Keywords
chelators, smear layer, dentin permeability, erosion
How to Cite
Effect of EDTAC and citric acid on dentinal walls: Variation of exposure time and dental age. (2019). Odontoestomatología, 21(34), 6-15. https://doi.org/10.22592/ode2019n34a2
Abstract
The aim of this study was to find a formula and application time for chelators effective in cleaning the root canal without causing erosion and considering dental age. The sample included 120 teeth: 60 taken from young patients and 60 from adult patients. They were instrumented and irrigated with 2.5% sodium hypochlorite (NaOCl). Each subgroup was divided randomly into six groups: 4 groups of 12 teeth and 2 control groups of 6 teeth. In the final irrigation, 17% ethylenediaminetetraacetic acid plus Cetavlon (EDTAC) or 10% citric acid was applied for 1 or 3 minutes according to each group. The results showed a high level of cleanliness, and a few showed erosion of the dentinal tubules. Satisfactory results were obtained in the removal of the smear layer when applying EDTAC or citric acid combined with NaOCl. Erosion was present in different degrees regardless of dental age, but it was indeed affected by the irrigant exposure time.
References
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canals after endodontic procedures. J Endod. 1975; 1 (7): 238-242.
2. Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root
canal irrigation regimens. J Endod. 1987; 13 (4): 147-157.
3. Mader Cl, Baumgartner JC, Peters DD. Scanning electron microscopic investigation of
the smeared layer on root canal walls. J Endod. 1984; 10 (10): 477- 483.
4. Hülsmann M, Heckendorff M, Lennon A. Chelanting agents in root canal treatment:
mode of action and indications for their use. Int Endod J. 2003; 36 (12): 810-830.
5. Orstavik D, Haapasalo M. Desinfection by endodontic irrigants and dressings of
experimentally infected dentinal tubules. Endod Dent Traumatol. 1990; 6 (4): 142 -149.
16
6. Kennedy WA, Walker WA, Gough RW. Smear layer removal effects on apical leakage.
J Endod. 1986; 12 (1): 21-27.
7. Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic
comparison of a high volume final flush with several irrigating solutions: Part 3. J
Endod 1983; 9 (4): 137-142.
8. Ostby NB. Chelation in root canal therapy. OdontolTidskr. 1957; 65: 1-11.
9. Von der Fehr FR, Ostby NB. Effect of EDTAC and sulfuric acid on root canal dentin.
Oral Surg, Oral Med, Oral Pathol. 1963; 16 (2): 199-205.
10. Giardino L, Estrela C, Generali L, Mohammadi Z, Asgary S. The in vitro effect of
irrigants with low surface tension on Enterococcus faecalis. Iranian Endod J. 2015; 10
(3): 174-178.
11. Di Lenarda R, Cadenaro M, Sbaizero O. Effectiveness of 1 mol L-1 citric acid and 15%
EDTA irrigation on smear layer removal. Int Endod J 2000; 33 (1): 46-52.
12. Haznedaroglu F. Efficacy of various concentrations of citric acid at different pH values
for smear layer removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96
(3): 340-344.
13. Wayman BE, Kopp WM, Pinero GL, Lazzari EP. Citric and lactic acids as root canal
irrigants in vitro. J Endod. 1979; 5(9): 258-265.
14. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K et al.: A new
solution for the removal of the smear layer. J Endod. 2003; 29 (3): 170-175.
15. Serper A, Calt S. The demineralizing effects of EDTA at different concentrations and
pH. J Endod 2002; 28 (7): 501-502.
17
16. Seidberg BH, Schilder H. An evaluation of EDTA in endodontics. Oral Surg Oral Med
Oral Pathol 1974; 37 (4): 609-620.
17. Schneider SW. A comparison of canal preparations in straight and curved root canals.
Oral Surg Oral Med Oral Pathol . 1971; 32 (2): 271-275.
18. Schäfer E, Diez C, Hoppe W, Tepel J. Roentgenographic investigation of frequency
and degree of canal curvatures in human permanent teeth. J Endod. 2002; 28(3):
211- 216.
19. Ricucci D, Siqueira JF. Fate of the tissue in lateral canals and apical ramifications in
response to pathologic conditions and treatment procedures. J Endod. 2010; 36 (1):
1-15.
20. Khedmat S, Shokouhinejad N. Comparison of the Efficacy of three chelating agents in
smear layer removal. J Endod. 2008; 34 (5):599-602.
21. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP.
Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular
dentin sealer penetration. Microsc Res Tech. 2018; 81 (3): 275-282
22. Giardino L, Ambu E, Becce C, Rimondini L, Morro M. Surface tension comparison of
four common root canal irrigants and two new irrigants containing antibiotic. J
Endod. 2006; 32(11): 1091-1093.
23. Goldberg F, Abramovich A. Analysis of the effect of EDTAC on the dentinal walls of
the root canal. J Endod. 1977; 3 (3): 101-105.
24. Niu W. Yoshioka T. Kobayashi C. Suda H. A scanning electron microscopic study of
dentinal erosion by final irrigation with EDTA and NaOCl solutions. Int Endod J. 2002;
35 (11): 934-939.
18
25. Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod 2002:
28 (1): 17-19.
26. Baldasso FER, Roleto L, Silva VDD, Morgental RD, Kopper PMP. Effect of final
irrigation protocols on microhardness reduction and erosion of root canal dentin.
Braz Oral Res. 2017; 15: 31-40.
27. Turk T, Kaval, ME, Sen BH. Evaluation of the smear layer removal and erosive
capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study.
BMC Oral Health. 2015; 15: 104.
28. Marending M, Paqué F, Fischer J, Zehnder M. Impact of irrigant sequence on
mechanical properties of human root dentin. J Endod. 2007; 33 (11): 1325-1328.
29. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley
DH, Tay FR. Effects of different exposure times and concentrations of sodium
hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of
mineralized dentin. J Endod. 2010; 36 (1): 105-109
30. Zhang K, Tay FR, Kim YK, Mitchell JK, Kim JR, Carrilho M, Pashley DH, Ling JQ. The
effect of initial irrigation with two different sodium hypochlorite concentrations on
the erosion of instrumented radicular dentin. Dent Mater. 2010; 26 (6): 514-523
31. Tartari T, Bachmann L, Zancan RF, Vivan RR, Duarte MAH, Bramante CM. Analysis of
the effects of several decalcifying agents alone and in combination with sodium
hypochlorite on the chemical composition of dentine. Int Endod J. 2018; 51 Suppl 1:
42- 54.
32. Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution
sequences on dentin erosion. J Endod. 2011; 37 (10): 1437-1441.
19
33. Haapasalo M, Qian W, Shen Y. Irrigation: beyond the smear layer. Endodontic Topics
2012; 27(1): 35-53.
34. Goldman LB, Goldman M, Kronman JH, Lin PS. The efficacy of several irrigating
solutions for endodontics: A scanning electron microscopic study. Oral Surg Oral Med
Oral Pathol. 1981; 52 (2): 197-204.
35. Martinelli S, Strehl A, Mesa M. Estudio de la eficacia de diferentes soluciones de
EDTA y ácido cítrico en la remoción del barro dentinario. Odontoestomatología.
2012; 14 (19): 52-63.
canals after endodontic procedures. J Endod. 1975; 1 (7): 238-242.
2. Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root
canal irrigation regimens. J Endod. 1987; 13 (4): 147-157.
3. Mader Cl, Baumgartner JC, Peters DD. Scanning electron microscopic investigation of
the smeared layer on root canal walls. J Endod. 1984; 10 (10): 477- 483.
4. Hülsmann M, Heckendorff M, Lennon A. Chelanting agents in root canal treatment:
mode of action and indications for their use. Int Endod J. 2003; 36 (12): 810-830.
5. Orstavik D, Haapasalo M. Desinfection by endodontic irrigants and dressings of
experimentally infected dentinal tubules. Endod Dent Traumatol. 1990; 6 (4): 142 -149.
16
6. Kennedy WA, Walker WA, Gough RW. Smear layer removal effects on apical leakage.
J Endod. 1986; 12 (1): 21-27.
7. Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic
comparison of a high volume final flush with several irrigating solutions: Part 3. J
Endod 1983; 9 (4): 137-142.
8. Ostby NB. Chelation in root canal therapy. OdontolTidskr. 1957; 65: 1-11.
9. Von der Fehr FR, Ostby NB. Effect of EDTAC and sulfuric acid on root canal dentin.
Oral Surg, Oral Med, Oral Pathol. 1963; 16 (2): 199-205.
10. Giardino L, Estrela C, Generali L, Mohammadi Z, Asgary S. The in vitro effect of
irrigants with low surface tension on Enterococcus faecalis. Iranian Endod J. 2015; 10
(3): 174-178.
