Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지
DOI QR코드

DOI QR Code

Blood clot stabilization after different mechanical and chemical root treatments: a morphological evaluation using scanning electron microscopy

  • Stefanini, Martina (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Ceraolo, Edoardo (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Mazzitelli, Claudia (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Maravic, Tatjana (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Sangiorgi, Matteo (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Zucchelli, Giovanni (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Breschi, Lorenzo (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna) ;
  • Mazzoni, Annalisa (Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna)
  • Received : 2021.05.06
  • Accepted : 2021.09.02
  • Published : 2022.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This in vitro study was conducted to evaluate the effects of different debridement techniques and conditioning procedures on root surface morphology and blood clot stabilization. Methods: Two debridement techniques (curette [CU] vs. high-speed ultrasound [US]) and 2 conditioning procedures (ethylenediaminetetraacetic acid [EDTA] and phosphoric acid [PA]) were used for the study. Seven experimental groups were tested on root surfaces: 1) no treatment (C); 2) CU; 3) US; 4) CU+EDTA; 5) US+EDTA; 6) CU+PA; and 7) US+PA. Three specimens per group were observed under scanning electron microscopy (SEM) for surface characterization. Additional root slices received a blood drop, and clot formation was graded according to the blood element adhesion index by a single operator. Data were statistically analyzed, using a threshold of P<0.05 for statistical significance. Results: The C group displayed the most irregular surface among the tested groups with the complete absence of blood traces. The highest frequency of blood component adhesion was shown in the CU+EDTA group (P<0.05), while no differences were detected between the CU, US+EDTA, and CU+PA groups (P<0.05), which performed better than the US and US+PA groups (P<0.05). Conclusions: In this SEM analysis, EDTA and conventional manual scaling were the most efficient procedures for enhancing smear layer removal, collagen fiber exposure, and clot stabilization on the root surface. This technique is imperative in periodontal healing and regenerative procedures.

Keywords

Acknowledgement

We would like to thank the Centro Interdipartimentale Grandi Strumenti (CIGS) of the University of Modena and Reggio Emilia for assistance in scanning electron microscopy (SEM) analysis.

