Root Conditioning Agents Research Articles

Root surface biomodification in periodontal therapy: Biological rationale and clinical applications.

Regenerative periodontal therapy aims to form new cementum, periodontal ligament, and alveolar bone, all sealed by gingival tissue. The root surface acts as the wound margin during this regeneration process. Root surface biomodification (root conditioning/root decontamination), therefore, seems instrumental in promoting surface decontamination and enhancing tissue attachment by removing the smear layer, exposing collagen fibrils, and facilitating blood clot formation and stabilization. This review attempted to provide an all-encompassing, evidence-based assessment of the role of root surface biomodification in regenerative periodontal therapy, particularly in intrabony defects, furcation defects, and root coverage procedures. The reviewed evidence suggested that root conditioning agents, whether used independently or in conjunction with bone graft materials, biological agents, membranes, or connective tissue grafts, do not offer any clinical advantage regarding clinical attachment gain. Thus, integrating chemical methods with the mechanical root instrumentation process does not necessarily contribute to superior clinical outcomes.

Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study.

The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth. The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed. The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third. On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent. Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

Fibroblast Viability Through Mechanical and Chemical Root Surface Modifications in Periodontal Healing: An In Vitro Comparative Study.

The wound-healing process incorporates a spectrum of periodontal therapeutic interventions that strive to restore the health and function of the periodontium. Fibroblasts play pivotal roles in tissue repair and regeneration. Extensive research has been focused on mechanical and chemical root surface modifications to enhance fibroblast adhesion, which is crucial for successful wound healing. This study aimed to assess the combined efficacy of mechanical and chemical root surface modifications in promoting fibroblast viability to root surfaces affected by periodontitis in comparison to chemical modifications alone. Root samples were collected from healthy individuals and those with advanced periodontitis. The specimens were prepared, and the experimental groups were categorized based on the type of surface modification with mechanical and/or chemical materials, including hyaluronic acid (HA), ethylenediaminetetraacetic acid(EDTA), enamel matrix derivatives (EMD), and EDTA/EMD. Fibroblasts were seeded onto previously treated root samples. Cell adhesion was assessed using a viability assay. Fibroblast viability was significantly higher on root surfaces treated with chemical agents than on those treated with mechanical and chemical modifications. Long-duration EDTA and short-duration EMD treatments were significantly effective in enhancing cell viability. EDTA/EMD surface treatments resulted in significantly higher cell viability in all groups compared to the periodontitis root surfaces. EDTA, EMD, and their combined application can potentially ameliorate periodontitis-induced surface structural impairments. Mechanical surface debridement can significantly affect the effectiveness of EDTA and EMD root conditioning agents.

A COMPARATIVE EVALUATION OF EFFICACY OF TETRACYCLINE HCL, EDTA & HYALURONIC ACID GEL AS ROOT BIOMODIFICATION AGENTS. -AN IN-VITRO SEM STUDY

Background: Scaling and Root Planing alone leaves a smear layer on the root surface which may interfere with reattachment of cells to root surface during regenerative periodontal therapy. Root bio-modification has been advocated for smear layer removal which may enhance regeneration. Objective: To evaluate and compare effect of 17% Ethylenediamine Tetra Acetic acid (EDTA), Tetracycline HCL and 1% Hyaluronic Acid gel as root conditioning agents on periodontally involved root surfaces of extracted teeth using a scanning electron microscope (SEM). Materials And Method: Freshly extracted 10 single rooted human teeth were sectioned into 30 samples and were segregated into 3 groups: 1. Group â… - tetracycline HCl (pH 1.6), 2. Group â…¡ – EDTA 17% (pH 7.3), 3. Group III – HA gel 2%. The samples were treated with respective agents and were viewed under 4000X magnification using a SEM. The specimens were assessed for the Residual smear layer score, Number of patent tubules, Total number of dentinal tubules, Proportion of patent to total number of dentinal tubules and Mean Diameter of dentinal tubules. Results: Group I and Group II were significantly better than Group III for all the measured parameters. However, the number of patent dentinal tubules, total number of dentinal tubules and mean diameter of dentinal tubules were significantly superior in Group II as compared to Group I. Conclusion: Tetracycline HCL was found to be the most effective root conditioning agent amongst the 3 groups, for the assessed parameters.

