Effect of Continuous Chelation on Physicochemical Properties of Dentin: A Systematic Review.

Abstract

Aim and background: This systematic review aimed to evaluate and summarize the existing literature on the effect of continuous chelation on the physicochemical characteristics of root canal dentin.

Methodology: This systematic review followed the PRISMA guidelines, and electronic databases such as PubMed, Cochrane, Lilacs, and Google Scholar were searched for articles, published from June 2013 to October 2024. The PICOS guidelines followed were: Population (P) - Root Canal Dentin; Intervention (I) - Continuous Chelation (Sodium hypochlorite and HEBP); Comparison (C) - Sequential irrigation protocol (Sodium hypochlorite and EDTA); Outcome (O) - Physical and Chemical Properties of root dentin (physical properties: root dentin roughness, microhardness, erosion, fracture resistance, flexural strength, push-out bond strength of fiber posts, and ultrastructural characteristics; chemical properties: mineral content, collagen degradation, and compositional changes); Study design (S) - In vitro studies. Data extracted from the included articles were author, publication year, place of study, the sample size, the concentration and duration of continuous chelation and sequential irrigation protocol, the impact of these variables on the physicochemical properties of root dentin, the results obtained, and the study's observations and limitations. Studies were qualitatively assessed utilizing Joanna Briggs Institute (JBI) tool.

Results: Out of 92 articles, 88 articles were screened after duplicates were excluded. On application of selection criteria, eight were included in the systematic review, of which, six studies focused solely on the effect of continuous chelation on physical properties, while two studies addressed effects on both physical and chemical properties of dentin. Root dentin roughness was evaluated by two studies, microhardness in two studies, erosion in one study, fracture resistance in three studies, flexural strength in one study, push-out bond strength of fiber posts in one study, and ultrastructural characteristics in one study. Mineral content and crystalline phase were evaluated in one study while chemical composition and collagen degradation were evaluated in another study. The included studies demonstrated an overall low risk of bias.

Conclusion: Within the limitations of this systematic review, it can be concluded that continuous chelation has a minimal effect on the physicochemical properties of dentin when compared to sequential chelation.

Clinical significance: Continuous chelation is favorable to the physicochemical properties of dentin. As it exerts less effect on dentin when compared to sequential chelation, it may contribute to the long-term survival of the root canal-treated tooth. How to cite this article: Kumaresan K, Govindaraju L, Rajendran MR. Effect of Continuous Chelation on Physicochemical Properties of Dentin: A Systematic Review. J Contemp Dent Pract 2025;26(3):321-330.