ORIGINAL RESEARCH
Influence of EDTA and dentine in tissue dissolution ability of
sodium hypochlorite
Luiza Helena Silva de Almeida, DDS
1
; Natália Gomes e Silva Leonardo, DDS
1
;
Ana Paula Neutzling Gomes, PhD
1
; Erick Miranda Souza, PhD
2
; and Fernanda Geraldes Pappen, PhD
1
1 Department of Semiology and Clinics, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
2 Florence Institute, São Luís, Brazil
Keywords
EDTA, dentine, sodium hypochlorite, tissue
dissolution.
Correspondence
Prof. Fernanda Geraldes Pappen, Division of
Endodontics, Faculty of Dentistry, Federal
University of Pelotas (UFPel), Rua Gonçalves
Chaves 457–507, Pelotas, RS 96015-560, Brazil.
Email: ferpappen@yahoo.com.br
doi:10.1111/aej.12044
Abstract
This study verified whether ethylenediaminetetraacetic acid (EDTA) influences
the pulp tissue dissolution capability of different concentrations of NaOCl, in
the presence of dentine. NaOCl and EDTA solutions were simultaneously
mixed in flasks either containing a dentine disc or those not containing a
dentine disc. Previously weighed bovine pulp tissues were immersed in the
solutions for 5, 15 and 30 min. The weight loss was measured. The dissolution
tests were performed in triplicate. Univariate analysis of variance, along with
further Tukey’s honestly significant difference pairwise comparisons, was used
to verify the effect of EDTA, different concentrations of NaOCl, dentine and
time of incubation on the tissue dissolution. Higher concentrations of NaOCl
increased the tissue dissolution. EDTA reduced the capacity of NaOCl to dis-
solve pulp tissue, even in presence of dentine. Dentine negatively affects the
capacity of NaOCl to dissolve pulp tissue. In conclusion, the presence of EDTA
and dentine negatively affects the tissue dissolution ability of NaOCl.
Introduction
Since its introduction for endodontic therapy, almost a
century ago (1), sodium hypochlorite (NaOCl) has
remained the leading endodontic irrigant due to its soft
tissue-dissolving and antimicrobial abilities (2–5). Both
properties of NaOCl solutions are believed to be a func-
tion of available chlorine (HOCl and OCl-) (2,6–8), which
can be influenced and vary according to concentration,
temperature, contact time, agitation, contact area and pH
of the solution (9–11). Sodium hydroxide (NaOH) is also
believed to dissolve organic tissue via saponification of
fats (11,12), although negligible due to the low levels of
NaOH found in NaOCl solutions (13).
Since hypochlorite solutions have an insignificant
dissolution effect on smear layer and dentine (7),
demineralising agents, such as ethylenediaminete-
traacetic acid (EDTA), which has a calcium-chelating
capability, have been widely recommended as adjuvants
in root canal therapy with the rationale to allow for a
deeper penetration of NaOCl into dentine, resulting in
more efficient cleansing of the root canal (14).
Nevertheless, there appears to be no agreement in the
literature on the most efficient sequence in which the
two solutions (NaOCl and EDTA) should be used
(15,16). Byström and Sundquist (17) recommended the
alternating use of these solutions with the claim that
this sequence is more efficient in reducing bacterial load
in the root canal than the use of NaOCl alone through-
out preparation. More recently, it has been shown,
however, that mixing NaOCl with EDTA reduced the
tissue-dissolving capability of NaOCl due to the reduc-
tion of available chlorine (6,8), which may also hamper,
in turn, the antimicrobial effectiveness of the solution
(6).
The exact mechanism by which EDTA reduces the
amount of available chlorine is still unknown. However,
it is interesting to highlight that EDTA is capable of main-
taining its calcium-chelating efficacy even in the presence
of NaOCl (6,18). The non-colloidal organic chelating
Aust Endod J 2013
1 © 2013 Australian Society of Endodontology