tetracycline and Smear-Layer

Root surface biomodification has been used to treat periodontitis and gingival recession. The rationale for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Although animal studies have shown promising results, human studies have been disappointing. Some experts claim that the use of low-pH biomodification agents may cause necrotizing effects, and the use of neutral-pH agents does not. However, clinical investigations generally have failed to find any improvement in clinical parameters when using such agents.

Topics: Acid Etching, Dental; Animals; Anti-Bacterial Agents; Cell Adhesion; Chelating Agents; Citric Acid; Collagen; Dental Scaling; Edetic Acid; Endotoxins; Gingival Recession; Humans; Hydrogen-Ion Concentration; Necrosis; Periodontal Diseases; Root Planing; Smear Layer; Tetracycline; Tooth Root; Wound Healing

To compare the adhesion and maturation of blood components on chemically conditioned root surfaces.. Clinical root samples of human teeth were obtained (n = 150) and manually scaled. Five groups of 30 samples were treated as follows: (1) saline solution irrigation (control); (2) 24% EDTA gel; (3) 25% citric acid solution; (4) tetracycline solution (50 mg/mL); and (5) 30% sodium citrate solution. After these treatments, 15 samples of each group received a blood drop and were analyzed by SEM. The remaining 15 had their surface morphology evaluated for collagen fibrils exposure by SEM. Photomicrographs were analyzed according to the score of adhesion of blood components. Kruskal-Wallis and Dunn multiple comparison tests were employed.. The control group was characterized by the absence of blood elements on the surface. The best result was observed in the citric acid group, which had a dense fibrin network with blood elements adhered. The EDTA group showed a moderate fibrin network formation. In contrast, a scarce fibrin network and a few cells were present in the tetracycline samples, and an absence of blood elements was found on sodium citrate specimens. The citric acid group was statistically different from the control group (P < .01). No differences were found among the control, EDTA, tetracycline, and sodium citrate groups (P > .05).. Under these experimental conditions, citric acid is indicated to stabilize clots on the root surface, which act as a scaffold for connective tissue cell development.

Topics: Acid Etching, Dental; Blood Cells; Blood Coagulation; Cell Adhesion; Chelating Agents; Citrates; Citric Acid; Collagen; Dental Cementum; Dental Scaling; Dentin; Edetic Acid; Fibrin; Humans; Materials Testing; Microscopy, Electron, Scanning; Root Planing; Single-Blind Method; Smear Layer; Sodium Chloride; Sodium Citrate; Tetracycline; Tooth Root

Scanning electron microscopy (SEM) was used to evaluate root surface characteristics of human teeth affected with periodontitis following periodontal instrumentation and topical application of tetracycline HCl (TTC-HCl; pH 1.6; 4 min). Specimens were randomly assigned to periodontal instrumentation alone (control 1); periodontal instrumentation plus TTC-HCl (test 1); periodontal instrumentation plus trypsin solution after extraction (control 2); and periodontal instrumentation plus TTC-HCl plus trypsin solution after extraction (test 2). Tetracycline solution was applied with a cotton pellet. Twenty-two single root periodontitis affected human teeth scheduled for extraction were selected. Mucoperiosteal flaps were raised, root surfaces were mechanically and chemically treated, flaps were repositioned and maintained in place for 20 min. Teeth were extracted, rinsed and placed in cold phosphate buffer solution (PBS) and control 2 and test 2 groups were treated with trypsin solution. Specimens were examined using SEM. Smear layer was successfully removed, exposing dentinal tubules; however, fibrin network formation in situ was not improved by application of TTC-HCl.

