Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning

Rodrigo Cavassim,Ricardo Samih Georges Abi Rached,José Eduardo Cezar Sampaio,Fábio Renato Manzolli Leite,Daniela Leal Zandim,Andrea Abi Rached Dantas

doi:10.1590/s1678-77572012000300014

Rodrigo Cavassim, Ricardo Samih Georges Abi Rached + Show 4 more

Open Access

https://doi.org/10.1590/s1678-77572012000300014

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Abstract

ObjectiveThe aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning. Material and MethodsA total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained. ResultsBrushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples. ConclusionDespite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning.

Highlights

Cementum is a mineralized tissue with primary function to insert the ligament fibers on the root surface and releasing oclusal forces to the surrounding alveolar bone
The most important event in the reattachment of the connective tissue is related to the adhesion of blood elements to the collagen present at the root surface, which retards the apical migration of the sulcular epithelium into the pocket[13,26]
As citric acid presented better results than ethylenediaminetetraacetic acid (EDTA) for clot stabilization[18] and as citric acid combined with platelet-derived growth factor-BB showed better results than EDTA and tetracycline hydrochloride on attachment of periodontal ligament cells on root surfaces[2], we proposed to test if a lower concentration of citric acid applied by a shorter time is capable of removing smear layer and exposing collagen fiber

Summary

Introduction

Cementum is a mineralized tissue with primary function to insert the ligament fibers on the root surface and releasing oclusal forces to the surrounding alveolar bone. It has been suggested that endotoxin present in the cement could impair periodontal healing and should be removed to promote a more biologically acceptable surface than the one obtained only after scaling and root planning[7]. The most important event in the reattachment of the connective tissue is related to the adhesion of blood elements to the collagen present at the root surface, which retards the apical migration of the sulcular epithelium into the pocket[13,26]. Ephitelial downgrowth is exacerbated by the strong adhesion of bacterial products and endotoxins, especially originated from Gram negative bacteria. These bacterial compounds have affinity to mineral structures such as the tooth, promoting a constant aggression on the periodontal tissue, causing loss of tissue support until the loss of the tooth.

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