Topography of periodontally involved human root surfaces after different chemical treatment modalities. An in vitro scanning electron microscopic study.

Abstract

The significance of chemical and conservative treatments of cemental tissue proximal to periodontal pockets has been pointed out in recent years. This in vitro scanning electron microscopy (SEM) study aimed to investigate the surface effects of topical applications of 0.1 % cetylpyridinium chloride (CPC) and 2 % sodium lauryl sulfate (SLS) and polishing on the periodontally involved root surfaces of human teeth. Ten single-rooted teeth from 8 patients with advanced adult periodontitis were included. Following extraction, any calculus was removed with extreme care to preserve as much cementum as possible. Eighty root specimens were prepared. Fresh solutions of CPC and SLS were applied for 1, 3 and 5 minutes each to 10 segments of root cementum. A total of 20 segments formed the polished (P) and control (C) groups, respectively. The results showed that the surfaces treated with CPC or SLS differed considerably from polished and control specimens. Depending on time, the surface coating was partly or wholly removed, leaving a nodular cementum structure, uncovering a fibrillar collagen substrate and the openings of dentinal tubules. Scarce debris was present on both control and polished surfaces, whereas bacteria were observed only on the control specimens. In view of these results, further definitive in vitro and in vivo research must be done to determine the advantages of chemical treatment and its effect on periodontal regeneration.

A scanning electron microscopy study of root surface smear layer removal after topical application of EDTA plus a detergent

“…This demonstrates that the addition of Texapon detergent in the EDTA gel formulation did not improve the in vitro results seen for the EDTA gel group. On the other hand, Okte & Bal using 2% sodium lauryl sulfate and 0.1% cetylpyridinium chloride on the root surface for a longer application time (5 minutes), observed that the treated root surface presented partially demineralized aspect, with dentinal tubules and collagen fibers exposure 20 . In this study, the EDTA gel (without detergent) in the concentrations of 5% and 10% resulted in statistically significantly lower smear layer scores than in higher concentrations.…”

“…The use of etching agents in gel form may provide a better control of the area that must be conditioned, once the liquid form may drop on the adjacent tissue 10 . Root surfaces treated with different detergents have shown a partially demineralized aspect, with open dentinal tubules and exposed collagen fibers 20 . Although detergents used alone seem to remove bacteria and toxins of the root surface, they have not led to a selective removal of hydroxyapatite and have not exposed collagen fibers of the cementum or dentin extracellular matrix 18 .…”

Molecular and morphological surface analysis: effect of filling pastes and cleaning agents on root dentin

“…On the other hand, cleaning agents, such as ethanol, can expand and maintain collagen fibrils of dentin 20 . Therefore, anionic detergent solution removed the smear layer and opened the dentin tubule and uncovered collagen fibrils 17 ; its use combined with phosphoric acid demineralizes the dentin, which could modify both the organic and the inorganic content 16 .…”