Topics: Anti-Bacterial Agents; Blood Coagulation; Fibrin; Humans; Periodontitis; Smear Layer; Tetracycline

Scanning electron microscopy was used to evaluate surface characteristics of periodontitis-exposed instrumented human cementum and dentin surfaces following topical application of tetracycline HCl (TTC). Specimens were randomly assigned to application of sterile saline for 1 minute (control); TTC (10 mg/ml) for 1 minute and 4 minutes, respectively; and TTC (100 mg/ml) for 1 minute and 4 minutes, respectively. Solutions were applied with a cotton pellet using a burnishing technique. Control specimens exhibited an amorphous irregular surface smear layer. TTC treatment of cementum for 1 minute resulted in a relatively debris-free, nonhomogeneous surface. The 4-minute application resulted in a surface exhibiting a densely fibrillar, mat-like texture. Dentin specimens conditioned for 1 minute showed a smooth surface with many tubule openings partially occluded by debris. The 4-minute treatment exposed a 3-dimensional network of intertubular and peritubular collagen fibrils. No consistent morphologic differences were observed between cementum or dentin specimens treated with TTC at concentrations of 10 and 100 mg/ml, respectively. The results suggest that topical application of TTC produces morphologic alterations of periodontitis-exposed cementum and dentin that appear related to application interval rather than concentration of the drug.

Topics: Actin Cytoskeleton; Administration, Topical; Adult; Anti-Bacterial Agents; Collagen; Dental Cementum; Dentin; Humans; Microscopy, Electron, Scanning; Middle Aged; Periodontitis; Smear Layer; Tetracycline

The purpose of this study was to assess the effect of citric acid and tetracycline HCl application to dentin surfaces by a "passive dripping" or an "active burnishing" technique. Twenty dentin blocks were prepared from freshly extracted non-diseased human impacted third molars. The blocks were root planed and randomly assigned to two groups for treatment with either citric acid or tetracycline HCl. The duration of treatment was 30, 60, 120, or 240 seconds. Control blocks were treated with distilled water. After treatment the blocks were processed for observation and measurements in the scanning electron microscope (SEM). Application of either of the acid solutions resulted in removal of the smear layer. Measurements indicated a time dependent increase in the mean dentinal tubule orifice diameter ranging from 1.05 microns in control specimens to 3.18 microns after 4 minutes treatment (citric acid group). The increase in tubule diameter was significantly greater (P less than or equal to 0.01) for both citric acid treatment modalities than tetracycline HCl treatment. There was also a time dependent increase in the depth of penetration as measured by a trumpeting of the tubule profiles, and this penetration was significantly greater (P less than or equal to 0.01) after citric acid treatments. Passive or active application of the acids did not seem to have any major impact on the measurements or on the surface morphology. It was concluded that citric acid causes more extensive changes than tetracycline HCl and that the mode of application of the agent is probably not critical.

Topics: Acid Etching, Dental; Administration, Topical; Citrates; Citric Acid; Dentin; Dentin Permeability; Humans; Microscopy, Electron, Scanning; Smear Layer; Tetracycline; Time Factors; Tooth Root

The aim of this research was to assess the binding of fibrin clot to the teeth affected by periodontal disease following exposure to different root conditioning agents.. A total of 60 human teeth with a solitary root that were subjected to extraction following severe periodontal disease were used as study samples in this research. Two analogous grooves were prepared on the proximal radicular surface of every sample employing a diamond-tapered fissure bur using an aerator handpiece beneath abundant irrigation. Every sample was assigned to one of the following groups: • Group I: Tetracycline hydrochloride solution • Group II: Ethylenediaminetetraacetic acid (EDTA) gel • Group III: Biopure MTAD™ Subsequent to conditioning, the samples were rinsed for 3 minutes with phosphate-buffered saline (PBS) and permitted to air-dry for 20 minutes. A drop of fresh human whole blood procured from a hale and hearty volunteer was coated onto the dentin blocks in all three groups. A scanning electron microscope under 5000× magnification at 15 kV was used to examine the samples. Kruskal-Wallis test and Mann-Whitney U test were performed to procure the inter- and intragroup assessments Results: The greatest fibrin clot union was noted in the EDTA gel group at 2.86 ± 0.14 in pursuit by Biopure MTAD™ group at 2.39 ± 0.08 as well as tetracycline hydrochloride solution group at 1.82 ± 0.10. A statistically significant difference was noted between the investigational groups (. This research arrived at a conclusion that the dentinal surfaces subjected to conditioning with EDTA gel group as well as coated with human whole blood resulted in appreciably superior fibrin clot bonding to dentin vs Biopure MTAD™ as well as the tetracycline hydrochloride solution group.. Connective tissue attachment subsequent to surgical procedures causing the adhesion of a fibrin clot to the radicular surface as a result of initial wound healing processes is directly related to periodontal regeneration. It depends on biocompatibility for the fibrin clot and the periodontal pathosis-affected radicular surface to stick together, which can be procured with the aid of a variety of root conditioning measures in course of periodontal treatment.

