Comparative Evaluation of the Effect of EDTA, Chitosan, Etidronic Acid, and Silver Citrate on the Mineral Content of Root Canal Dentin Using Energy Dispersive X-ray Spectroscopy: An In-Vitro Study.

Abstract

Objective: Sodium hypochlorite is a common irrigant in endodontics, used to eliminate microorganisms and dissolve pulpal tissue. However, adjunctive chelating agents, while aiding in smear layer removal, can reduce dentinal wall microhardness, affecting dentin permeability, solubility, and the sealing ability of root canal sealers. This study aims to evaluate the impact of newer chelating agents-Silver Citrate, Chitosan, HEBP, and EDTA-on the mineral composition of root canal dentin using energy-dispersive X-ray Spectroscopy (EDXS).

Methods: The root canals of 120 freshly extracted human mandibular premolars with single straight canals and intact, mature apices were prepared following standard endodontic procedures using Rotary Pro Taper nickel-titanium files. Final irrigation was conducted with 5 mL of the respective chelating solution. Changes in the mineral composition of the root canal dentin were analyzed using EDXS. Descriptive statistics were presented as means and standard deviations. The impact of chelating solutions on the mineral content of root canal dentin at the cervical, middle, and apical thirds was compared between groups using One-Way ANOVA followed by a post hoc Bonferroni test.

Results: The highest mean concentrations of minerals such as Mg, Ca, and P at both the coronal and apical levels (p<0.05), along with the Ca/P ratio in the coronal third, were observed with distilled water, followed by HEBP, Chitosan, EDTA, and Silver Citrate, which showed the lowest values. In the middle third, the concentrations of Ca and P, as well as the Ca/P ratio in the apical and middle thirds, followed the sequence: Distilled Water>EDTA>HEBP>Chitosan>Silver Citrate. The difference in the levels of all minerals was statistically significant (p<0.05) at the coronal, middle and apical third levels.

Conclusion: Among the tested solutions, 9% HEBP caused the least alteration in the mineral content of root canal dentin when compared to 0.2% Chitosan, 17% EDTA, and Silver Citrate. This suggests that HEBP may be a preferable choice in endodontic procedures where minimal alteration of dentin mineral content is desired. (EEJ-2024-08-124).