Dimensional evaluation of blood clot gap distances within intrabony defects following grafting and EDTA root surface treatment—experimental study in dogs

Gamal, Ahmed; Abdel-Ghaffar, Khaled; Zouair, Mohamed Gomaa Attia; Salama, Mohamed Hanfi; Destawy, Mahmoud T. El

doi:10.1002/jper.17-0361

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…However, EDTA gel root surface etching claimed in many studies to improve graft availability, act as a non-space-occupying delivery vehicle, and improved significant drug substantivity to periodontally affected root surfaces without compromising regenerating tissues. [19][20][21][22][23] The main hypothesis behind this study is that using simvastatin within the defect could promote chemoattraction, osteoblastic differentiation, and increased collagen expression capacity of gingival cells with its associated gingival mesenchymal stem cells that was reported by the same group to be migrated through fibrin clot-occluded membrane perforations. 7,9,10 EDTA root surface etching with its known smear removal and selective demineralization effects 19 could improve SMV adsorption to the root surface improving its availability within the defect for more enhanced clinical effects.…”

Section: Introductionmentioning

confidence: 90%

“…Chemical root etching agents have been reported to induce no significant clinical benefit for the patient with respect to the reduction in probing depth (PD) or gain in clinical attachment level (CAL).However, EDTA gel root surface etching claimed in many studies to improve graft availability, act as a non‐space‐occupying delivery vehicle, and improved significant drug substantivity to periodontally affected root surfaces without compromising regenerating tissues …”

Section: Introductionmentioning

confidence: 99%

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Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study

Issa

Abdel-Ghaffar

Al-Shahat

et al. 2019

J of Periodontal Research

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Background Perforated barrier membranes (PBM) were suggested to enhance periodontal regeneration by allowing positive charity of wanted elements from the gingival tissue side. The present study was designed to evaluate clinically and biochemically the use of PBM combined with simvastatin (SMV) gel with and without an associated EDTA gel root surface etching as a suggested option that could improve SMV availability and clinical outcomes of PBM. Methods Forty patients having moderate‐to‐severe chronic periodontitis with 40 intrabony defects were randomly divided into four treatment groups (10 sites each). Patients in group 1 received 1.2% SMV gel and covering the defect with occlusive membrane (OM). Patients in group 2 received 1.2% SMV gel and covering the defect with PBM. Group 3 received 24% EDTA root surface etching, 1.2% SMV gel, and defect coverage with OM (eOM). Patients in group 4 were treated as in group 3 but the defect was covered with PBM (ePBM). Clinical parameters were recorded at baseline before surgical procedures and were reassessed at 6 and 9 months after therapy. The mean concentration of SMV in gingival crevicular fluid (GCF) was estimated by reverse‐phase high‐performance liquid chromatography at days 1, 7, 14, 21, and 30. Results At 6‐ and 9‐month observation periods, groups 3 and 4 showed a statistically significant improvement in PD reduction and CAL gain compared with groups 1 and 2. Group 4 showed a statistically significant more defect fill compared with groups 1, 2, and 3 (P ≤ .05). Group 2 showed statistically significant higher defect fill compared with group 1 and group 3 (P < .05). Bone density was significantly increased with no significant difference between the four groups at 6‐ and 9‐month observation periods. SMV‐GCF concentration in group 4 showed the highest mean concentration with no significant difference than that of group 3. Conclusion The use of perforated barrier membranes in association with SMV enhances the clinical hard tissue parameters compared with occlusive ones in treating intrabony periodontal defects. Moreover, EDTA root surface treatment could enhance SMV availability in the defect area.

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Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study

Issa

Abdel-Ghaffar

Al-Shahat

et al. 2019

J of Periodontal Research

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“…The idea behind the application of root modifiers was to favor attachment of the regenerated periodontal structures to the root surface. It was assumed that with the smear layer removal and collagen fiber exposure, EDTA might stabilize the connection between the fibrin of the blood clot and the root surface [ 31 , 32 ]. In an in vitro study by Kasaj et al [ 33 ], EDTA alone or in combination with EMD enhanced proliferation and density of fibroblasts.…”

Section: Resultsmentioning

confidence: 99%

Effect of Root Surface Biomodification on Multiple Recession Coverage with Modified Coronally Advanced Tunnel Technique and Subepithelial Connective Tissue Graft: A Retrospective Analysis