Topics: Cell Adhesion; Dentin; Edetic Acid; Fibrin; Humans; Microscopy, Electron, Scanning; Periodontitis; Smear Layer; Tetracycline; Thrombosis; Tooth Root

The present study aimed to evaluate the effect of various root-conditioning agents on root surfaces that are periodontally affected.. A total of 90 human teeth having single root that were extracted because of chronic periodontitis were chosen. The extracted teeth were cleaned of saliva and blood using a soft-bristled brush and distilled water. The investigational groups were categorized into group I-doxycycline HCl, group II-ethylenediaminetetraacetic acid, and group III-tetracycline HCl. Samples were readied for histological study by scanning electron microscope (SEM). The SEM was used to assess the effectiveness of smear layer removal, amount of patent dentinal tubules out of the totality of dentinal tubules present, and the appreciation of collagen fiber-like structures inside the intertubular area.. The highest efficacy for smear layer removal was seen for group III-tetracycline HCl samples (1.80 ± 0.148) followed next by group II-EDTA (1.36 ± 0.230), and group I-doxycycline HCl (1.30 ± 0.283). The highest number of patent dentinal tubules were seen in group III-tetracycline HCl (44.50 ± 0.18) followed immediately by group II-EDTA (38.10 ± 0.42), and group I-doxycycline HCl (34.90 ± 0.23). The highest number of appreciation of collagen-like structures was recorded in group III-tetracycline HCl (2.64 ± 0.04) followed next by group I-doxycycline HCl (1.88 ± 0.10) and group II-EDTA (1.76 ± 0.28).. The present. The modification of the root surface of human teeth with the use of root conditioning agents leads to enhanced attachment by connective tissue resulting in improved reconstructive periodontal treatment goals.

Topics: Dentin; Edetic Acid; Humans; Microscopy, Electron, Scanning; Smear Layer; Tetracycline; Tooth Root

Endodontic success depends heavily on effective chemo-mechanical debridement of root canals through the use of instruments and irrigating solutions.. To compare the effectiveness of chamomile hydroalcoholic extract, Biopure™ mixture of tetracycline isomer, acid and detergent (MTAD) and 2.5 % sodium hypochlorite (NaOCl) on removal of the smear layer.. Randomised controlled trial.. Thirty extracted single-rooted, primary human teeth were allocated at random into three experimental groups of 10 teeth each. For each tooth, the canal was prepared using the step-back technique. During instrumentation, 2 ml of the irrigant was used for at least 10 s after each file and 10 ml as a final flush for 2 min for chamomile and NaOCL irrigants. Whereas for MTAD, an initial rinse with 1.3 % NaOCl for a cumulated period of 20 min, and use of MTAD as the final rinse for a period of 5 min was followed. Longitudinal grooves were made on root segments, then split into two halves with a chisel, stored in 2.5 % glutaraldehyde solution and fixed in ethanol series. Specimens were examined for the smear layer according to Hulsmann et al. (Int Endod J 35:668-679, 2002) criteria using a scanning electron microscope.. Kruskal-Wallis and Mann-Whitney U tests were used.. The most effective result in removal of smear layer occurred with the use of MTAD, followed by chamomile extract. The chamomile extract was found to be significantly more effective than 2.5 % NaOCl solution which had only minor effects.. The efficacy of chamomile to remove the smear layer was superior to 2.5 % NaOCl alone, but less effective than MTAD mixture.