11. Di Lenarda R, Cadenaro M, Sbaizero O. Effectiveness of 1 mol L-1 citric acid and 15%
EDTA irrigation on smear layer removal. Int Endod J 2000; 33 (1): 46-52.
12. Haznedaroglu F. Efficacy of various concentrations of citric acid at different pH values
for smear layer removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96
(3): 340-344.
13. Wayman BE, Kopp WM, Pinero GL, Lazzari EP. Citric and lactic acids as root canal
irrigants in vitro. J Endod. 1979; 5(9): 258-265.
14. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K et al.: A new
solution for the removal of the smear layer. J Endod. 2003; 29 (3): 170-175.
15. Serper A, Calt S. The demineralizing effects of EDTA at different concentrations and
pH. J Endod 2002; 28 (7): 501-502.
17
16. Seidberg BH, Schilder H. An evaluation of EDTA in endodontics. Oral Surg Oral Med
Oral Pathol 1974; 37 (4): 609-620.
17. Schneider SW. A comparison of canal preparations in straight and curved root canals.
Oral Surg Oral Med Oral Pathol . 1971; 32 (2): 271-275.
18. Schäfer E, Diez C, Hoppe W, Tepel J. Roentgenographic investigation of frequency
and degree of canal curvatures in human permanent teeth. J Endod. 2002; 28(3):
211- 216.
19. Ricucci D, Siqueira JF. Fate of the tissue in lateral canals and apical ramifications in
response to pathologic conditions and treatment procedures. J Endod. 2010; 36 (1):
1-15.
20. Khedmat S, Shokouhinejad N. Comparison of the Efficacy of three chelating agents in
smear layer removal. J Endod. 2008; 34 (5):599-602.
21. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP.
Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular
dentin sealer penetration. Microsc Res Tech. 2018; 81 (3): 275-282
22. Giardino L, Ambu E, Becce C, Rimondini L, Morro M. Surface tension comparison of
four common root canal irrigants and two new irrigants containing antibiotic. J
Endod. 2006; 32(11): 1091-1093.
23. Goldberg F, Abramovich A. Analysis of the effect of EDTAC on the dentinal walls of
the root canal. J Endod. 1977; 3 (3): 101-105.
24. Niu W. Yoshioka T. Kobayashi C. Suda H. A scanning electron microscopic study of
dentinal erosion by final irrigation with EDTA and NaOCl solutions. Int Endod J. 2002;
35 (11): 934-939.
18
25. Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod 2002:
28 (1): 17-19.
26. Baldasso FER, Roleto L, Silva VDD, Morgental RD, Kopper PMP. Effect of final
irrigation protocols on microhardness reduction and erosion of root canal dentin.
Braz Oral Res. 2017; 15: 31-40.
27. Turk T, Kaval, ME, Sen BH. Evaluation of the smear layer removal and erosive
capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study.
BMC Oral Health. 2015; 15: 104.
28. Marending M, Paqué F, Fischer J, Zehnder M. Impact of irrigant sequence on
mechanical properties of human root dentin. J Endod. 2007; 33 (11): 1325-1328.
29. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley
DH, Tay FR. Effects of different exposure times and concentrations of sodium
hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of
mineralized dentin. J Endod. 2010; 36 (1): 105-109
30. Zhang K, Tay FR, Kim YK, Mitchell JK, Kim JR, Carrilho M, Pashley DH, Ling JQ. The
effect of initial irrigation with two different sodium hypochlorite concentrations on
the erosion of instrumented radicular dentin. Dent Mater. 2010; 26 (6): 514-523
31. Tartari T, Bachmann L, Zancan RF, Vivan RR, Duarte MAH, Bramante CM. Analysis of
the effects of several decalcifying agents alone and in combination with sodium
hypochlorite on the chemical composition of dentine. Int Endod J. 2018; 51 Suppl 1:
42- 54.
32. Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution
sequences on dentin erosion. J Endod. 2011; 37 (10): 1437-1441.
19
33. Haapasalo M, Qian W, Shen Y. Irrigation: beyond the smear layer. Endodontic Topics
2012; 27(1): 35-53.
34. Goldman LB, Goldman M, Kronman JH, Lin PS. The efficacy of several irrigating
solutions for endodontics: A scanning electron microscopic study. Oral Surg Oral Med
Oral Pathol. 1981; 52 (2): 197-204.
35. Martinelli S, Strehl A, Mesa M. Estudio de la eficacia de diferentes soluciones de
EDTA y ácido cítrico en la remoción del barro dentinario. Odontoestomatología.
2012; 14 (19): 52-63.