Um Salal Health Centre, Primary Health Care Corporation, Doha, Qatar.
Department of Restorative Dentistry, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa.
BMC Oral Health. 2022 Sep 12;22(1):398. doi: 10.1186/s12903-022-02433-6.
This scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory.
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.
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.
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.
本范围综述系统总结了 N-乙酰半胱氨酸（NAC）作为根管内抗菌和/或抗炎剂的疗效的现有证据。
截至 2022 年 2 月，我们通过 PubMed、Scopus、Web of Science 和 Google scholar 搜索引擎/数据库检索了相关研究。评估了这些研究是否符合纳入标准，并确定了相关研究。
在 193 项研究中，有 15 项符合纳入标准并进行了数据提取。13 项体外研究评估了 NAC 的抗菌/抗生物膜功效，并报告了良好和有前景的功效：NAC 与对照剂（洗必泰、次氯酸钠、氢氧化钙）一样有效，甚至显示出更高的功效。关于 NAC 的抗炎功效，一项体外研究发现其与氢氧化钙等效，而一项临床试验则表明其比氢氧化钙更有效。
越来越多的证据表明 NAC 在牙髓学领域具有抗微生物和抗炎功效。然而，需要进一步进行具有稳健方法学的临床试验，并采用客观和可靠的临床、生物学和微生物终点，以便将其在人类中的临床实践中应用。
