Root conditioning has introduced to dissolve the smear layer and to produce surface demineralization, resulting to exposure of dentin collagen fibril and opening of dentinal tubules. The purpose of the present study was to examine the effect of different concentration and application time of tetracycline-HCL on root conditioning. Total 40 root specimen were prepared from 20 periodontitis-prone human single rooted tooth. The specimen were treated with tetracycline-HCL solution(20mg/ml, 50mg/ml, 100mg/ml)for 20 sec, 3 min, 5 min., and saline for 30 sec. The application method was rubbing method with cotton pellet. Under the scanning electron microscopy(20KV), the extent of smear removal and opening of the dentinal tubules were examined at x 3000. The following results were obtained. 1. Treatment of root specimen with saline did not remove the smear layer and open the dentinal tubules. 2. Treatment of root specimen with different concentration of tetracycline-HCL for 20 sec also did not remove the smear layer completely. 3. Treatment of root specimen with different concentration of tetracycline-HCL for 3 min opened the dentinal tubules and removed smear layer. 4. Treatment of root specimen with 50mg/ml of tetracycline-HCL for 3 min showed collagen fibril within the opened dentinal tubules. In conclusion, the effect of root conditioning with tetracycline-HCL is more dependent on the application time than the application concentration. Root conditioning with 50mg/ml tetracycline-HCL for 3 min is enough for obtaining the periodontal regeneration.
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.
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.
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.
The purpose of this study was to compare effects of demineralization of citric acid and tetracycline HCI on periodontally involved root surface. Twelve periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning with citric acid and tetracycline HCI were carried and the teeth were processed scanning electron microscopic observation.The results were as follows: The scaled root surface was covered by much debris and calculus. The effect of demineralization of citric acid and tetracycline HCI was more reduced on scaling group than root planing group, because of hypermineralization of cementum surface and demineralization effect on root surface of tetracycline HCI showed tendency to reduction. The root planed group displayed more smooth root surface than scaling group, the surface was covered by smear layer, thus no exposure of dentinal tubule opening and collagen fiber, especially after root planing, citric acid and tetracycline HCl treated group showed exposure of dentinal tubule and collagen fiber, thus it was thought that new connective tissue attachment could be acquired.
PURPOSE. Post surface conditioning is necessary to expose the glass fibers to enable bonding between fiber post and resin cement. The purpose of the present study was to evaluate the effect of different surface conditioning on tensile bond strength (TBS) of a glass fiber reinforced post to resin cement. MATERIALS AND METHODS. In this in vitro study, 40 extracted single canal central incisors were endodontically treated and post spaces were prepared. The teeth were divided into four groups according to the methods of post surface treatment (n=10): 1) Silanization after etching with 20% $H_2O_2$, 2) Silanization after airborne-particle abrasion, 3) Silanization, and 4) No conditioning (Control). Adhesive resin cement (Panavia F 2.0) was used for cementation of the fiber posts to the root canal dentin. Three slices of 3 mm thick were obtained from each root. A universal testing machine was used with a cross-head speed of 1 mm/minute for performing the push-out tests. Two-way ANOVA and Tukey post hoc tests were used for analyzing data (${\alpha}$=0.05). RESULTS. It is revealed that different surface treatments and root dentin regions had significant effects on TBS, but the interaction between surface treatments and root canal regions had no significant effect on TBS. There was significant difference among $H_2O_2$ + Silane Group and other three groups. CONCLUSION. There were significant differences among the mean TBS values of different surface treatments. Application of hydrogen peroxide before silanization increased the bond strength between resin cements and fiber posts. The mean TBS mean values was significantly greater in the coronal region of root canal than the middle and apical thirds.
The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ml 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment
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.
The purpose of this study was to evaluate the biocompatibility of the Nd:YAG lased root surface followed by root planing and/or tetracyline-HCI(T.C.-HCI) conditioning. $30,4mm{\times}4mm$ root segments were obtained from unerupted third molars and 21, periodontally involved root segments. The treatment groups were as follows : (1) healthy root cementum surface groups : 1) control(non-treated group), 2) lased only, 3) lased/root planed, and 4) lased/T.C.-HCI. (2) diseased root cementum surface groups : 1) control(root planed only), 2) lased/root planed, and 3) lased/root planed/T.C.-HCI. The specimens were treated with a Nd:YAG laser using a $320{\mu}m$ noncontact optic fiber handpiece with an energy setting of 1.5W($114.6J/cm^2$), 2.0W($152.9J/cm^2$), 5.0W($382J/cm^2$) for one minute. The fiber was held perpendicular to the petri dish(NUNC) 2cm apart in an attempt to expose the entire root segments equally. Human gingival fibroblasts were cultured from explants of normal interdental gingival tissue obtained during third morlar extraction. The attachment assay was performed with third-generation fibroblasts. The numbers of gingival fibroblasts attached to the root surface were counted on each specimen under the light microscope, and were statistically analyzed by the oneway ANOVA followed by Tukey's test in SPSS/PC+programs. The results were as follows : 1) In healthy root cementum surfaces, lased/root planed groups exhibited a significantly increased fibroblast attachment compared to controls, lased only, and lased/T.C.-HCI groups(p<0.05), 2) In diseased root cementum surfaces, laser treatment followed by root planing and/or T.C.HCl groups exhibited a increased tendency of fibroblast attachment compared to root planed only group. The results suggest that laser treatment followed by root planing and/or T.C.-HCl would appear necessary so as to render the root surface biocompatible.
The goal of Periodontal treatment is predictable periodontal regeneration. But until now, many products including GTR materials and growth factors are beyond of complete regeneration. BMP can induce ectopic bone formation when implanted into sites such as rat muscle and can greatly enhance healing of bony defects when applied exogenously. BMP can promote periodontal regeneration by their ability to stimulate new bone and new cementum formation. But little is known about optimal conditions required for the application. Root conditioning is used for bioacive root change so altered root surface provides a substrate that promotes chemotaxis, migration and attachment of peridontal cells encouraging connective attachment to the denuded root surface. The aim of this study is to investigate whether the acid conditioning change effect of rhBMP-2 on human periodontal ligament cell and osteoblast cell line. 288 periodontally involved root dentin slices are divided into 6 groups, each 48, 1)control, 2)treated with BMP, 3)treated with citric acid 4)treated with citric acid+BMP 5)treated with tetracycline 6)treated with TC+BMP. Each group was devided half, so 12 root dentin slices were seeded with periodontal ligament cells and 12 were seeded with osteoblasts. At day 2 and 7, cell number, protein assay, ALP activitiy was measured. To investigate morphology of cultured cells, SEM was employed. Statistical analysis was performed with SPSS 8.0 either t-test or ANOVA test. The results are ; Protein assay and cell number was slightly decreased in CA+BMP group compared to Ca group but it was not statistically significant and ALP activity was much more increased in CA+BMP group compared to CA group so there was no statistically significance between BMP and CA+BMP group and statistically significant compared to control group. Cell number and protein assay was slightly increased in TC group and ALP activity was much less the BMP group and CA group. Cell number and protein and ALP activity was not much increased in TC+BMP group. TC group and TC+BMP group showed cell morphology change in SEM. This results suggested that application of root surface with citric acid before BMP treatment might give better result in periodontal regeneration.
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