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

Abstract

Background The 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). Methods Fifteen 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. Results The 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. Conclusion SRP 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.

High Performance Conditioning Shampoo with Hyaluronic Acid and Sustainable Surfactants

“…The experiment concluded that hyaluronic acid decreases the friction coefficient, which proves its ability to increase lubrication between joints. In the personal care industry, Babgi et al observed the effects of applying hyaluronic acid to a healthy root surface as a conditioning agent [13]. In this study, the roots treated with HA resulted in higher cell viability compared to other samples.…”

A Local Desiccant Antimicrobial Agent as an Alternative to Adjunctive Antibiotics in the Treatment of Periodontitis: A Narrative Review

“…High levels of tetracycline, minocycline, and doxycycline determined a dose-dependent decrease in the differentiation potential of osteoprecursor cells [ 76 ]. Chlorhexidine induced a cytotoxic effect on human periodontal cells such as gingival fibroblasts, gingival epithelial cells, periodontal ligament cells, and osteoblasts [ 77 , 78 , 79 , 80 , 81 ]. Different concentrations of sodium hypochlorite had cytotoxic effects on human periodontal ligament cells [ 79 ] and negatively affected the viability and morphology of human bone marrow mesenchymal stem cells (MSCs) [ 82 ] as well impaired the viability and proliferation of gingival MSCs [ 14 ].…”

“…Subgingival mechanical instrumentation accumulates debris onto the root surfaces, also known as the smear layer ( Figure 2 a–c), which limits the spreading of specialized cells and impairs periodontal wound healing [ 86 , 92 ]. Several adjunctive subgingivally applied agents may enhance the removal of the smear layer and stimulate the colonization of specialized cells [ 77 , 93 ], thus creating the premises for the development of a new connective tissue attachment [ 86 , 92 ]. However, some products, such as citric acid, tetracycline, or EDTA, did not provide any additional clinical benefits in an attempt to regenerate an affected periodontium [ 94 ].…”

Role of hyaluronic acid in periodontal therapy (Review)

“…Collectively, the results of previous studies have demonstrated the effective use of HA in periodontal therapy. An overview of studies using HA as a periodontal therapeutic intervention with different sample sizes and HA forms are presented in Table I (49,(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69).…”