A Scanning Electron Microscope Evaluation of the Adhesion of Fibrin Clot to the Periodontally Compromised Teeth after Exposed to Different Root-conditioning Agents: An In Vitro Study.

The aim of this research was to assess the binding of fibrin clot to the teeth affected by periodontal disease following exposure to different root conditioning agents. A total of 60 human teeth with a solitary root that were subjected to extraction following severe periodontal disease were used as study samples in this research. Two analogous grooves were prepared on the proximal radicular surface of every sample employing a diamond-tapered fissure bur using an aerator handpiece beneath abundant irrigation. Every sample was assigned to one of the following groups: • Group I: Tetracycline hydrochloride solution • Group II: Ethylenediaminetetraacetic acid (EDTA) gel • Group III: Biopure MTAD™ Subsequent to conditioning, the samples were rinsed for 3 minutes with phosphate-buffered saline (PBS) and permitted to air-dry for 20 minutes. A drop of fresh human whole blood procured from a hale and hearty volunteer was coated onto the dentin blocks in all three groups. A scanning electron microscope under 5000× magnification at 15 kV was used to examine the samples. Kruskal-Wallis test and Mann-Whitney U test were performed to procure the inter- and intragroup assessments Results: The greatest fibrin clot union was noted in the EDTA gel group at 2.86 ± 0.14 in pursuit by Biopure MTAD™ group at 2.39 ± 0.08 as well as tetracycline hydrochloride solution group at 1.82 ± 0.10. A statistically significant difference was noted between the investigational groups (p < 0.001). This research arrived at a conclusion that the dentinal surfaces subjected to conditioning with EDTA gel group as well as coated with human whole blood resulted in appreciably superior fibrin clot bonding to dentin vs Biopure MTAD™ as well as the tetracycline hydrochloride solution group. Connective tissue attachment subsequent to surgical procedures causing the adhesion of a fibrin clot to the radicular surface as a result of initial wound healing processes is directly related to periodontal regeneration. It depends on biocompatibility for the fibrin clot and the periodontal pathosis-affected radicular surface to stick together, which can be procured with the aid of a variety of root conditioning measures in course of periodontal treatment.

Comparative Evaluation of Fibrin Network Formation after Root Conditioning using Erbium, Chromium-Doped Yttrium Scandium Gallium and Garnet Laser, Ethylene-Diamine-Tetra-Acetic Acid, and Tetracycline on Dentin: A Scanning Electron Microscopic Study.

Regeneration of periodontal tissues depend on the adhesion and development of fibrin clots to the root surface. Demineralization of the root surface ensures removal of smear layer uncovering dentin tubules and collagen matrix. Root conditioning agents were introduced to remove the smear layer and enhance the adhesion of blood components. The aim of the study was to determine the effect of erbium, chromium-doped yttrium, scandium, gallium and garnet (Er, Cr: YSGG) laser on smear layer removal (SLR) and fibrin network formation when compared to tetracycline, and ethylene-diamine-tetra-acetic acid (EDTA) for periodontal regeneration. The study was conducted at Amrita school of dentistry and the study design involves in vitro comparative study. Forty dentinal sections were prepared from freshly extracted teeth that were periodontally affected. The samples were divided into four groups: Scaling and root planing (SRP), tetracycline, EDTA, and Er, Cr: YSGG laser. The samples were assessed using a scanning electron microscope and photomicrographs were taken and analyzed for removal of smear layer, blood component adhesion (BCA), and fibrin network formation. Analysis of variance test and Kruskal-Wallis test with P < 0.05 considered to be statistically significant. There was a significant difference between Er, Cr: YSGG laser, tetracycline hydrochloride, and EDTA categories when compared with SRP categories. There was no significant difference between Er, Cr: YSGG laser, tetracycline, and EDTA according to SLR scoring and BCA scoring. It can be concluded that Er, Cr: YSGG laser-treated samples presented complete elimination of smear layer, formation of fibrin network, and BCA along with desensitizing effect for a better reduction in dentin hypersensitivity.

