EC Dental Science

Research Article Volume 22 Issue 4 - 2023

Evaluation of Root Biomodification by Citric Acid, Tetracycline and Doxycycline on Instrumented Periodontally Involved Root Surfaces Using a Scanning Electron Microscope - An Invitro Study

Arru Khajuria1, Navneet Kaur2* and Gurpreet Kaur3

1PG Student, Department of Periodontics and Oral Implantology, National Dental College and Hospital, Derabassi, Punjab, India
2Reader, Department of Periodontics and Oral Implantology, National Dental College and Hospital, Derabassi, Punjab, India
3Professor and HOD, Department of Periodontics and Oral Implantology, National Dental College and Hospital, Derabassi, Punjab, India

*Corresponding Author: Navneet Kaur, Reader, Department of Periodontics and Oral Implantology, National Dental College and Hospital, Derabassi, Punjab, India.
Received: February 26, 2023; Published: March 08, 2023



Background: A surface smear layer consisting of organic and inorganic material with minute particle sizes is found on root surface containing remnants of dental calculus, contaminated root cementum, and subgingival plaque after scaling and root planing. Various types of agents such as citric acid, conc. tetracycline HCl and doxycycline have been placed on root surface not only to remove the surface inorganic smear layer but also to enlarge dentinal tubules into which healing connective tissue can enter. They have also shown a long lasting substantivity on periodontally diseased root surfaces.

Aim and Objective: 1. To treat root planed surfaces of extracted teeth with citric acid, tetracycline HCl and doxycycline and observe the surface characteristics under Scanning Electron Microscope (SEM). 2. To compare changes in surface characteristics after treating with all the three agents. 3. To establish which of these three agents give most desirable root surface characteristics favourable for periodontal healing.

Materials and Methods: The study was done in vitro using scanning electron microscopy on a total of 5 single rooted anterior teeth with 15 samples indicated for extraction due to Stage III or IV with Grade B or C periodontitis. 5 samples were divided into three groups A, B, C of 5 each based on type of conditioning done, either with saturated citric acid (pH 1) or tetracycline HCl (pH 1.6) - 250 mg/ml or doxycycline (pH 2.2) - 100 mg/ml for 5 minutes. Scanning photomicrographs of root surfaces were taken at ×2000 and × 6000 magnification. The micrographs were taken and evaluated for presence or absence of smear layer, total number of dentinal tubules per unit area, number of patent tubules per unit area and diameter of randomly selected patent dentinal tubules were measured.

Results: All the three groups showed slight difference in mean number of total dentinal tubules and showed statistically significant difference. The proportion of patent dentinal tubules was (36 ± 1.51) in tetracycline HCl group compared to citric acid (31 ± 1.58) and doxycycline (28 ± 1.78) showing the differences statistically significant. Tetracycline group showed higher number of patent tubules and increase in tubule diameter when compared to citric acid and doxycycline and the difference was statistically significant.

Conclusion: Results of this study suggest that tetracycline is the best current tetracycline form for root surface conditioning as measured by its ability to affect both dentin smear layer removal, diameter and tubule exposure.

Keywords: Root Biomodification; Root Conditioning; Citric Acid; Tetracycline; Doxycycline