Górski

Szerszeń

2022

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To improve treatment efficacy of gingival recessions (GR), chemical preparation of the exposed root surface was advocated. The aim of this study was to compare the additional influence of root biomodifications with 24% ethylenediaminetetraacetic acid (EDTA) alone or with enamel matrix derivative (EMD) on the 12 month outcomes of modified coronally advanced tunnel (MCAT) with subepithelial connective tissue graft in the treatment of multiple GR. Average root coverage (ARC), complete root coverage (CRC), reduction in GR, reduction in recession width (RW), gain in clinical attachment level (CAL), increase in gingival thickness (GT), increase in keratinized tissue width (KTW) and changes in root coverage esthetic score (RES) were evaluated. A total of 60 patients with 215 GR were enrolled. In 70, GR root surfaces were treated with EDTA + EMD, in other 72, with EDTA, while in the remaining 73 saline solution was applied. ARC was 94%, 89%, and 91% in the EDTA + EMD, the EDTA and the saline groups, respectively (p = 0.8871). Gains in clinical attachment level (CAL; 2.1 ± 1.1 mm) and RES values (9.6 ± 0.9) were significantly higher in the EDTA + EMD group, when compared with two other groups. The differences between other preoperative and postoperative parameters showed statistical significance only within but not between groups. MCAT outcomes may benefit from adjunctive use of EDTA + EMD regarding 12 month CAL gain and professionally assessed esthetics using RES following treatment of GR.

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“…In another in vitro study, EDTA alone or in combination with enamel matrix protein promoted enlargement, proliferation, and density of fibroblast [ 40 ]. It was also assumed that root conditioning might stabilize the bond between the fibrin of the blood clot and the root surface in the early healing process [ 41 ]. A clinical repair with fiber attachment would provide preferable functional permanence compared with long junctional epithelium [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of 24% EDTA root conditioning on the outcome of modified coronally advanced tunnel technique with subepithelial connective tissue graft for the treatment of multiple gingival recessions: a randomized clinical trial

2021

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Objectives To investigate effects of root conditioning with 24% ethylenediaminetetraacetic acid (EDTA) on the 12-month outcomes after treatment of multiple gingival recessions (GR) with modified coronally advanced tunnel (MCAT) and subepithelial connective tissue graft (SCTG). Materials and methods Twenty patients with 142 GR were treated (72 test sites: SCTG + EDTA and 70 control sites: SCTG). Average and complete root coverage (ARC, CRC), gain in keratinized tissue width (KTW), gain in gingival thickness (GT), root esthetic coverage score (RES), and patient-reported outcome measures (PROMs) were evaluated at 12 months post-operatively. Results Differences between pre- and post-operative values were statistically significant only within but not between treatment modalities. At 12 months, ARC was 86.0% for SCTG + EDTA-treated and 84.6 for SCTG-treated defects (p = 0.6636). CRC was observed in 90.2% (tests) and 91.4% (controls) of all cases (p = 0.9903). Professional assessment of esthetic outcomes using RES showed highly positive results reaching the value of 8.9 in case of test sites and 8.7 for control sites (p = 0.3358). Severity of pain and swelling did not differ between sites, regardless of whether EDTA was used. Conclusions Test and control sites presented similarly positive outcomes related to root coverage, periodontal and esthetic parameters, and patient satisfaction and self-reported morbidity with no statistical differences between them 12 months after surgery. No significant differences in evaluated variables were observed between sites treated with and without 24% EDTA. Clinical relevance Considering the limitations of the present study, the use of 24% EDTA for root conditioning did not improve 12-month outcomes after treatment of multiple RT1 and RT2 gingival recessions with MCAT and SCTG. Trial registration ClinicalTrials.gov identifier: NCT03354104

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Dimensional evaluation of blood clot gap distances within intrabony defects following grafting and EDTA root surface treatment—experimental study in dogs

Abstract: following intrabony defect debridement, blood clot undergoes clot retraction creating a micro gap with the root surface. EDTA root surface etching before graft application into the defect area significantly reduced the amount of gap distance.

Cited by 7 publications

References 34 publications

Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study

Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study

Effect of Root Surface Biomodification on Multiple Recession Coverage with Modified Coronally Advanced Tunnel Technique and Subepithelial Connective Tissue Graft: A Retrospective Analysis

Effect of 24% EDTA root conditioning on the outcome of modified coronally advanced tunnel technique with subepithelial connective tissue graft for the treatment of multiple gingival recessions: a randomized clinical trial

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