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Sonic, ultrasonic and Er:Yag laser agitation, in general, offer better biofilm removal when compared to conventional irrigation methods delivered by syringe and needle. The choice of the right irrigation solution is an important factor for removal of the endodontic biofilm, with water and saline being less effective compared to NaOCl and CHX. However, due to heterogeneity in methodologies, it is difficult to compare adjuvant endodontic techniques with one another and give recommendations for the most efficient method in biofilm removal.