  1. Chandra RV., et al. “The Attachment of V79 and Human Periodontal Ligament Fibroblasts on Periodontally Involved Root Surfaces Following Treatment with EDTA, Citric Acid, or Tetracycline HCL: An SEM in vitro Study”. The Journal of Contemporary Dental Practice1 (2006): 044-059.
  2. Theodoro Haypek., et al. “Effect of Er:YAG and diode laser irradiation on the root surface: Morphological and Thermal Analysis”. Journal of Periodontology 74 (2003): 838-843.
  3. Wen CR., et al. “In vitro effects of citric acid application techniques on dentin surfaces”. Journal of Periodontology 63 (1992): 883-889.
  4. Blomlof J and Lindskog S. “Periodontal tissue-vitality after different etching modalities”. Journal of Clinical Periodontology 22 (1995): 464-468.
  5. Lafferty TA., et al. “Comparative SEM study on the effect of acid etching with tetracycline HCL or citric acid on Instrumented periodontally involved human root surfaces”. Journal of Periodontology 64 (1993): 689-693.
  6. Smith BA., et al. “Effect of citric acid and various s concentrations of fibronectin on healing following periodontal flap surgery in dogs”. Journal of Periodontology 58 (1987): 667-673.
  7. Madison JS and Hokett SD. “The effect of different tetracyclines on the dentin root surface of instrumented, periodontally involved human teeth: A Comparative Scanning Electron Microscope study”. Journal of Periodontology 68 (1997): 739-745.
  8. Rosawen C., et al. “In vitro effects of citric and application techniques on dentin surfaces”. Journal of Periodontology 63 (1992): 883-889.
  9. Trombelli L and Okomoto H. “The effect of ultrasonic irrigation before and after citric acid treatment on collagen fibril exposure: An invitro SEM study”. Journal of Periodontology 66 (1995): 887-891.
  10. Labhan R., et al. “Root dentin morphology after different modes of citric acid and tetracycline hydrochloride conditioning”. Journal of Periodontology 63 (1992): 303-309.
  11. Minabae M., et al. “The effect of root conditioning with minocycline HCL in removing endotoxin from the roots of periodontally involved teeth”. Journal of Periodontology 65 (1994): 387-392.
  12. Rosawen C., et al. “In vitro effects of citric and application techniques on dentin surfaces”. Journal of Periodontology 63 (1992): 883-889.
  13. Nathalia GA., et al. “Comparison among four commonly used demineralizing agents for root conditioning. A scanning electron microscopy”. Journal of Applied Oral Science - SciELO5 (2011): 469-475.
  14. Parashis AO and Mitsis FJ. “Clinical evaluation of the effect of tetracycline root preparation on guided tissue regeneration in the treatment of class II furcation defects”. Journal of Periodontology 64 (1993): 133-136.
  15. Mythili R and Ahamed BR. “Efficacy of tetracycline hydrochloride and doxycycline hydrochloride as a root conditioner-a scanning electron microscopic study”. Journal of Indian Society of Periodontology 10 (2006): 227-232.
  16. Wang Y., et al. “Tetracycline at subcytotoxic levels inhibits matrix metalloproteinase 2 and 9 but does not remove the smear layer”. Journal of Periodontology 76 (2005): 1129-1139.
  17. Shetty B., et al. “The comparative effects of tetracyclines and citric acid on dentin root surface of periodontally involved human teeth: a scanning electron microscope study”. Journal of Indian Society of Periodontology1 (2008): 8-15.
  18. Penmatsa T., et al. “Effect of various concentrations of tetracycline hydrochloride demineralization on root dentin surface: A scanning electron microscopic study”. Journal of Pharmacy and Bioallied Sciences 5 (2003): 48-53.
  19. Preeja C., et al. “Fibrin clot adhesion to root surface treated with tetracycline hydrochloride and ethylenediaminetetraacetic acid: A scanning electron microscopic study”. Journal of Dental Research 10 (2013): 382-388.
  20. Chahal GS., et al. “Effect of citric acid, tetracycline, and doxycycline on instrumented periodontally involved root surfaces: A SEM study”. Journal of Indian Society of Periodontology 18 (2014): 32-37.
  21. Bhushan K., et al. “Root Biomodification in Periodontics - The Changing Concepts”. Journal of Dentistry and Oral Care Medicine 2 (2016): 105-113.

Navneet Kaur., et al. “ Evaluation of Root Biomodification by Citric Acid, Tetracycline and Doxycycline on Instrumented Periodontally Involved Root Surfaces Using a Scanning Electron Microscope - An Invitro Study”.”. EC Dental Science 22.4 (2023): 33-46.

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