Abstract
Background: Smear layer removal and collagen fiber exposure may improve regeneration which can be accomplished by use of root biomodifiers. These enhance the degree of connective tissue attachment to denuded roots. The objective of this in vitro study was to evaluate and compare novel root canal irrigant and other root biomodifiers for smear layer removal on periodontally involved human teeth.
 Materials and Methods: Forty human teeth were collected and stored in saline. After scaling and root planing, two samples were obtained from each tooth. A total of 100 dentin blocks were randomly divided into four groups: Mixture of tetracycline, acid and detergent (MTAD), tetracycline hydrochloride (TTC HCl), citric acid (CA), and ethylenediaminetetraacetic acid (EDTA). The agents were applied for 3 min by active burnishing. Immediately following treatment, the specimens were rinsed, dehydrated, fixed and prepared for scanning electron microscope and were examined at × 3500 magnification. Sampaio’s index was evaluated by the previously trained blind examiner using photomicrographs. Groups were compared using analysis of variance followed by Tukey’s post?hoc test.
 Results: Mixture of tetracycline, acid, and detergent is most efficacious in removing the smear layer and showed statistically significant dentinal tubules opening, followed by EDTA, TTC HCl, and CA.
 Conclusion: Mixture of tetracycline, acid and detergent and conventional root biomodifiers used in the study alters the dentin surface by smear layer removal and exposure of dentinal tubules. Hence, MTAD as a root biomodifier may have a significant role in periodontal regeneration.
 Key words: Citric acid, ethylenediaminetetraacetic acid, MTAD, root biomodifier, scanning electron microscope study, tetracycline hydrochloride
Highlights
Regeneration is defined as reproduction or reconstitution of a lost or injured part, in contrast to repair, which describes healing of a wound by tissue that does not fully restore the architecture or the function of the part
Root conditioning has been recommended as an adjunct to mechanical root surface debridement to remove smear layer and root associated endotoxins and to expose collagen fibres on the dentin surface
Smear layer is an amorphous, granulated, and irregular layer covering the root surface when observed under scanning electron microscope (SEM).It is constituted of inorganic, and organic material and bacterial products resulting in hyper mineralization of root surface which may function as a physical barrier to the growth of a connective tissue attachment to the root surface.[1]
Summary
Regeneration is defined as reproduction or reconstitution of a lost or injured part, in contrast to repair, which describes healing of a wound by tissue that does not fully restore the architecture or the function of the part. Smear layer removal and collagen fiber exposure may improve regeneration which can be accomplished by use of root biomodifiers. These enhance the degree of connective tissue attachment to denuded roots. The objective of this in vitro study was to evaluate and compare novel root canal irrigant and other root biomodifiers for smear layer removal on periodontally involved human teeth. Conclusion: Mixture of tetracycline, acid and detergent and conventional root biomodifiers used in the study alters the dentin surface by smear layer removal and exposure of dentinal tubules.
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