Effect of Endodontic Irrigants on the Cyclic Fatigue Resistance of Nickel-Titanium Rotary Instruments: A Systematic Review.

Instrument fracture during endodontic treatment significantly compromises treatment outcomes, with sodium hypochlorite (NaOCl) and other irrigants potentially affecting the cyclic fatigue resistance of nickel-titanium (NiTi) rotary files. This systematic review evaluated the impact of endodontic irrigants on NiTi instrument durability. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Embase, Cochrane Library, and WorldCat databases through June 2025, following PRISMA guidelines. Studies investigating cyclic fatigue resistance of NiTi rotary instruments exposed to various irrigants were included. Twenty-seven in vitro studies met the inclusion criteria, involving instruments across multiple file systems and irrigant solutions. The review revealed that NaOCl, particularly at concentrations ≥5% and elevated temperatures, significantly reduced cyclic fatigue resistance in most studies, with scanning electron microscopy confirming surface corrosion and microcrack formation. Heat-treated NiTi alloys demonstrated superior fatigue resistance compared to conventional austenitic alloys. Short-term NaOCl exposure (1-5 min) showed minimal impact, while prolonged exposure combined with autoclave sterilization produced cumulative weakening effects. Alternative irrigants such as EDTA and chlorhexidine showed more neutral effects on instrument integrity. These findings suggest that irrigant selection and exposure protocols significantly influence NiTi instrument longevity, with implications for clinical endodontic practice and instrument safety protocols.