Update on citric acid use in endodontic treatment: a systematic review

Gómez-Delgado, M.; Camps-Font, O.; Luz, L.; Sanz, D.; Bellido, Montserrat Mercadé

doi:10.1007/s10266-022-00744-2

Cited by 14 publications

(21 citation statements)

References 62 publications

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“…Adverse effects on mineralized radicular and coronal dentin's physicochemical and mechanical properties following endodontic irrigation are mentioned throughout the literature. 4,5,[7][8][9][10][11][12][13][14][15][16][17][18][19]22,23,25,27,30,31,[39][40][41][42][43] Besides the morphological differences, distinct nanohardness, elastic modulus and fracture toughness of coronal and radicular dentin substrates have been reported. 28,44 Understanding the structural, chemical and mechanical condition of post-irrigation coronal dentin is crucial to guide the subsequent adhesive restorative procedures and potentiate survival of endodontically treated teeth.…”

Section: Discussionmentioning

confidence: 99%

“…To date, the effects of endodontic irrigation on root dentin have been thoroughly investigated, but few report its impact on coronal dentin 10–16,18,19,25–27 . When comparing root and coronal dentin, some morphological differences come to notice.…”

Section: Introductionmentioning

confidence: 99%

“…5,7 Despite crucial for the fulfillment of endodontic treatment goals, deleterious effects of recommended irrigation protocols on root dentin are well-described. [8][9][10][11][12][13][14][15][16][17][18][19] Human dentin comprises approximately 20 wt%/33 vol% organic matrix, 70 wt%/45 vol% inorganic phase and the remaining being water. 20 It consists of type I collagen, encapsulated by mineralized apatite crystals, which all together determine the mechanical properties of this biological composite.…”

Section: Introductionmentioning

confidence: 99%

“…4,[13][14][15]23,24 To date, the effects of endodontic irrigation on root dentin have been thoroughly investigated, but few report its impact on coronal dentin. [10][11][12][13][14][15][16]18,19,[25][26][27] When comparing root and coronal dentin, some morphological differences come to notice. The coronal dentin's increased tubule density, higher mineral-to-collagen ratio, and distinct tubule orientation may serve as pivotal variables that impact both irrigant choices-based on mineral and organic content-and adhesive approaches.…”

Section: Introductionmentioning

confidence: 99%

“…Despite crucial for the fulfillment of endodontic treatment goals, deleterious effects of recommended irrigation protocols on root dentin are well‐described 8–19 . Human dentin comprises approximately 20 wt%/33 vol% organic matrix, 70 wt%/45 vol% inorganic phase and the remaining being water 20 .…”

Section: Introductionmentioning

confidence: 99%

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

Marques,

Falacho,

Santos

et al. 2023

J Esthet Restor Dent

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ObjectiveThis review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation.Materials and MethodsReporting 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.ResultsFrom 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.ConclusionsOverall, 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 SignificanceEndodontic 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.

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