Comparative study of effects of Triphala and Tetracycline gel on root conditioning

Background: Remnants of dental calculus, contaminated cementum, and subgingival plaque act as a physical barrier between periodontal tissues and root surfaces, which inhibits the formation of new attachment. Treatment of denuded root surface using various chemicals and antimicrobial agents with scaling and root planing helps in active periodontal regeneration. Aim: The aim of this study was to evaluate and compare the demineralizing effects of Triphala and 1% Tetracycline HCl gel on root conditioning using a Scanning Electron Microscope. Settings and design: A total of 50 hemi-sectioned root samples were obtained from 25 extracted, and root planed samples. These were divided into two groups, Group 1: 1% Tetracycline HCl gel and Group 2: Triphala. Materials and method: The two root conditioning agents were applied with cotton pellets on the sectioned roots. The samples were then examined under the scanning electron microscope. Statistical analysis used: Data obtained was compiled on a MS Office Excel Sheet. Inter group comparison was done using Mann Whitney U test. Comparison of frequencies of categories of variables with groups was done using Chi Square Test. Results: The root conditioning agents used in this study were found to be equally effective in removing the smear layer. &#x0D;

Effect of citric acid on periodontally involved root surface after mechanical debridement as root conditioning agent– A SEM study

Periodontitis-affected root surfaces are hypermineralized and contaminated with cytotoxic and other biologically active substances. Chemical root conditioner are playing important role in decontaminating root surface as well as enlarge dentinal tubules into which healing connective tissue can enter. The various root conditioning agents used are citric acid, tetracycline, doxycycline, phosphoric acid, ethylene diamine tetra acetic acid etc. The present study was aimed to compare the efficacy of citric acid as root conditioner with scaling and root planing scaling and root planing alone by observing the change in root surface under SEM. For the present study 40 samples were obtained from 20 single rooted anterior teeth indicated for extraction having hopeless prognosis. The obtained samples are scaled and root planed properly then tooth root are divided in two parts and. One part of each root sample were treated with saline and other with citric acid. Scanning photomicrographs of the root surfaces were taken at 3000X. Photomicrography analysis of SEM samples revealed that removal of smear layer and opening of dentinal tubules was more in samples treated by citric acid with SRP than the SRP alone.

Effect of root conditioning agents hyaluronic acid, EDTA and chlorhexidine on the attachment of human gingival fibroblasts to healthy root surface

BackgroundThe gold standard treatment of periodontal diseases is scaling and root planing (SRP). Different adjunctive root conditioning agents such as hyaluronic acid (HA), ethylenediaminetetraacetic acid(EDTA), and chlorhexidine (CHX) have been used with SRP to improve the smear layer removal and the healing of periodontal tissues. The aim of this study was to compare the effect of manual scaling with or without HA, EDTA, or CHX root conditioning on the attachment and viability of human gingival fibroblasts (GF). MethodsFifteen healthy single rooted teeth were co llected and divided randomly into a scaled (n = 12) and non-scaled control group (n = 3). The scaled roots were subdivided equally into four groups; the first group did not receive any chemical treatment, while the remaining groups were treated with the conditioning agents HA or 17% EDTA or 0.2% CHX gel. Gingival fibroblasts were seeded on the top of each root and incubated for 48 h to allow attachment to the roots. The viability of fibroblasts attached to the root surface was assessed using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay. ResultsThe cell viability was the highest in the scaled only group (p = 0.0001) while the lowest was in the scaled with EDTA group (p > 0.05). The scaled group was the highest followed by the HA and CHX groups, while the EDTA group showed the lowest mean value. ConclusionSRP remains the superior method for regaining cell attachment to the root surface, leading to better periodontal health, and adjunctive therapies did not enhance the GF attachment to the root surface beyond the effect of SRP. Further studies are needed to investigate the effect of root conditioning agents on periodontally diseased teeth in vitro and compare them in vivo.

