The effect of citric acid conditioning of the root surfaces during periodontal surgery was studied in 12 patients with residual pockets ≥ 5 mm two months following oral hygiene instruction and ...initial root planing. Full thickness, replaced flap procedure (“modified Widman”) was performed with or without topical citric acid application using a split mouth approach. Six months post‐operatively, improvement of the periodontal conditions was observed as evidenced from reduction of probing pocket depth, gain of probing attachment level and gingival recession. A mean probing attachment level gain for pooled acid treated surfaces of 2.1 mm was obtained as compared to 1.5 mm for the non‐acid treated control surfaces.
Our previous dog and human studies have demonstrated new connective attachment after acid conditioning of root surfaces as contrasted to readaplation of a junctional epithelium in the non‐acid treated controls. However, the results of the present study indicate that from a clinical standpoint, the use of citric acid application might only provide a small improvement in probing attachment levels.
The daily post‐operative use of topical chlorhexidine application has been compared to daily toothbrushing. Periodontal defects were experimentally created in the bifurcations of lower premolars in ...dogs. The defects were treated by surgical debridment. Chlorhexidine application and toothbrushing were performed post‐operatively for six weeks on contra‐lateral pairs of teeth. The amounts of connective tissue and bone regeneration were evaluated from microscopic sections of the bifurcation areas. No difference between chlorhexidine and toothbrushing was found for the connective tissue attachment. However, significantly more bone had regenerated in the chlorhexidine treated areas than the tooth‐brushed areas.
In a previous study, citric acid‐conditioning of the root surface greatly improved the rate of success of new‐attachment procedures in periodontal furcation pockets in mandibular premolars of ...Labrador retrievers (Crigger et al. 1978). In the present study, this experimental approach was tested in six beagles. The furcations on one side in each dog were reoperated six weeks after the first surgery. In 27 of the 35 treated teeth, mesiodistal sections showed closure of the furcation and new connective tissue attachment including deposition of new cementum. The extension of new attachment in the buccolingual dimension of the furcation, however, was not improved by repeating the surgical procedure.
A study was made to investigate the biological principle of new attachment of connective tissue to periodontally diseased root surfaces utilizing the previous finding that topical application of ...citric acid to the affected area may stimulate periodontal regeneration. Reconstructive surgery was performed on ten surfaces of nine teeth involved in advanced chronic periodontal disease. A muco‐periosteal flap was raised and the apical extent of existing subgingival calculus was demarcated by a notch made through the calculus and into the root. Following thorough instrumentation, a saturated solution of citric acid was applied to the root surface for five minutes and the flap repositioned and sutured. Four months later the teeth with attached periodontal tissues were removed and processed for histological analysis. Connective tissue regeneration characterized by deposition of new cementum, and more coronally, by tightly apposed soft connective tissue had occurred in all specimens. The junctional epithelium ended 1.2–2.6 mm coronal to the apical border of the notch in the various specimens. The results demonstrate that regeneration of periodontal tissues to a root surface that has become denuded as a result of chronic, destructive periodontal disease and that has been covered by calculus is, in fact, a biological possibility. This study does not establish whether or not acid conditioning of the root surface is a prerequisite for new attachment.
REPORT OF FINANCE COMMITTEE May 25, 1920 ANDREWS, CLEMENT W.; Wyer, J. I.; Anderson, Edwin H. ...
Bulletin of the American Library Association,
07/1920, Letnik:
14, Številka:
4
Journal Article