Topics: Chamomile; Dental Pulp Cavity; Dentin; Detergents; Edetic Acid; Humans; Materials Testing; Matricaria; Microscopy, Electron, Scanning; Root Canal Irrigants; Root Canal Preparation; Smear Layer; Sodium; Sodium Hypochlorite; Statistics, Nonparametric; Tetracycline; Tooth Apex

Root conditioning is aimed at smear layer removal and at dental matrix collagen exposure, which may promote periodontal regeneration. This in vitro study assessed smear layer removal, collagen fiber exposure and the influence of PRP (platelet-rich plasma) application on adhesion of blood cells to the root surface using scanning electron microscopy (SEM).. Scaled root samples (n = 160) were set in five groups and conditioned with: group I - control group (saline solution); group II (EDTA 24%); group III (citric acid 25%); group IV (tetracycline hydrochloride 50 mg/ml); group V (sodium citrate 30%). Eighty samples were assessed using the root surface modification index (RSMI). The other eighty samples were set in two groups. The first group (n = 40) received PRP gel application with a soft brush and the second group (n = 40) received PRP application and then a blood drop. The fibrin clot formation was assessed in the first group and the blood cells adhesion was assessed in the second group using the BEAI (blood elements adhesion index). A previously trained, calibrated, and blind examiner evaluated photomicrographs. Statistical analysis was performed using the Kruskal-Wallis's and Dunn's tests.. Group III attained the best results for RSMI and BEAI. Moreover, it was the only group showing fibrin clot formation.. Citric acid was the most efficient conditioner for smear layer removal, collagen fiber exposure and blood cell adhesion. Moreover, it was the only group showing fibrin clot formation after PRP application.. This study demonstrated that root conditioning followed by PRP application may favor blood cell adhesion on root surface which may optimize periodontal healing.

Topics: Blood Cells; Blood Coagulation; Cell Adhesion; Chelating Agents; Citrates; Citric Acid; Dental Cementum; Dentin; Edetic Acid; Fibrin; Humans; Male; Microscopy, Electron, Scanning; Platelet-Rich Plasma; Smear Layer; Sodium Citrate; Tetracycline; Tissue Conditioning, Dental; Tooth Demineralization; Tooth Root

Dental roots that have been exposed to the oral cavity and periodontal pocket environment present superficial changes, which can prevent connective tissue reattachment. Demineralizing agents have been used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots.. This study compared four commonly used demineralizing agents for their capacity of removing smear layer and opening dentin tubules.. Fifty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: 1) CA: demineralization with citric acid for 3 min; 2) TC-HCl: demineralization with tetracycline-HCl for 3 min; 3) EDTA: demineralization with EDTA for 3 min; 4) PA: demineralization with 37% phosphoric acid for 3 min; 5) CONTROL: rubbing of saline solution for 3 min. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules.. Smear layer was present in 100% of the specimens from the groups PA and control; in 80% from EDTA group; in 33.3% from TC-HCl group and 0% from CA group. The mean numbers of exposed dentin tubules in a standardized area were: TC-HCl=43.8±25.2; CA=39.3±37; PA=12.1±16.3; EDTA=4.4±7.5 and CONTROL=2.3±5.7. The comparison showed significant differences between the following pairs of groups: TC-HCl and CONTROL; TC-HCl and EDTA; CA and CONTROL; and CA and EDTA. The mean percentages of area occupied by exposed dentin tubules were: CA=0.12±0.17%; TC-HCl=0.08±0.06%; PA=0.03±0.05%; EDTA=0.01±0.01% and CONTROL=0±0%. The CA group differed significantly from the others except for the TC-HCl group.. There was a decreasing ability for smear layer removal and dentin tubule widening as follows: AC>TC-HCl>PA>EDTA. This information can be of value as an extra parameter for choosing one of them for root conditioning.

Topics: Acid Etching, Dental; Analysis of Variance; Citric Acid; Dental Cavity Preparation; Dentin; Edetic Acid; Humans; Microscopy, Electron, Scanning; Phosphoric Acids; Smear Layer; Statistics, Nonparametric; Surface Properties; Tetracycline; Time Factors; Tooth Root

Although in vitro studies have shown encouraging results for root surface conditioning with demineralizing agents, in vivo studies have failed to show its benefits in periodontal healing. This can be attributed to several factors, among which, the hypermineralization of dental surface. Therefore, this in vitro study compared, using scanning electron microscopy (SEM), the effect of root surface conditioning with different conditioners (1% and 25% citric acid, 24% EDTA and 50 mg/mL tetracycline hydrochloride) in impacted teeth and in teeth that had their roots exposed to the oral environment. One trained examiner assessed the SEM micrographs using a root surface modification index. There was a tendency of more root surface modification in the group of impacted teeth, suggesting that the degree of root mineralization influences its chemical demineralization.