Impact of Different Root Conditioning Agents on Periodontally Affected Root Surface: A Scanning Electron Microscope Study

The present study aimed to evaluate the effect of various root-conditioning agents on root surfaces that are periodontally affected. A total of 90 human teeth having single root that were extracted because of chronic periodontitis were chosen. The extracted teeth were cleaned of saliva and blood using a soft-bristled brush and distilled water. The investigational groups were categorized into group I-doxycycline HCl, group II-ethylenediaminetetraacetic acid, and group III-tetracycline HCl. Samples were readied for histological study by scanning electron microscope (SEM). The SEM was used to assess the effectiveness of smear layer removal, amount of patent dentinal tubules out of the totality of dentinal tubules present, and the appreciation of collagen fiber-like structures inside the intertubular area. The highest efficacy for smear layer removal was seen for group III-tetracycline HCl samples (1.80 ± 0.148) followed next by group II-EDTA (1.36 ± 0.230), and group I-doxycycline HCl (1.30 ± 0.283). The highest number of patent dentinal tubules were seen in group III-tetracycline HCl (44.50 ± 0.18) followed immediately by group II-EDTA (38.10 ± 0.42), and group I-doxycycline HCl (34.90 ± 0.23). The highest number of appreciation of collagen-like structures was recorded in group III-tetracycline HCl (2.64 ± 0.04) followed next by group I-doxycycline HCl (1.88 ± 0.10) and group II-EDTA (1.76 ± 0.28). The present in vitro study concludes tetracycline HCl root-conditioning agent to be significantly more efficient in smear layer removal, exposing collagen fibers and amount of patent dentinal tubules than doxycycline HCl and EDTA. The modification of the root surface of human teeth with the use of root conditioning agents leads to enhanced attachment by connective tissue resulting in improved reconstructive periodontal treatment goals.

Efficacy of citric acid on periodontal disease.

Background: The single most common primary etiological factor in periodontal disease is a bacterial plaque. Periodontitis affected root surface undergo physical and chemical damage that makes them a poor base for attachment and proliferation of fibroblast. Citric acid has a bacteriostatic effect and can cause root biomodification to remove the smear layer and expose root collagen fiber. Method: Forty swabs were taken from patients having periodontitis attended Al-Furat General hospital/ Dentistry department from August to November 2018. Each swab was taken around the tooth before and after tooth extraction. These swabs were cultured on blood and MacConkey agar plates. Different types of bacteria were isolated in the area of periodontitis. In addition, different concentrations of citric acid solution (0.3, 0.4, 0.5, 0.75 and 1 g/ml) were prepared and added to bacterial growth, and then the minimum inhibition zone was determined. Results: Four types of bacteria were isolated from the patient in the area of periodontitis: Streptococcus mutans, Escherichia coli, Staphylococcus aureus and anaerobic bacteria. No bacteria were isolated in the area after tooth extraction. Concentrations of the citric acid that showed the zone of inhibition on bacterial growth were 0.4, 0.5, 0.75, and 1 g/ml. Conclusion: Streptococcus mutans appeared at a high level in patients with periodontitis. The concentration of citric acid (0.4, 0.5, 0.75, 1 g/ml) was proved to inhibit the growth of bacteria in the smear area of diseased teeth; therefore, could be suggested to be used as a root conditioning agent.

