Chitosan: A Natural Substitute of EDTA Solution for Final Irrigation in Endodontics Treatment

Abstract

Background: The purpose of this study was to assess the quantity of the chelated calcium ions and the smear layer removal efficiency after root  canal final irrigation with three different solutions.

Materials and Methods: Forty‑five teeth were instrumented with rotary‑files, then randomly divided into 3 equal groups (n = 15) depending on the final irrigation solution; group I: 17% ethylenediaminetetraacetic acid (EDTA), group II: 0.2% chitosan, and group III: 10% trisodium citrate. According to the time of application, every group was divided into 3 subgroups (1 min, 5 min, and 24 h). The quantification analysis of chelated  calcium ions was performed by flame atomic absorption spectrometry (FAAS). Then, the presence of smear layer was examined by splitting the samples longitudinally and using scanning electron microscopy (SEM) to examine coronal, middle, and apical root canal levels. One‑way analysis of variance (ANOVA) test was used for the evaluation of treatment effect. Kruskal–Wallis test was executed to detect a significant difference between groups, while Mann–Whitney U test has determined the difference between each two groups for smear layer.

Results: Both 17% EDTA and 0.2% chitosan had not been statistically significant difference for smear layer removal efficiency and observed calcium ion concentrations. Although, they were more efficient of 10% trisodium citrate with a significant difference (P < 0.05).

Conclusion: The application time of the chelators’ solutions must not exceed 5 min to completely remove smear layer, and 0.2% chitosan is a  natural substitute for 17% EDTA with a safety application for 24 h.

Keywords: Calcium ion, chelator, chitosan, scanning electron microscopy, smear layer