Basic Research—Technology
Effect of Ethylenediaminetetraacetic Acid on Root Fracture
with Respect to Concentration at Different Time Exposures
Emel Uzunoglu, DDS, Sevinc Aktemur, DDS, M. Ozgur Uyanik, DDS, PhD, Veli Durmaz, DDS, PhD,
and Emre Nagas, DDS, PhD
Abstract
Introduction: The objective of this study was to eval-
uate the effect of ethylenediaminetetraacetic acid
(EDTA) on root fracture with respect to various concen-
O ne of the main goals of root canal treatment is the elimination of microorganisms
trations at different time exposures. Methods: A total
of 48 mandibular incisors were selected. Eight nonpre-
pared roots were selected as a negative control. The re-
maining 40 specimens were instrumented with rotary
files and randomly assigned to one of the following
groups for final irrigation: (1) 10 mL distilled water for
10 minutes (positive control); (2) 10 mL of 17% EDTA
for 1 minute + 10 mL of 1% NaOCl for 1 minute; (3)
10 mL of 5% EDTA for 1 minute + 10 mL of 1% NaOCl
for 1 minute; (4) 10 mL of 17% EDTA for 10 minutes +
10 mL of 1% NaOCl for 1 minute; (5) 10 mL of 5% EDTA
for 10 minutes + 10 mL of 1% NaOCl for 1 minute.
Thereafter, the root canals were filled by using AH26
root canal sealer with a single-cone technique. The spec-
imens were loaded vertically at 1 mm/min crosshead
speed until vertical root fracture occurred. Results
were evaluated statistically with 1-way analysis of vari-
ance and Student’s t test. Results: Statistically signifi-
cant differences were detected among the groups (P <
.05). The highest mean fracture resistance was obtained
from the group treated with 5% EDTA for 10 minutes.
This is about 2 times more than the weakest mean frac-
ture resistance, which was obtained from the 17%
EDTA-10 minute group. Conclusions: The fracture resis-
tances of endodontically treated roots were found to be
differently affected by the various concentrations of
EDTA at different time exposures. (J Endod
2012;38:1110–1113)
Key Words
EDTA, final irrigation, fracture resistance
From the Department of Endodontics, Faculty of Dentistry,
Hacettepe University, Ankara, Turkey.
Address requests for reprints to Dr Emel Uzunoglu, Depart-
ment of Endodontics, Faculty of Dentistry, Hacettepe University,
Sihhiye, 06100, Ankara, Turkey. E-mail address: emel.
uzunoglu@hacettepe.edu.tr
0099-2399/$ - see front matter
Copyright ª 2012 American Association of Endodontists.
doi:10.1016/j.joen.2012.04.026
1110 Uzunoglu et al.
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from the contaminated root canal system (1). Instrumentation alone will not allow
for adequate debridement and disinfection of the complex root canal system (2). There-
fore, chemomechanical debridement is required (3). Chemomechanical debridement,
or cleaning of the root canal systems, has been described as the removal of microor-
ganisms, tissue remnants, and dentin chips from the root canal systems (4). Moreover,
chemomechanical debridement is composed of mechanical debridement combined
with irrigation (5).
Irrigation, or chemical debridement, is accepted as being the most effective
method for the removal of the smear layer (6) formed on instrumented root canals,
which consists of dentin particles, remnants of vital or necrotic pulp tissue, bacterial
components, and retained irrigants (7). It is generally recommended that the complete
removal of smear layer is an essential requirement in root canal therapy (8). Effective
methods for removing smear layer have been widely investigated (9–11), and
numerous irrigants have been recommended for that purpose (12). Sodium hypochlo-
rite (NaOCl) in a 1%–5.25% concentration is the most widely recommended irrigation
solution because of its dissolving capacity of vital and necrotic tissues as well as its anti-
microbial power (13). However, NaOCl cannot dissolve inorganic components of
dentin and thus prevent the formation of a smear layer during instrumentation (14).
Therefore, demineralizing agents such as ethylenediaminetetraacetic acid (EDTA)
have been recommended as adjuvants in root canal therapy (15).
It has been reported that endodontic irrigation is capable of causing alterations in
the chemical composition of dentin, and this effect can increase by extended application
time and concentration of irrigation solutions (16–18). These changes in the chemical
property of dentin arise because of the changes in the inorganic and the organic phases
of the dentin. In turn, the microhardness, permeability, and solubility characteristics of
dentin change, and this might also adversely affect the fracture resistance of teeth.
In light of these observations, the aim of this study was to evaluate the effect of
EDTA on root fracture with respect to different concentrations at different time expo-
sures. The null hypothesis tested was that prolonged use of high concentrations of
EDTA would increase the risk for root fracture of endodontically treated teeth.
Materials and Methods
Tooth Selection
Human mandibular incisors were extracted and stored in an aqueous solution of
0.5% chloramine-T at 4 C before use. The crowns were sectioned below the cement-
enamel junction so that the length of all roots was adjusted to 13 mm. All specimens
were examined under magnification and fiberoptic lighting to ensure that there were
no cracks or craze lines in the teeth, especially within the root portions. With the
aim of specimen standardization, the mesiodistal and buccolingual diameters of the
coronal planes were measured with a digital caliper, and the mean mesiodistal and buc-
colingual dimensions were obtained. Thereafter, roots presenting a difference of 20%
from the mean were discarded (19), leaving a total of 48 mandibular incisor roots.
Specimen Preparation
The working length of each root was determined to be 1 mm less than the length of
a #10 K-file (Dentsply-Maillefer, Ballaigues, Switzerland) just exiting the foramen,
JOE — Volume 38, Number 8, August 2012

except for 8 randomly selected teeth as a negative control group
(nonprepared group). The root canals were prepared to apical size
30 (F3) with ProTaper nickel-titanium rotary instruments (Dentsply-
Maillefer), and between each file, 2 mL of 1% NaOCl was used as an in-
tracanal irrigant during instrumentation. This procedure was followed
by irrigation with 2 mL of saline solution. At this point 40 specimens
were randomly divided into 5 groups (n = 8) according to the final
irrigation procedures (Table 1). The irrigation solutions were delivered
via 27-gauge needles that penetrated to within 2 mm of the working
length. Thereafter, roots were filled with ProTaper F3 gutta-percha
and AH26 (Dentsply DeTrey, Konstanz, Switzerland) epoxy resin–based
root canal sealer by using a single-cone technique. Excessive coronal
gutta-percha was removed, and samples were stored in 100% humidity
for 7 days to allow the sealer to set.
Fracture Test
The apical 5 mm of roots was embedded along the long axis in
self-curing acrylic blocks, with 9 mm of each root exposed. The spec-
imens were then mounted in a universal testing machine (Lloyd LRX;
Lloyd Instruments, Fareham, UK). A custom stainless steel loading
fixture with a round tip (r = 2 mm) was centered over the canal
opening, and a compressive force was applied at a crosshead speed
of 1 mm/min until a fracture occurred. The forces necessary to fracture
each root were recorded in newtons (N).
Moreover, representative specimens from each group were evalu-
ated by EVO 50 EP environmental scanning electron microscope (SEM)
(Carl Zeiss NTS GmbH, Oberkochen, Germany) for assessment of canal
walls. Each root canal was first examined at low magnification. Then, the
most representative regions of the middle portion of root canals were
selected and investigated at 5000.
Statistical Analysis
The data were analyzed by using 1-way analysis of variance and
Student’s t test. A P value <.05 was considered significant.
Results
The fracture resistance values (N) are presented in Table 1 as mean
 standard deviation (SD). Statistically significant differences were de-
tected among the groups by 1-way analysis of variance (P < .05). The
highest mean fracture resistance was obtained from the group treated
with 5% EDTA for 10 minutes. This is about 2 times more than the weak-
est mean fracture resistance, which was obtained from the 17% EDTA-10
minute group. In addition, the fracture resistance of root canal dentin
irrigated with 17% EDTA for 1 minute was statistically higher when
compared with positive control (distilled water).
Discussion
The aim of the present study was to evaluate the effect of 2
different concentrations of EDTA at 2 different time periods on
Basic Research—Technology
vertical root fracture of endodontically treated roots. Previous
studies reported that applying the force vertically to the long axis
of the tooth transmits the force uniformly (20, 21). Therefore,
in the present study, a single load to fracture was applied
vertically to evaluate the fracture resistance of endodontically
treated roots.
