Comparison of Root Fractures Associated with Three Different Endodontic Irrigants of Varied pH: An In-vitro Study

Introduction: Vertical root fractures present significant challenges, and most often, the affected tooth is indicated for extraction. Root canal irrigants are employed synergistically alongside filing instruments during root canal therapy. The acidic nature of such irrigants is responsible for the removal of dentin during the process of biomechanical preparation. This subsequently leads to weakening of the tooth structure, ultimately leading to the fracture of the tooth. Aim: To compare the incidence of incomplete root fractures after treatment with three different root canal irrigants- citric acid, Ethylenediaminetetraacetic acid (EDTA), Regulated Ethylenediaminetetraacetic Acid (R-EDTA at two different Potential of Hydrogen (pH) levels (5.5 and 10.5). Materials and Methods: This in-vitro research was undertaken at Manav Rachna Dental College, Faridabad, Haryana, India for a period of six months from July 2024 to December 2024. Total of 48 human mandibular lateral incisors were selected and split into six groups on the premise of application of endodontic irrigants- citric acid, EDTA, R-EDTA with a particular pH. The irrigants employed were 17% citric acid pH 10.5 (Group 1), 17% citric acid pH 5.5 (Group 2), 17% R-EDTA pH 10.5 (Group 3), 17% R-EDTA pH 5.5 (Group 4),17% EDTA pH 10.5 (Group 5) and 17% EDTA pH 5.5 (Group 6). The samples were then subjected to Oil Red O Stain and analysed under a microscope for fractures. The data obtained was subjected to a Chi-squared test. Results: While no significant statistical differences were found between treatment groups (p-value>0.05), a trend was observed where lower pH formulations demonstrated more fractures compared to higher pH formulations of the same irrigant. The group treated with 17% REDTA at pH 5.5 showed the highest number of tooth fractures. Conclusion: Lowering of pH might have a role in causation of incomplete root fractures. Further analysis is required to assess the impact of R-EDTA on the structural integrity of teeth.