Cell and fiber attachment to demoralized dentin A comparison between normal and periodontitis‐affected root surfaces

Abstract

The purpose of the present study was to compare and contrast cellular, connective tissue, and epithelial responses to dentin specimens derived from the roots of either normal or periodontitis-affected human teeth after surface demineralization. Rectangular dentin specimens, with opposite faces of root and pulpal dentin, were derived from beneath root surfaces covered by periodontal ligament (normal) or calculus-covered areas of periodontitis-affected teeth. In each of the groups, the specimens were treated with citric acid (pH 1 for 3 min), whereupon they were implanted transcutaneously into incisional wounds on the dorsal surface of rats with one end of the implant protruding through the skin. 4 specimens were available in each group at 10 days after implantation. Histologic and histometric analyses of the root surfaces of the implants included counts of adhering cells, evaluation of connective tissue fiber relationships, and assessment of epithelial migration. New connective tissue attachment with inhibition of epithelial migration occurred in both groups. Cementum formation was not present. Comparisons between the groups showed no significant differences regarding length of implant surface adjacent to connective tissue, number of attached cells, or density and diameter of attached fibers. The fiber attachment system which had developed on these demineralized surfaces seemed intrinsic to the connective tissue location, and differed morphologically from corresponding fibers attaching the root surface in a normal periodontium. It was concluded that there were no observable differences between the new connective tissue attachment systems which developed on demineralized dentin from either normal or periodontitis-affected root surfaces.

Dentin demineralization

“…One feature of many of these investi-gations has been methodoiogy inconsistency; with variations in citric acid application time, appiication technique, as weii as soiution pH/concentration. With respect to the citric acid soiution used, some have reported detaiied information (e.g., 50% concentration, pH = 2.1 (Heritier i982) or "16 g in 9 ml of distiiied water at room temperature, 20"C, pH=l" (Hanes et al,199i)), Nevertheiess, other studies have made vague references to the citric acid solution used, e.g., (i) a "pH = r' with no reference to saturation (Register & Burdick 1975, Register & Burdick 1976, Stahi & Froum 1977, Fernyhough & Page 1983, Poison & Proye 1983, Hanes et al 1985, Poison & Hanes 1987, (ii) a "pH=l and saturated" (Register 1978, Nyman et al 198i, Renvert & Egeiberg 1981, Albair et al 1982, Naibandian & Cote i982. Common & McFail 1983, (iii^ a "saturated soiution" with no respect of soiution pH (Coie et al 1980), and (iv) a "highly concentrated citric acid solution", again with no mention of pH (Miiier 1982(Miiier , !9S3, 1985.…”

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

“…Differences between studies likely relate to basic biomechanical factors of periodontal wound healing overriding the experimental condition in the study by Polson and Hanes. [6]…”

“…[56] It partially exposes collagen from radicular dentin which has been shown to improve fibrin linkage and consequently inhibit epithelial downgrowth to stimulate fibrous attachment and migration. [7] It may also act as a potent antibacterial agent.…”

Efficacy of citric acid on periodontal disease.

“…Citric acid has the ability to change the surfaces of the treated root by removing the smear layer, expose the dentinal tubules and making the tubules appear wider and with funnel-shaped orifices [1,2]. In periodontal disease, exposed cementum show accumulation of plaque and calculus on root surface with loss of collagen cross banding [3].…”

“…In periodontal disease, exposed cementum show accumulation of plaque and calculus on root surface with loss of collagen cross banding [3]. Citric acid partially exposes the collagen from radicular dentin that improves fibrin linkage and inhibits epithelial down growth to stimulate fibrous attachment and migration [4], it also acts as a potent antibacterial agent [2]. Periodontal diseases are a bacterial infection that destroys the gum and the bone that hold the teeth in the mouth.…”