An in vitro study to evaluate the demineralizing effect of maleic acid and cell attachment on cemental surface

Introduction: Root biomodifying agents are adjuncts to periodontal regeneration. Aim: This study evaluates the demineralization effect of a chelating agent, maleic acid (MA) when used as a root biomodifier on the cemental surface. Materials and Methods: Thirty single-rooted anterior teeth were selected for this study. The teeth were decoronated and split longitudinally to form sixty radicular halves. They were randomly assigned to four groups of 15 fragments each according to the demineralizing agents used and treatment time of 1 and 3 min. Group 1 treated with 50% citric acid (CA) solution at pH 1, Group 2 treated with 17% ethylenediaminetetraacetic acid (EDTA) solution at pH 7. Group 3 treated with 7% MA at pH 1.3 and Group 4 treated with saline. The specimens were then prepared to view under scanning electron microscopy (SEM). To study the adherence of cells on the root surface, human periodontal ligament cells were cultured and were placed in plates containing root halves, and cell adherence was viewed using SEM. The data were statistically analyzed by Pearson's Chi-square test (χ2) to evaluate the effect of the each test agent. A significance level was set at P Results: All the three test agents were successful in eliminating smear layer at both time intervals. Intergroup comparison at both time intervals demonstrated, MA to have a better smear layer removal ability than CA and EDTA. Conclusion: This particular study provided preliminary evidence on the demineralizing effect of 7% MA when used as a root conditioning agent.

The effect of EDTA root conditioning on periodontal surgery outcome: A meta-analysis.

Chemical root conditioning is a procedure to remove the smear layer, which influences periodontal healing. The purpose of this study was to determine the effect of using ethylenediaminetetraacetic acid (EDTA) as a root conditioning agent on periodontal surgery outcomes. The databases searched from their earliest records to February 2015 included Pubmed, Embase, the Cochrane library, and ISI Web of Science. Quality assessment of the methodologies of all the included studies and data was performed with Review Manager software. Probing depth (PD) and clinical attachment level (CAL) were analyzed using inverse variance. The evaluation of the three articles that met the inclusion criteria showed that the differences between the EDTA groups and the control groups were not statistically significant (6 months PD: mean difference [MD] = -0.15 mm, Z = 1.09, P = .27; CAL: MD = 0.15 mm, Z = 0.89, P = .37). EDTA was not able to significantly improve the PD and CAL. A positive outcome of using EDTA as a root conditioning agent was not evident. Thus, future research should focus on EDTA in combination with other drugs or a better alternative drug to EDTA.

Endodontic irrigant as a root conditioning agent: An in vitro scanning electron microscopic study evaluating the ability of MTAD to remove smear layer from periodontally affected root surfaces

BackgroundInstrumentation of the root surface, results in formation of a smear layer of organic and mineralized debris which serves as a physical barrier, inhibiting new connective tissue attachment to the root surface. The present study advocates the use of an endodontic irrigant MTAD (mixture of tetracycline, citric acid and detergent) as a root conditioning agent.The main aim of the study was to compare the root conditioning ability of an endodontic irrigant MTAD (mixture of tetracycline, acid and detergent) with 17% EDTA (ethylenediaminetetraacetic acid). Materials and methodsSixty freshly extracted human single rooted teeth with confirmed periodontal involvement were selected for this study and decoronated. The apical third of each root was removed and the remaining root was sectioned longitudinally to produce a 6mm to 8mm long tooth section. The root surface was then instrumented by hand using a sharp Gracey 1–2 periodontal curette with 6–8 strokes per area to achieve a smooth glass-like surface. A total of 60 specimens were prepared which were randomly divided into three groups (n=20). Each group received the root conditioning treatments as follows:Group A: Control Group: only saline rinsing.Group B: root conditioning treatment with 17% EDTA for 5min.Group C: root conditioning treatment with BioPure MTAD for 5min.All specimens were prepared for SEM and scored according to the presence of smear layer. Results and conclusionsMTAD removed the smear layer successfully from the root surfaces. The mean smear score for samples treated with Biopure MTAD was lower than those treated with EDTA, (p=0.04). MTAD can be used as a root conditioning agent with efficient smear layer removal ability and known antimicrobial and anticollagenase activity.

Root conditioning in periodontology - Revisited.