Topics: Adult; Chelating Agents; Citric Acid; Collagen; Dental Calculus; Dental Cementum; Dentin; Edetic Acid; Gingival Hemorrhage; Humans; Microscopy, Electron, Scanning; Middle Aged; Periodontal Pocket; Root Planing; Smear Layer; Tetracycline; Tooth Root; Tooth, Impacted

Smear layer removal and collagen fiber exposure may improve periodontal treatment and regeneration. This in vitro study assessed smear layer removal and collagen fiber exposure after tetracycline hydrochloride (TTC) application on root surfaces using scanning electron microscopy (SEM).. Root cementum was removed with diamond burs followed by scaling and root planning. Four hundred fifty samples were divided into ten groups: a control (saline application) and nine different TTC concentrations were applied at doses of 10, 25, 50, 75, 100, 125, 150, 200, and 250 mg/ml. The TTC application was performed in all groups in three different ways (passive, brushing, and burnishing) and at three different periods of conditioning (1, 2, and 3 minutes). A previously trained, calibrated, and blind examiner evaluated photomicrographs of the samples using Sampaio's index (2005). Statistical analysis was performed using the Kruskal-Wallis' and Dunn's tests.. The concentrations of 50 mg/mL and 75 mg/mL applied by burnishing were the most effective in smear layer removal and collagen fiber exposure. Both the passive mode of application (p=0.0001) and 1 minute period of application (p=0.002) were the least effective.. The concentrations of 50 mg/mL and 75 mg/mL applied by burnishing during 2 or 3 minutes were the most effective.. These parameters may be applied in periodontal procedures involving TTC root conditioning to optimize results.

Topics: Anti-Bacterial Agents; Decalcification Technique; Dental Cementum; Dose-Response Relationship, Drug; Fibrillar Collagens; Humans; Microscopy, Electron, Scanning; Root Planing; Smear Layer; Tetracycline

The present in vitro study has been designed to establish and compare the effects of citric acid, EDTA, and tetracycline HCl on human periodontally diseased roots on the structure, attachment, and orientation of V79 (primary Chinese hamster lung fibroblasts) cells and human periodontal ligament fibroblasts (HPDL).. Commercially available V79 cells and HPDL derived from healthy human third molars were used in this study. These fibroblasts were left in solution for seven days in order to attain confluence. Forty single-rooted teeth were obtained from patients diagnosed with periodontitis. The crown part was removed under constant irrigation and the root was split vertically into two equal halves, thus, yielding 80 specimens. Following scaling and root planing, the specimens were washed with phosphate buffered saline (PBS) and kept in 50 microg/ml gentamycin sulphate solution for 24 hours. The root pieces were then treated as follows: citric acid at pH 1, 24% EDTA, or with a 10% solution of tetracycline HCl and were then placed in V79 fibroblast cultures and HPDL cultures. The specimens were harvested after four weeks and were fixed in 2.5% glutaraldehyde in PBS before preparation for scanning electron microscopy (SEM).. The behavior of V79 cells was similar to that of human periodontal ligament cells on root conditioned surfaces. V79 and HPDL showed a healthy morphology on root surfaces treated with citric acid and EDTA and a relatively unhealthy appearance on root surfaces treated with tetracycline HCl and distilled water (control group).. The results suggest the use of citric acid and EDTA as root conditioning agents favorably affects the migration, attachment, and morphology of fibroblasts on human root surfaces, which may play a significant role in periodontal healing and regeneration.

