Antibacterial and anti-inflammatory efficacy of N-acetyl cysteine in endodontic treatment: a scoping review.

Sadeq Ali Al-Maweri, Saleem Abdulrab, Nawras Mostafa, Hisham Abada, Esam Halboub, Hatem A Alhadainy

Journal: BMC oral health 2022;22(1):398

PMID: 36096839

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Abstract

BACKGROUND

This scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory.

METHODS

PubMed, Scopus, Web of Science, and Google scholar search engines/databases were searched up to February 2022 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and identifying relevant studies.

RESULTS

Out of 193 studies, 15 fulfilled the inclusion criteria and were processed for data extraction. Thirteen in vitro studies assessed antibacterial/antibiofilm efficacy of NAC, and reported good and promising efficacy: NAC was found as efficacious as the comparators (chlorhexidine, sodium hypochlorite, calcium hydroxide), or even showed higher efficacy. Regarding the anti-inflammatory efficacy of NAC, one in vitro study found it equivalent to, while one clinical trial revealed it more efficacious than calcium hydroxide.

CONCLUSIONS

There is accumulating evidence on the anti-microbial and anti-inflammatory efficacy of NAC in context of endodontics. However, further clinical trials with robust methodology and objective and reliable clinical, biological and microbial outcomes are warranted to translate its use for clinical practice on humans.

Address: Um Salal Health Centre, Primary Health Care Corporation, Doha, Qatar. [email protected].; Department of Restorative Dentistry, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa. [email protected].; Um Salal Health Centre, Primary Health Care Corporation, Doha, Qatar.; College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.; Department of Endodontics, Faculty of Oral and Dental Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.; Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sanaa, Yemen.; Department of Endodontics, College of Dentistry, University of Tanta, Tanta, Egypt.

DOI: 10.1186/s12903-022-02433-6

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MeSH Terms: Acetylcysteine, Anti-Bacterial Agents, Anti-Inflammatory Agents, Calcium Hydroxide, Chlorhexidine, Humans