References

  1. Baker PJ, Rotch HA, Trombelli L, Wikesjo UM. An in vitro screening model to evaluate root conditioning protocols for periodontal regenerative procedures. J Periodontol 2000;71:1139-43. https://doi.org/10.1902/jop.2000.71.7.1139
  2. Adriaens PA, Adriaens LM. Effects of nonsurgical periodontal therapy on hard and soft tissue. Periodontol 2000 2004;36:121-45. https://doi.org/10.1111/j.1600-0757.2004.03676.x
  3. Graziani F, Karapetsa D, Alonso B, Herrera D. Nonsurgical and surgical treatment of periodontitis: How many options for one disease? Periodontol 2000 2017;75:152-88. https://doi.org/10.1111/prd.12201
  4. Nascimento GG, Leite AA, Leite ER, Sampaio JE, Leite FR. Blood clot stabilization on root dentin conditioned by the combination of tetracycline and EDTA. Braz J Oral Sci 2014;13:83-8. https://doi.org/10.1590/1677-3225v13n2a01
  5. Fontanari LA, Pinto SC, Cavassim R, Spin-Neto R, Ishi EP, Sampaio JE. Influence of dental exposure to oral environment on smear layer removal and collagen exhibition after using different conditioning agents. Braz Dent J 2011;22:479-85. https://doi.org/10.1590/S0103-64402011000600007
  6. Baker DL, Stanley Pavlow SA, Wikesjo UM. Fibrin clot adhesion to dentin conditioned with protein constructs: an in vitro proof-of-principle study. J Clin Periodontol 2005;32:561-6. https://doi.org/10.1111/j.1600-051X.2005.00714.x
  7. Zandim DL, Leite FR, da Silva VC, Lopes BM, Spolidorio LC, Sampaio JE. Wound healing of dehiscence defects following different root conditioning modalities: an experimental study in dogs. Clin Oral Investig 2013;17:1585-93. https://doi.org/10.1007/s00784-012-0848-4
  8. Leite FR, Sampaio JE, Zandim DL, Dantas AA, Leite ER, Leite AA. Influence of root-surface conditioning with acid and chelating agents on clot stabilization. Quintessence Int 2010;41:341-9.
  9. Manzolli Leite FR, Nascimento GG, Manzolli Leite ER, Leite AA, Cezar Sampaio JE. Effect of the association between citric acid and EDTA on root surface etching. J Contemp Dent Pract 2013;14:796-800. https://doi.org/10.5005/jp-journals-10024-1405
  10. Ruggeri A Jr, Prati C, Mazzoni A, Nucci C, Di Lenarda R, Mazzotti G, et al. Effects of citric acid and EDTA conditioning on exposed root dentin: an immunohistochemical analysis of collagen and proteoglycans. Arch Oral Biol 2007;52:1-8. https://doi.org/10.1016/j.archoralbio.2006.07.001
  11. Heritier M. Ultrastructural study of new connective tissue attachment following phosphoric acid application on human root dentin. J Periodontol 1983;54:515-21. https://doi.org/10.1902/jop.1983.54.9.515
  12. Heritier M. Effects of phosphoric acid on root dentin surface. A scanning and transmission electron microscopic study. J Periodontal Res 1984;19:168-76. https://doi.org/10.1111/j.1600-0765.1984.tb00805.x
  13. Josic U, Maravic T, Bossu M, Cadenaro M, Comba A, Ierardo G, et al. Morphological characterization of deciduous enamel and dentin in patients affected by osteogenesis imperfecta. Appl Sci (Basel) 2020;10:7835. https://doi.org/10.3390/app10217835
  14. Dantas AA, Fontanari LA, Ishi EP, Leite FR, Zandim DL, Rached RS, et al. Blood cells attachment after root conditioning and PRP application: an in vitro study. J Contemp Dent Pract 2012;13:332-8. https://doi.org/10.5005/jp-journals-10024-1147
  15. Amaral NG, Rezende ML, Hirata F, Rodrigues MG, Sant'ana AC, Greghi SL, et al. Comparison among four commonly used demineralizing agents for root conditioning: a scanning electron microscopy. J Appl Oral Sci 2011;19:469-75. https://doi.org/10.1590/S1678-77572011000500006
  16. Gamal AY, Mailhot JM. The effects of EDTA gel conditioning exposure time on periodontitis-affected human root surfaces: surface topography and PDL cell adhesion. J Int Acad Periodontol 2003;5:11-22.
  17. Barootchi S, Tavelli L, Ravida A, Wang CW, Wang HL. Effect of EDTA root conditioning on the outcome of coronally advanced flap with connective tissue graft: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2727-41. https://doi.org/10.1007/s00784-018-2635-3
  18. Caffesse RG, De LaRosa M, Garza M, Munne-Travers A, Mondragon JC, Weltman R. Citric acid demineralization and subepithelial connective tissue grafts. J Periodontol 2000;71:568-72. https://doi.org/10.1902/jop.2000.71.4.568
  19. Leite FR, Moreira CS, Theodoro LH, Sampaio JE. Blood cell attachment to root surfaces treated with EDTA gel. Braz Oral Res 2005;19:88-92. https://doi.org/10.1590/S1806-83242005000200003
  20. Subramanian S, Appukuttan D, Tadepalli A, Gnana PP, Athmarao RT. Root conditioning with citric acid and ethylenediaminetetraacetic acid and their effect on fibrin clot adhesion to dentin-a scanning electron microscopic study. J Clin Diagn Res 2017;11:ZC82-5.
  21. Silva AC, Moura CC, Ferreira JA, Magalhaes D, Dechichi P, Soares PB. Biological effects of a root conditioning treatment on periodontally affected teeth--an in vitro analysis. Braz Dent J 2016;27:160-8. https://doi.org/10.1590/0103-6440201600427
  22. Singh S, Uppoor A, Nayak D. A comparative evaluation of the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instruments--an in vitro profilometric and SEM study. J Appl Oral Sci 2012;20:21-6. https://doi.org/10.1590/S1678-77572012000100005
  23. Babay N. Attachment of human gingival fibroblasts to periodontally involved root surface following scaling and/or etching procedures: a scanning electron microscopy study. Braz Dent J 2001;12:17-21.
  24. Soares PB, Castro CG, Branco CA, Magalhaes D, Neto AJ, Soares CJ. Mechanical and acid root treatment on periodontally affected human teeth - a scanning electron microscopy. Braz J Oral Sci 2010;2:128-32.
  25. Blomlof J, Blomlof L, Lindskog S. Effect of different concentrations of EDTA on smear removal and collagen exposure in periodontitis-affected root surfaces. J Clin Periodontol 1997;24:534-7. https://doi.org/10.1111/j.1600-051X.1997.tb00225.x
  26. Blomlof JP, Blomlof LB, Lindskog SF. Smear removal and collagen exposure after non-surgical root planing followed by etching with an EDTA gel preparation. J Periodontol 1996;67:841-5. https://doi.org/10.1902/jop.1996.67.9.841