Efecto Antimicrobiano del EDTA sobre la Infección Endodontica de Dientes Permanentes: Revision Sistemática

Abstract

Introduction: The objective of this study was to systematically review the evidence regarding the antimicrobial activity of EDTA when used as an irrigant during the disinfection of infected root canals. Methods: An electronic search was conducted in the PubMed, Sibila, SciELO, and LILACS databases (from 1990 onward), using free-text keywords and controlled vocabulary. Additional studies were identified through manual searches of specialized endodontic journals. The studies were selected by two reviewers according to predefined criteria. The included studies were critically evaluated, and the extracted data were organized in Excel tables. The electronic and manual searches yielded 1,114 titles, of which two clinical studies and 32 in vitro studies were selected. Results: Antimicrobial activity of EDTA was found in 19 of the 34 studies. Conclusion: EDTA exhibits antibacterial and antifungal activity by destabilizing cell membranes through the chelation of divalent cations (Ca²⁺, Mg²⁺), and it also has an antibiofilm effect by reducing exopolysaccharide production. During the irrigation of infected root canals, EDTA not only removes the smear layer but also enhances the antimicrobial effect of other root canal irrigation solutions, such as NaOCl. No significant differences were found among the different variables. The level of evidence was low and was primarily based on in vitro studies. Further clinical studies are recommended to better reflect the conditions of the actual clinical procedure.