Objective:Root surfaces of periodontitis-affected teeth are hypermineralized and contaminated with cytotoxic and other biologically active substances. To achieve complete decontamination of the tooth surfaces, various methods including root conditioning following scaling and root planning are present. The main objective of this article is to throw light on the different root conditioning agents used and the goals accomplished by root conditioning in the field of periodontology.Materials and Methods:20 human maxillary anterior teeth indicated for extraction due to chronic periodontitis were collected and root planned. The teeth were sectioned and specimens were divided into two groups — Group I and II. Group I dentin specimens were treated with EDTA and group II specimens were treated with tetracycline HCl solution at concentration of 10% by active burnishing technique for 3 minutes. The root surface samples were then examined by scanning electron microscope (SEM).Results:The results of the study showed that EDTA and tetracycline HCl were equally effective in removing the smear layer. It was observed that the total and patent dentinal tubules were more in number in teeth treated with tetracycline as compared to EDTA group. However, EDTA was found to be much more effective as root conditioning agent because it enlarged the diameter of dentinal tubules more than that of tetracycline HCl.Conclusion:Results of in-vitro study showed that both the agents are good root conditioning agents if applied in addition to periodontal therapy. However, further studies are required to establish the in-vivo importance of EDTA and tetracycline HCL as root conditioners.

Comparative evaluation between 20% EDTA-S &amp; ornidazole gel as root biomodification agent asem study

Background: It should be well understood that the root surface receptiveness to clot formation & initial periodontal wound healing decides the nature of the connective tissue attachments. This study was carried out to assess the initial wound healing events after the application of 20% EDTA-S & Ornidazole gel and assess the formation of fibrin network following blood. Material& Method: Thirty multi-rooted teeth indicated for extraction due to periodontal disease were selected & divided into group A (20%EDTA-S), group B (Ornidazole gel (1% W/V)), group C (7.4pH phosphate buffer saline), group D (20%EDTA-S+ Blood), group E (Ornidazole gel+ Blood), group F (7.4pH) phosphate buffer saline+ Blood). Following root planning, the root surface was cut using diamond disc under copious irrigation. Samples from each group were subjected for root conditioning agent application by passive method. Specimens were then subjected to scanning electron microscopic study. Smear layers removal were analysed by Sampaia et al index. Results: 20%EDTA-S removed the smear layer better than ornidazole gel. Fibrin network formation was seen with specimen treated with 20% EDTA-S + Blood. Conclusion: Use of 20% EDTA-S as root conditioning agent has a beneficial effect on initial wound healing events, which are important for periodontal regenerative therapies.

Effect of citric acid, tetracycline, and doxycycline on instrumented periodontally involved root surfaces: A SEM study.

Background:A surface smear layer consisting of organic and inorganic material is formed on the root surface following mechanical instrumentation and may inhibit the formation of new connective tissue attachment to the root surface. Modification of the tooth surface by root conditioning has resulted in improved connective tissue attachment and has advanced the goal of reconstructive periodontal treatment.Aim:The aim of this study was to compare the effects of citric acid, tetracycline, and doxycycline on the instrumented periodontally involved root surfaces in vitro using a scanning electron microscope.Settings and Design:A total of 45 dentin samples obtained from 15 extracted, scaled, and root planed teeth were divided into three groups.Materials and Methods:The root conditioning agents were applied with cotton pellets using the Passive burnishing technique for 5 minutes. The samples were then examined by the scanning electron microscope.Statistical Analysis Used:The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 15.0 for Windows). For all quantitative variables means and standard deviations were calculated and compared. For more than two groups ANOVA was applied. For multiple comparisons post hoc tests with Bonferroni correction was used.Results:Upon statistical analysis the root conditioning agents used in this study were found to be effective in removing the smear layer, uncovering and widening the dentin tubules and unmasking the dentin collagen matrix.Conclusion:Tetracycline HCl was found to be the best root conditioner among the three agents used.

