Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review

Joana A Marques; Rui I Falacho; João Miguel Santos; João Carlos Ramos; Paulo J Palma

doi:10.1111/jerd.13135

Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review

J Esthet Restor Dent. 2024 Apr;36(4):606-619. doi: 10.1111/jerd.13135. Epub 2023 Sep 12.

Authors

Joana A Marques^{1

2}, Rui I Falacho^{2

3}, João Miguel Santos^{1

2

4}, João Carlos Ramos^{2

5}, Paulo J Palma^{1

2}

Affiliations

¹ Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
² Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³ Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁴ Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.
⁵ Institute of Operative Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

PMID: 37698359
DOI: 10.1111/jerd.13135

Abstract

Objective: This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation.

Materials and methods: Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings.

Results: From the initial 1916 studies, and by adding 2 cross-references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%-17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2-240 min (NaOCl) and 1-1440 min (EDTA) being evaluated.

Conclusions: Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration- and time-dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes.

Clinical significance: Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration- and time-dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations.

Keywords: dentin; endodontics; irrigation; root canal irrigants; root canal therapy.

Publication types

Systematic Review
Review

MeSH terms

Chelating Agents / analysis
Chelating Agents / pharmacology
Dental Pulp Cavity*
Dentin* / chemistry
Edetic Acid / analysis
Edetic Acid / pharmacology
Humans
Root Canal Irrigants / analysis
Root Canal Irrigants / pharmacology

Substances

Edetic Acid
Root Canal Irrigants
Chelating Agents