Results obtained within the experimental conditions of the present
study indicated that the fracture resistances of endodontically treated
roots were found to be differently affected by the various concentrations
of EDTA at different time exposures. A 10-minute irrigation of 17%
EDTA resulted in the lowest fracture resistance values. A possible expla-
nation for this result could be that long-term exposure of 17% EDTA
might give rise to damaging effects on the peritubular and intertubular
dentin (22, 23). This effect resulted in decreased modulus of elasticity
and flexure strength values (24), which might affect the physical and
mechanical properties of dentin adversely, and consequently this dimin-
ishes the fracture resistance of the root.
A previous study by Saghiri et al (25) indicated that 5-minute appli-
cation of 17% EDTA decreased dentin microhardness more than its 1-
minute application. Moreover, according to the results of the previous
study, dentin microhardness decreased after irrigating with 17% EDTA
followed by 2.5% NaOCl (26). Accordingly, the decrease in dentin micro-
hardness can be a result of EDTA’s capability to dissolve mineral content
of dentin (27, 28). The present results are in accordance with these
previous studies. Eventually, microhardness might be used as an
indicator of the overall strength or resistance to fracture (29).
A combination of EDTA and NaOCl solution is recommended for
the efficient removal of the smear layer from the surface of the root canal
wall (30). However, this combined irrigation regimen with a long
duration can easily produce too much erosion of the dentin surface
(18). Moreover, it was shown that erosion can be avoided by using
chelators at low concentrations (30) or shorter chelating times (31).
In the present study, although it efficiently removed the smear layer,
the erosive effect of 17% EDTA on dentin has been established in the
SEM photomicrographs after a 10-minute application (Fig. 1). This
could result in a decrease in dentin microhardness and, consequently,
in lower fracture strength values. On the other hand, treatment with 5%
EDTA for 10 minutes and 17% EDTA for 1 minute had positive effect on
fracture resistance of endodontically treated root. A possible explana-
tion could be that these irrigation regimens remove smear layer effec-
tively without an erosive effect (Fig. 1). The removal of smear layer has
been shown to increase the sealing effect and bond strength of resin-
based root canal sealers to dentin (32, 33). Therefore, high fracture
strength values of 5% EDTA for 10 minutes and 17% EDTA for
1 minute might be explained by increased bond strengths of resin-
based root canal sealer.
The present experiment emphasized the potential deleterious
mechanical effects that could be seen on root canal dentin structure
by the extensive application of 17% EDTA. Consequently, the results
obtained from the present study supported the hypothesis that

TABLE 1. Final Irrigation Procedures and Fracture Resistance (FR) Values (N) of Test Specimens (mean  SD)
FR
Final irrigation procedures values
Group 1 (negative control group) No canal instrumentation was carried out 598  64ab
Group 2 (positive control group) 10 mL distilled water for 10 minutes 486  44bd
Group 3 10 mL of 17% EDTA for 1 minute, followed by 10 mL of 1% NaOCl for 1 minute 613  43a
Group 4 10 mL of 5% EDTA for 1 minute, followed by 10 mL of 1% NaOCl for 1 minute 519  43b
Group 5 10 mL of 17% EDTA for 10 minutes, followed by 10 mL of 1% NaOCl for 1 minute 379  41c
Group 6 10 mL of 5% EDTA for 10 minutes, followed by 10 mL of 1% NaOCl for 1 minute 668  63a
n = 8 for each group.
Different superscript letters indicate significant differences between the groups (P < .05).

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Basic Research—Technology
Figure 1. Representative scanning electron micrographs of the test groups. (A) 17% EDTA for 1 minute; (B) 17% EDTA for 10 minutes; (C) 5% EDTA for 10
minutes; (D) 5% EDTA for 1 minute.
prolonged use of high concentrations of 17% EDTA might increase the
risk for root fracture. From a clinical point of view, it would be impor-
tant to select a suitable EDTA concentration that has minimal adverse
effect on the mechanical properties of the tooth. This might be achieved
by using EDTA at high concentration with short application time or at
low concentration with longer application time.
Acknowledgments
The authors deny any conflicts of interest related to this study.
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