Comparison among four commonly used demineralizing agents for root conditioning: a scanning electron microscopy

Abstract

Dental roots that have been exposed to the oral cavity and periodontal pocket environment present superficial changes, which can prevent connective tissue reattachment. Demineralizing agents have been used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots.ObjectiveThis study compared four commonly used demineralizing agents for their capacity of removing smear layer and opening dentin tubules. MethodsFifty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: 1) CA: demineralization with citric acid for 3 min; 2) TC-HCl: demineralization with tetracycline-HCl for 3 min; 3) EDTA: demineralization with EDTA for 3 min; 4) PA: demineralization with 37% phosphoric acid for 3 min; 5)Control: rubbing of saline solution for 3 min. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules. ResultsSmear layer was present in 100% of the specimens from the groups PA and control; in 80% from EDTA group; in 33.3% from TC-HCl group and 0% from CA group. The mean numbers of exposed dentin tubules in a standardized area were: TC-HCl=43.8±25.2; CA=39.3±37; PA=12.1±16.3; EDTA=4.4±7.5 and Control=2.3±5.7. The comparison showed significant differences between the following pairs of groups: TC-HCl and Control; TC-HCl and EDTA; CA and Control; and CA and EDTA. The mean percentages of area occupied by exposed dentin tubules were: CA=0.12±0.17%; TC-HCl=0.08±0.06%; PA=0.03±0.05%; EDTA=0.01±0.01% and Control=0±0%. The CA group differed significantly from the others except for the TC-HCl group. ConclusionThere was a decreasing ability for smear layer removal and dentin tubule widening as follows: AC>TC-HCl>PA>EDTA. This information can be of value as an extra parameter for choosing one of them for root conditioning.

Cambios histomorfométricos en dentina al utilizar biomodificadores radiculares. Revisión sistemática / Histomorphometric Changes in Root Dentine after using Biomodifiers. A Systematic Review

“…Concentraciones del EDTA que oscilan entre el 1 % y el 50 % se han puesto a prueba en diferentes estudios. Igualmente, desde 1978 ya se indicaba que la irrigación con ácido cítrico al 50 % era eficaz en la eliminación de esta capa (2, 15,16,18). En el 2016, Wayman y colaboradores (2) comprobaron que el uso de NaOCl al 2,5 % y ácido cítrico al 10 % fue eficaz para eliminar la capa de barrillo.…”

“…Además, el ácido cítrico al 1 % produce ensanchamiento de los túbulos dentinales y elimina el barro dentinario (16). Al comparar EDTA y MTAD, en el estudio de Mohammadzadeh y colaboradores (14) se encontró que el MTAD fue más eficaz que el EDTA en la eliminación de la capa de barro dentinal.…”

“…Amaral y colaboradores (16), en 2011, publicaron una investigación sobre la eficacia y la capacidad de remoción de los tres biomodificadores en diferentes concentraciones: EDTA, ácido cítrico y tetraciclina. El EDTA al 24 % y el ácido cítrico al 25 % produjeron hiperdesmineralización y eliminación del barro dentinal, en tanto que el ácido cítrico al 1 % mostró ensanchamiento de los túbulos dentinarios con eliminación del barro dentinario.…”

A new calcium silicate-based material (Biodentine) for filling radicular perforation in an endodontic-periodontal lesion: A case report

“…[22] Although the papilla base incision provides better soft tissue preservation in the early postoperative period, the intrasulcular flap option was due to the impossible mensuration of alveolar bone loss at the site next to the root perforation. [12,[23][24][25] Therefore, the use of Biodentine as root perforation filling material is an alternative for the tooth function preservation, even in situations with simultaneous periodontal involvement, presenting satisfactory radiographic and clinical prognosis.…”

Efeito da desmineralização óssea sobre parâmetros de superfície e sobre o comportamento de pré-osteoblastos em cultura: estudo em microscopia eletrônica de varredura e confocal

“…A mesma camada de reprecipitação já havia antes sido observada por Amaral et al (2011) sobre superfícies de dentina condicionadas com ácido fosfórico a 37 % durante 3 minutos, a qual foi atribuída a uma provável precipitação de sais de fosfato de cálcio decorrente da saturação gradativa do ácido durante esse longo tempo de desmineralização.…”