants with moderate to severe pain 72 hours to 14 days after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 5.25% vs Normal saline

Proportion of participants with new or worsening signs/symptoms of inflammation requiring a revisit, up to 14 days after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 1% with chlorhexidine 2% final rinse vs Sodium hypochlorite 1% with normal saline final rinse

Mean change in health-related quality of life or participant-expressed satisfaction with the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 5% vs Sodium hypochlorite 5% with proteolytic enzyme

Mean change in health-related quality of life or participant-expressed satisfaction with the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Change in periapical radiolucency (radiography or CBCT), up to 1 year after treatment · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 1.3% with MTAD final rinse vs Sodium hypochlorite 1.3% with normal saline final rinse

Proportion of participants or samples with positive bacterial growth culture, up to 72 hours after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
Vital bacterial counts decreased after the active intervention (MTAD) but live bacteria were present in all of the samples; no further usable data reported.
1 study
GRADE not reported

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Proportion of participants with moderate to severe pain up to 6 hours after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 1.3% with MTAD final rinse vs Sodium hypochlorite 1.3% with normal saline final rinse

Change in periapical radiolucency (radiography or CBCT), up to 1 year after treatment · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

The review found no eligible studies for this question.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Sodium hypochlorite 5.25% vs Sodium hypochlorite 5.25% with hydrogen peroxide 3%

Proportion of participants with moderate to severe pain 72 hours to 14 days after the procedure · Patients aged 14 to 78 years with mature permanent teeth (fully formed roots), single or multi-rooted, with pulpal or periapical…

Sodium hypochlorite 5.25% showed no clear difference in proportion of participants with moderate to severe pain 72 hours to… compared with sodium hypochlorite 5.25% with hydrogen peroxide 3%; GRADE not reported.

1 finding from 1 review

Irrigants for non‐surgical root canal treatment in mature permanent teeth 2012 · Cochrane All outcomes
RR 1.22 [0.4, 4.2]
1 study · 167 participants
GRADE not reported

Low edentulism prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by edentulism prevalence.

1 finding from 1 review

Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes
Baseline for longitudinal studies · Community · Low edentulism prevalence
There were no statistically significant differences reported in the OHRQoL sum scores based on prevalence of edentulism.
Studies not reported
GRADE not reported

High edentulism prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by edentulism prevalence.

1 finding from 1 review

Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes
Baseline for longitudinal studies · Community · High edentulism prevalence
There were no statistically significant differences reported in the OHRQoL sum scores based on prevalence of edentulism.
Studies not reported
GRADE not reported

Intervention not reported

Oral health-related quality of life (OHRQoL sum score, transformed 0-100)

1 finding from 1 review

Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes
Overall (pooled across all studies)
MEAN 77.0
45 studies
GRADE not reported

Intervention not reported

Clinical and radiographic success rate

1 finding from 1 review

Partial pulpotomy for carious pulp exposure in adult mature permanent teeth: a systematic review and meta-analysis. 2025 All outcomes
Full meta-regression: preoperative diagnosis
Meta-regression No significant association
Studies not reported
GRADE not reported

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level periodontal disease prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes
Community-dwelling older adults across 25 countries · Across periodontal disease prevalence categories
No statistically significant difference in OHRQoL based on periodontal disease prevalence (Fig. 4b).
Studies not reported
GRADE not reported

What do systematic reviews say?

828 questions · 1,007 findings · 63 reviews · Oral Health

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Chlorhexidine 0.2% vs Normal saline

Sodium hypochlorite 5.25% vs Normal saline

Chlorhexidine 0.2% vs Normal saline

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Sodium hypochlorite 5.25% vs Normal saline

Sodium hypochlorite 1% with chlorhexidine 2% final rinse vs Sodium hypochlorite 1% with normal saline final rinse

Sodium hypochlorite 5% vs Sodium hypochlorite 5% with proteolytic enzyme

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Chlorhexidine, 0.2% to 2% (solution or gel)

Sodium hypochlorite 1.3% with MTAD final rinse vs Sodium hypochlorite 1.3% with normal saline final rinse

Sodium hypochlorite (NaOCl), 2.5% to 5.25% vs Sodium hypochlorite 1%

Sodium hypochlorite 1.3% with MTAD final rinse vs Sodium hypochlorite 1.3% with normal saline final rinse

Sodium hypochlorite 5.25% vs Sodium hypochlorite 5.25% with hydrogen peroxide 3%

Low edentulism prevalence vs Not applicable

High edentulism prevalence vs Not applicable

Intervention not reported

Intervention not reported

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence