Influence of Citric Acid on the Vitality of Stem Cells from Apical Papilla

Abstract

The endodontic treatment of immature permanent teeth with necrotic pulp is a serious clinical challenge. The chemical agents, used in regenerative procedures, should be selected not only based on their bactericidal/bacteriostatic properties, but also on their ability to ensure the survival of the patient’s stem cells. The aim of this study was to evaluate the effect of citric acid on the vitality of SCAP in a model of an immature tooth root. Models of immature roots were created from 12 freshly extracted teeth. The models were gas sterilized with ethylene oxide and they were separated into three groups, based on the used combinations of irrigants: 1) 1.5% sodium hypochlorite / 17% EDTA; 2) 1.5% sodium hypochlorite / 10% citric acid; 3) saline. SCAPs in a hyaluronic acid–based scaffold were seeded into the canals and cultured for 7 days. Viable cells were quantified using a colorimetric assay. There was no statistically significant difference between the groups, irrigated with NaOCl/EDTA and NaOCl/citric acid. The results from our experiment show that 10% citric acid can be used in combination with 1.5% NaOCl in a regenerative endodontic procedure.

The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update

“…In regenerative endodontics, Hristov et al suggested that 10% citric acid can be used in combination with 1.5% NaOCl, since there is no statistically significant difference between the effect of 10% citric acid and 17% EDTA on the vitality of SCAPs [35]. Moreover, Chae et al found that 10% citric acid is efficient for releasing TGF-β1 in vitro with more biocompatibility than EDTA [36].…”

Efficacy of disinfection procedures performed prior to regenerative endodontic therapy: An integrative review

“…Furthermore, it was possible to observe that 100% efficacy of disinfection was attained only after final irrigation with 17% EDTA [32]. Although EDTA has limited antimicrobial action, it has the capacity to remove the inorganic layer from the root canal walls by means of its chelating effect [44][45][46]. Therefore, it interferes in the adhesion, mass, viscosity and formation of biofilm on the intracanal dentinal surface [44][45][46].…”

“…Although EDTA has limited antimicrobial action, it has the capacity to remove the inorganic layer from the root canal walls by means of its chelating effect [44][45][46]. Therefore, it interferes in the adhesion, mass, viscosity and formation of biofilm on the intracanal dentinal surface [44][45][46]. Moreover, it is valid to emphasise that the use of EDTA exposes part of the organic portion of the dentinal matrix and its morphogenic proteins (growth factors) [47].…”

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review

“…After the first screening (Step 1), 55 articles were selected and submitted to a full-text review (Step 2). Then, 19 studies were excluded, in which 13 (Arslan et al, 2014;Bosaid et al, 2020;Buldur et al, 2019;Ivica et al, 2020;Kandemir Demirci et al, 2020;Nagata et al, 2014;Nerness et al, 2016;Saghiri et al, 2016;Shawli et al, 2020;Ustun et al, 2018;Widbiller et al, 2018;Yassen et al, 2014Yassen et al, , 2015 were outside of the proposed theme, and 6 had no control group (Ferreira et al, 2020;Galler et al, 2011;Graham et al, 2006;Hristov et al, 2018;Tomson et al, 2007;Trevino et al, 2011; Figure 1). A total of 36 studies were included in the qualitative analysis and are presented in Tables 1, 2 and 3. The assessed Cohen's kappa coefficient for interinvestigator agreement during the studies' selection was 0.843 for PubMed, 0.970 for Scopus, 1.000 for the Cochrane Library and OpenGrey, 0.925 for the Web of Science and 0.876 for the Embase.…”