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Update on chelating agents in endodontic treatment: A systematic review
Laura Fortea1, Diana Sanz-Serrano1, Luciana-Batista Luz2
1Department of Dentistry, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain.
Journal of Clinical and Experimental Dentistry
|May 10, 2024
Summary
17% EDTA effectively removes smear layer and aids growth factor release in regenerative endodontics. Newer etidronic acid chelating agents show promise due to compatibility and smear layer prevention, but more in vivo research is needed.
Area of Science:
- Endodontics
- Biomaterials Science
- Dental Research
Background:
- Chelating agents are crucial in endodontic procedures.
- Common agents include EDTA, citric acid, and maleic acid.
- Emerging agents like HEDP offer potential advantages.
Purpose of the Study:
- To systematically review the evidence on commonly used chelating agents in endodontics.
- To assess their efficacy, cytotoxicity, antimicrobial effects, and impact on regenerative endodontics.
- To compare the properties of EDTA, citric acid, maleic acid, peracetic acid, and HEDP.
Main Methods:
- A systematic literature search was conducted on MEDLINE, Cochrane Library, and Scopus up to January 2023.
- Studies evaluating specific chelating agents (EDTA, HEDP, citric acid, peracetic acid, maleic acid) were included.
- Study quality was assessed using modified CONSORT and Cochrane Collaboration tools.
Main Results:
- 56 articles were included, predominantly in vitro studies (55/56).
- 17% EDTA excels in smear layer removal and growth factor release.
- 9% and 18% HEDP demonstrate compatibility with sodium hypochlorite and prevent smear layer formation.
Conclusions:
- 17% EDTA remains a benchmark for smear layer removal and regenerative endodontics.
- HEDP shows promise for its stability and smear layer prevention.
- Further in vivo studies and methodological standardization are essential to validate findings.
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