Effects of Phytic Acid and Etidronic Acid Using Continuous and Sequential Chelation on The Removal of Smear Layer, Dentin Microhardness, and Push-out Bond Strength of Calcium Silicate-based Cement

Background This study assessed the effects of sequential and continuous chelation using phytic acid and etidronic acid on smear layer removal, microhardness, and push-out bond strength (PBS) at radicular dentin. Methods One hundred twenty single-rooted teeth were selected. Thirty teeth were split longitudinally, and initial microhardness was measured. The roots were then divided into six groups. In sequential chelation, 2.5% sodium hypochlorite (NaOCl) was used for 20 minutes, followed by 17% ethylenediaminetetraacetic acid (EDTA), 9% etidronic acid (HEDP), or 2.5% phytic acid (PA) for 2 minutes, while no chelator was applied in the control group. In continuous chelation, etidronic acid (DR HEDP) or phytic acid (DR PA) was mixed with NaOCl and applied for 20 minutes. Final microhardness values were measured, and the change was calculated as a percentage. Mid-root sections were obtained from the 60 teeth for the PBS test and divided into six groups. Irrigants were applied as in the microhardness test. Sections obturated with calcium silicate cement. PBS values were measured, and the types of failures were analyzed. Thirty teeth were analyzed using scanning electron microscopy (SEM). In sequential chelation, 2.5% NaOCl irrigation was performed during instrumentation, followed by 17% EDTA, 9% HEDP, or 2.5% PA for 2 minutes, while no chelator was applied in the control group. In continuous chelation, DR HEDP or DR PA was mixed with NaOCl and used during instrumentation. Images were taken, and smear layer scores were recorded. The PBS data were analyzed using one-way ANOVA, and the alterations in microhardness and remaining smear layer were analyzed using a two-way ANOVA test. The pairwise comparisons were analyzed using Tukey’s HSD post hoc test. The failure patterns and smear scores were compared using Pearson’s chi-squared test (α=0.05). Results Results showed that DR HEDP (4.02±0.68%) caused the least reduction in microhardness. DR HEDP (10.26±1.74 MPa) exhibited the highest bond strength, followed by PA (7.97±0.92 MPa) and DR PA (7.74±1.16 MPa). Failure patterns did not differ significantly. Lower percentages of the remaining smear layer area were observed in the DR PA (26.7±18%), PA (24.2±9.8%), and DR HEDP (37.1±16.5%) groups compared to the others. Conclusions The use of etidronic acid with the continuous chelation technique and phytic acid with the sequential chelation technique may be an alternative method to sequential EDTA irrigation.