Topics: Animals; Anti-Bacterial Agents; Cell Adhesion; Cell Line, Transformed; Cell Proliferation; Chelating Agents; Citric Acid; Cricetinae; Cricetulus; Dental Etching; Edetic Acid; Fibroblasts; Humans; Microscopy, Electron, Scanning; Periodontal Ligament; Periodontitis; Regeneration; Smear Layer; Surface Properties; Tetracycline; Tooth Root

The antibacterial and anticollagenolytic properties of tetracycline (TCN) are valuable in periodontal therapy, and TCN treatment can remove the smear layer following root instrumentation. However, recent reports pointing to cytotoxic effects of several acids prompted this study to define TCN concentrations that are anticollagenolytic and remove the smear layer, but have low cytotoxicity.. Human gingival (hGF) and periodontal ligament (hPDL) cells were treated short- (3 minutes) or long-term (24 hours) with TCN to determine concentrations yielding 50% (TD(50)) and 90% (TD(10)) cell survival. Activity assays measured TCN concentrations with half-maximal inhibition (IC(50)) of matrix metalloproteinase- 2 and -9 (MMP-2 and -9). Finally, we analyzed the effects of TCN with high (75 mg/ml) or low (1 mg/ml) cytotoxicity on the smear layer by scanning electron microscopy (SEM).. The TD(50) for TCN after short-term treatment was 4 mg/ml for both hGF and hPDL. Ninety percent of the cells survived 0.2 mg/ml. With long-term treatment, the TD(50) for hGF and hPDL was 70 and 30 microg/ml, respectively, and the TD(10) was 20 and 5 microg/ml. HGF and hPDL recovered from the 3-minute treatment with 1 mg/ml, but not from concentrations exceeding 3 and 9 mg/ml, respectively. The IC(50) was 25 microg/ml for both MMP-2 and MMP-9. Whereas 75 mg/ml TCN removed the smear layer, 1 mg/ml TCN had no effects.. Tetracycline has significant cytotoxicity on periodontal cells. Since non-cytotoxic concentrations of TCN inhibited MMP-2 and -9 but had no effects on the smear layer, TCN is not recommended for root surface treatment.

Topics: Anti-Bacterial Agents; Cell Survival; Cells, Cultured; Dose-Response Relationship, Drug; Fibroblasts; Gingiva; Humans; Inhibitory Concentration 50; Matrix Metalloproteinase Inhibitors; Periodontal Ligament; Protease Inhibitors; Smear Layer; Tetracycline; Tooth Root

The aim of this study was to investigate the in vitro attachment behavior of human periodontal ligament fibroblasts on periodontally involved root surface after conditioning with CO2 laser and to compare its efficacy with chemical conditioning agents, namely tetracycline hydrochloride, citric acid, hydrogen peroxide (H2O2) and EDTA, using scanning electron microscopy.. A total of 84 scaled and root-planed specimens from periodontally involved single-rooted human teeth showing hopeless prognosis were selected and assigned to two groups. One group was lased with a CO2 laser (from 5 cm at 3 W for 0.8, 1.0 and 1.2 s), and the other group was treated with either tetracycline hydrochloride (2.5%), citric acid (saturated solution, pH 1), H2O2 (6%) or EDTA (5%; pH 7.4) for 3 min. The specimens were then seeded with human periodontal ligament fibroblasts, incubated for either 12 h or 24 h, and then the cell attachment behavior was observed.. CO2 laser irradiation for 1.0 s was found to be the most efficient, showing consistently good cell attachment with the highest mean value (15.00 +/- 3.41 cells/10,000 microm2 after incubation for 12 h and 29.17 +/- 2.04 cells/10,000 microm2 after 24 h), followed by irradiation for 0.8 s (13.11 +/- 3.04 cells/10,000 microm2 after incubation for 12 h and 22.91 +/- 7.10 cells/10,000 microm2 after 24 h). Charring was observed following irradiation for 1.2 s. Amongst chemical conditioning agents, citric acid was found to be the most efficient, with a mean cell attachment of 17.82 +/- 2.16 cells/10,000 microm2 after incubation for 12 h and 23.62 +/- 1.94 cells/10,000 microm2 after 24 h. EDTA and H2O2 did not do well in the study.. The results suggest that CO2 laser irradiation for 1.0 s may promote comparatively better attachment of periodontal ligament fibroblast on dentinal root surfaces than the conventional chemical conditioning agents used in the study.

