• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.257-264
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• 2010

Purpose: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. Methods: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. Results: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. Conclusions: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.719-730
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• 2005

The purpose of this study was to compare the effect of tetracycline HCL, Citric acid and PrefGel applied on the root surfaces that planed with periodontal curret with Roto bur. In this study, 20 extracted teeth with advanced periodontal disease were used. The teeth were root planing with periodontal curette and Roto bur. Following root planing, each agents was burnished on the prepared root surface for 3 minutes to find opened dentinal tubules. And then, each specimens were investigated using scanning electron microscope. Amount of remained cementum by loss of tooth substance index and the number of opened dentinal tubules were evaluated to each specimens The results were as follows. 1. Groups treated with periodontal curette were almost seemed no removed. Other groups treated with Roto bur showed partially opened dentinal tubule orifices. 2. Loss of tooth substance index were compared between groups. There was no statistically difference between periodontal curette groups. Between Roto bur groups was alike. But there were statistically differences between periodontal curette and Roto bur groups. 3. At comparing with various root conditioning agents, Tetracycline HCL group took statistically higher than Citric acid and PrefGel in opened dentinal tubules. On the other hand, there was no statistically difference between Citric acid group and PrefGel group. As a result of this study, groups treated with Roto bur showed more cementum removed than groups treated with periodontal curette. In a treatment for regeneration of periodontal tissue, it was regarded that Roto bur should be used and that Tetracycline HCL would be more effective as chemical root conditioning agent.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.847-863
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• 1999

The present study was performed to evaluate the effect of EDTA on diseased root surfaces with regard to the removal of the smear layer, exposure of dentinal tubule openings, and demineralization of the peritubular dentin. 20 periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning was carried out with 3%, 17%, and 24% EDTA solution for 20 sec., 3 min., and 5 min. respectively. Then, the specimens were rinsed with tap water for 5 min. and processed for scanning electron microscopic observation. The following results were obtained. 1. In control group which was conditioned with cotton pellets soaked with saline for 3 min., the surface showed an amorphous irregular coating. The tubule orifices seemed to be com-pressed in the direction of the curette strokes. 2. In test group which was conditioned with EDTA solution, the number of opening dentinal tubules and the extent of the dentinal tubule opening increased with time irrespective of the concentration of EDTA solution. 3. In the group which was conditioned with EDTA solution for 20 sec., the smear layer was not completely removed. 4. If the time of root conditioning is above 3 min., collagen-like fibers covering the circum tubular dentin surface were shown even in the group which was conditioned with 3% EDTA solution. In conclusion, EDTA solution was a very effective root conditioning agent like low pH root conditioning agents which had various disadvantages. Therefore, using EDTA solution, more successful periodontal regeneration could be obtained.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.561-578
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• 1999

The goal of periodontal therapy is the periodontal regeneration by the removal of microorganisms and their toxic products from the periodontally diseased root surface. To achieve periodontal regeneration, root conditioning as an adjunct to root planing has been done. There are low pH etchants such as citric acid, tetracycline-HCl, and EDTA solution which is a neutral chelating agent. The purpose of present study was to examine the effect of root conditioning by citric acid, tetracycline HCl, and EDTA. Total 35 root specimens(6${\times}$3${\times}$2mm) were prepared from the periodontally diseased teeth, scaled and root planed. The specimens were treated with normal saline for 1 minute, saturated citric acid(pH 1) for 3 minutes, 50mg/ml tetracycline-HCl(pH 2) for 5 minutes, 15% EDTA(pH 7) for 5 minutes using rubbing technique. The specimens were examined under scanning electron microscopy at 1000, and 3000 magnification. On the microphotographs taken at 1000 magnification, the numbers of opened and patent dentinal tubules per unit area(10,640${\mu}m^2$) were counted. And the diameters of opened dentinal tubules per unit are (10,640${\mu}m^2$) were measured. The differences of number and diameter among all groups were statistically analyzed by Kruskal Wallis Test. The results were as follows; 1. In the specimens applied with normal saline(control group), the root surface was finely cracked, and was covered by irregular smear layer. Neither exposed dentinal tubules nor any patent dentinal tubules could be seen. 2. In the specimens applied with saturated citric acid(experimental 1 group), the globular collagen fibers were exposed around the peritubular space, and many dentinal tubules were revealed. 3. In the specimens applied with tetracycline-HCl(experimental 2 group), the process-like collagen fibers were exposed around the peritubular space, and some dentinal tubules were revealed. 4. In the specimens applied with 15% EDTA(experimental 3 group), the root surface was covered by the collagenous fibrillar network, and many dentinal tubules were revealed. 5. The numbers of opened and patent dentinal tubules were significantly more in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the number of opened and patent dentinal tubules could not be counted because any dentinal tubules couldn't be seen. 6 . The diameter of opened dentinal tubules was significantly smaller in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the diameter of opened dentinal tubules could not be measured because any dentinal tubules couldn't be seen. The results demonstrate that root conditioning with citric acid, tetracycline- HCl, and EDTA is more effective in periodontal healing than only root planing, and 15% EDTA solution can replace low pH etching agents such as citric acid, tetracycline-HCl for root conditioning.

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.133-146
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• 2000

Histological studies indicate a tetracycline HCl similar to citric acid to induce connetive tissue repair in animals. When tetracycline HCl was used as a root conditioning agent in humans, there was a trend toward more connective tissue attachment than in root planing alone. The purpose of this study was to evaluate clinical effect of tetracycline HCl in the treatment of gingival recession. 44 teeth in 12 patients with bilaterally gingival recession & Miller classification I, II gingival recession were selected and 22 teeth were treated with 125mg/ml tetracycline HCl , the others was not treated with tetracycline HCl. Gingival recession, pocket depth, clinical attachment level, width of keratinized gingiva were observed at baseline, postoperative 4, 12, 20weeks. Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Wilcoxon's rank sum test(Mann-whitney test) using SPSS program.(5% significance level) The results were as follows: 1........The change of gingival recession, clinical attachment level, keratinized gingiva in both groups were increased significantly at 4, 12, 20 weeks. 2.......The pocket depth exhibited no marked changes throughout the entire investigation in both groups. 3........The change of gingival recession in tetracycline group was increased significantly than control group at 4, 12, 20 weeks and the percentage of root coverage was 93% in tetracycline group and 83% in control group. 4........The change of clinical attachment level, pocket depth, keratinized tissue from baseline to 4, 12, 20 weeks was not differ significanltly in both group.