Comparison of the efficacy of ethylenediaminetetraacetic acid and tetracycline hydrochloride as root conditioning agents: An in vitro study

Objective: Root surfaces of periodontitis-affected teeth are hypermineralized and contaminated with cytotoxic and other biologically active substances. Various root conditioning agents have been recommended as an adjunct to mechanical root surface debridement to expose dentin collagen and cementum bound proteins. The aim of the present in vitro study was to compare the efficacy of ethylenediaminetetraacetic acid (EDTA) and tetracycline hydrochloride (HCl) as root conditioning agents on planed root surfaces. Materials and Methods: A total of 20 human maxillary anterior teeth indicated for extraction due to chronic periodontitis were collected and root planed. The teeth were sectioned and specimens were divided into two groups - Group I and II. Group I dentin specimens were treated with EDTA and Group II specimens were treated with tetracycline HCl solution at a concentration of 10% by active burnishing technique for 3 min. The root surface samples were then examined by scanning electron microscope. Results: The results of this study showed that EDTA and tetracycline HCl were equally effective in removing the smear layer. It was observed that the total and patent dentinal tubules were more in number in teeth treated with tetracycline when compared to EDTA group. However, EDTA was found to be much more effective as root conditioning agent because it enlarged the diameter of dentinal tubules more than that of tetracycline HCl. Conclusion: The results of in vitro study showed that both the agents are good root conditioning agents if applied in addition to periodontal therapy. However, further studies are required to establish the in vivo importance of EDTA and tetracycline HCL as root conditioners.

Comparative evaluation of fibrin clot adhesion to root modified with citric acid, tetracycline hydrochloride, minocycline, and ethylenediaminetetraacetic acid: An in vitro study

Background: The objective of periodontal therapy is to convert periodontitis affected root surface into a surface which is biologically compatible for connective tissue adherence and attachment. The present study was to compare the efficacy of citric acid, ethylenediaminetetraacetic acid (EDTA), tetracycline hydrochloride (TTC-HCl), and minocycline as root conditioning agents in terms of fibrin clot adhesion to the dentinal surfaces under Scanning Electron Microscope (SEM). Materials and Methods: A total of 40 specimens were obtained from fresh extracted human teeth which were divided into four groups comprising 10 specimens in each group. The root conditioning agents used were: citric acid, EDTA, TTC-HCl, and minocycline. The root surfaces were planed and specimen blocks (7 × 5 mm) were obtained. They were subjected to various conditioning agents and then exposed to fresh blood which was allowed to clot. These specimens were then rinsed and subjected to SEM analysis. Results: The results showed that citric acid conditioned root specimens presented with the best fibrin clot adhesion than any other group. Conclusion: It was concluded that root conditioning agents have a significant role in periodontal wound healing and future new attachment.

EDTA-S: A novel root conditioning agent

Background:To evaluate the efficacy of 15% ethylenediaminetetraacetic acid (EDTA)-S (EDTA with soft soap) preparation for the removal of smear layer at human root surfaces.Materials and Methods:Twenty teeth indicated for extraction due to periodontal disease were sectioned using high speed cylindrical bur under copious irrigation. The root surfaces were instrumented with Gracey 7-8 curette (Hu-Friedy), 12 times to induce an “experimental smear layer”. Following root planning, the root surface was cut using diamond disc and separated from the crown. Samples were randomly distributed into five groups. One group was control, saline and test groups were EDTA 15% alone, by active and passive applications (groups 2 and 3), and EDTA 15%+soft soap, by active and passive applications (groups 4 and 5). Specimens were then subjected to scanning electron microscope study. Smear layer removal was evaluated according to Sampaio et al., index.Results:EDTA-S removed the smear layer better than plain EDTA and the control group, while active application of the root conditioning agent had significant difference than the passive application of the agent.Conclusion:EDTA-S has favorable benefits over EDTA alone, and active application is better in comparison with passive application of root conditioning agent.Clinical Relevance:Removal of smear layer has been considered as an important step in periodontal regenerative therapy. Scaling and root planning alone with saline irrigation does not remove the smear layer. EDTA is a commonly used root conditioning agent in periodontal therapy. The addition of a detergent to EDTA proved to remove smear layer more efficiently than EDTA alone.