Exploring the effect of flavonoid-based solutions or formulations as antibiofilm agents in endodontics: A scoping review

Research output: Contribution to journal › Review article › Contributed › peer-review

Contributors

  • Gabriel Pereira Nunes - , State University of Campinas (Author)
  • Elise Saint-Etienne - , Catholic University of Portugal (Author)
  • Anna Carolina Volpi Mello-Moura - , Catholic University of Portugal (Author)
  • Marcelle Danelon - , Department of Dental Maintenance (Author)
  • Torsten Sterzenbach - , Department of Dental Maintenance (Author)
  • Christian Hannig - , Department of Dental Maintenance (Author)
  • Cristiane Duque - , Catholic University of Portugal (Author)
  • Renata Toledo Alves - , Catholic University of Portugal (Author)

Abstract

Objective: This scoping review aimed to map and summarize the evidence on the antimicrobial and antibiofilm efficacy of flavonoid-based solutions or formulations for endodontic applications. Design: The review was conducted in accordance with the PRISMA-ScR guidelines. A comprehensive search was performed across databases for articles published up to April 2025. Eligible studies included those evaluating the antimicrobial effects of flavonoids on microorganisms associated with endodontic infections. Relevant data were extracted, and a descriptive synthesis of the findings was carried out. Results: The results showed that fifteen studies met the inclusion criteria, demonstrating significant antimicrobial and antibiofilm activity of various flavonoids. Epigallocatechin-3-gallate was the most extensively studied compound, showing dose-dependent activity against E. faecalis, F. nucleatum, A. israelii, S. mutans, and C. albicans, with enhanced efficacy when combined with agents such as fosfomycin or the peptide KR-12-a5. Quercetin also displayed concentration-dependent antibiofilm effects and gene modulation in E. faecalis. Proanthocyanidin showed superior efficacy compared to conventional irrigants, especially at higher concentrations. Rutin, although limited in standalone efficacy, showed promising results when used as a photosensitizer. Other flavonoids such as apigenin, theaflavin, isoquercitrin, ampelopsin, chalcone, and chrysin also demonstrated varying degrees of antimicrobial activity, often similar to or surpassing conventional agents like chlorhexidine and calcium hydroxide in specific models. Conclusions: Flavonoids exhibit significant potential as alternative or adjunctive agents for endodontic disinfection, especially in biofilm-related infections. Their efficacy is influenced by compound type, concentration, formulation, and synergistic combinations. Further research, especially clinical trials, is warranted to validate their therapeutic applicability and optimize delivery systems for clinical use in endodontics.

Details

Original languageEnglish
Article number106559
JournalArchives of oral biology
Volume186
Publication statusPublished - Jun 2026
Peer-reviewedYes

External IDs

PubMed 41791262

Keywords

Keywords

  • Antimicrobial activity, Biofilms, Endodontics, Flavonoids, Intracanal medication