Topics: Analysis of Variance; Anti-Bacterial Agents; Carbon Dioxide; Cell Adhesion; Cells, Cultured; Chelating Agents; Citric Acid; Dentin; Dentin Permeability; Edetic Acid; Fibroblasts; Humans; Lasers; Microscopy, Electron, Scanning; Periodontal Ligament; Smear Layer; Tetracycline; Tooth Root

Twenty four human teeth, extracted due to severe periodontitis were used in the present Following extraction, the border between healthy and diseased was marked with a small dental bur. The portions of diseased roots were either untreated or were treated with ultrasonic scaling or tetracycline hydrochloride, or ultrasonic scaling followed by tetracycline hydrochloride. Human gingival fibroblasts were then added to the roots so treated and were allowed to incubate for 72 h and examined by scanning electron microscopy. There were a significantly greater number of fibroblasts attached to specimens treated with ultrasonic scaling and ultrasonic scaling followed by root demineralization. No cells were could be seen on the untreated surfaces whether or not root surface conditioning was used.

Topics: Anti-Bacterial Agents; Cell Adhesion; Dental Scaling; Fibroblasts; Gingiva; Humans; Microscopy, Electron, Scanning; Periodontitis; Random Allocation; Smear Layer; Tetracycline; Tooth Root; Ultrasonic Therapy

The scanning electron microscope was used to evaluate the dentin surface of diseased teeth subjected to two methods of conditioning with tetracycline hydrochloride (TTC) for 1 and 4 minutes respectively. Five groups of twelve specimens each received root planing (control); were immersed in TTC for 1 and 4 minutes; and burnished in TTC for 1 and 4 minutes. Control specimens exhibited an amorphous irregular surface smear layer. TTC, irrespective of the method used, was effective in removing the smear layer. Immersion in TTC for 1 minute revealed obstructed dentinal tubules, while burnishing for 1 minute revealed the presence of collagen fibrils. The 4-minute application of TTC, irrespective of the conditioning method used, showed wide exposed dentinal tubules. No significant difference between Groups III, IV, and V was noted (p>0.05).

Topics: Analysis of Variance; Decalcification Technique; Dentin; Dose-Response Relationship, Drug; Fibrillar Collagens; Humans; Microscopy, Electron, Scanning; Periodontitis; Root Planing; Smear Layer; Statistics, Nonparametric; Tetracycline; Time Factors; Tooth Root

The effect of tetracycline hydrochloride as an endodontic irrigant on smear layer removal was examined by scanning electron microscopy and compared with bidistilled water, 2.5% sodium hypochlorite (NaOCl), and 50% citric acid in 20 extracted teeth. Five teeth, as a control, were irrigated with bidistilled water only in group 1. All the other groups were irrigated with NaOCI during instrumentation. The final rinses were NaOCl in group 2, citric acid in group 3, and 1% tetracycline hydrochloride in group 4. Scanning electron microscopic results and statistical analysis revealed that bidistilled water and NaOCl were ineffective in removing the smear layer, whereas citric acid and tetracycline hydrochloride were significantly more effective (p < 0.001). No statistically significant difference was detected between tetracycline hydrochloride and citric acid (p > 0.05). However tetracycline hydrochloride demineralized less peritubular dentin.

Topics: Anti-Bacterial Agents; Citric Acid; Cuspid; Dentin Permeability; Humans; Microscopy, Electron, Scanning; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite; Statistics, Nonparametric; Surface Properties; Tetracycline

The use of demineralizing agents has been reported to enhance the degree of connective tissue attachment to denuded roots. Of the agents used, tetracycline HCI has received the most attention.. The purpose of this study was to evaluate and compare the SEM surface morphology of human root dentin following various concentrations and application times of tetracycline HCl. The surface characteristics were compared and the width of dentin tubule orifices were measured and analyzed. Twelve human teeth were collected and stored in distilled water after soft tissue removal using hand instruments. The apical third of each root was removed and remaining mid-root region was sectioned longitudinally through the root canal following removal of its cementum with a fine diamond bur. A total of 48 dentin specimens were randomly divided into 8 groups for conditioning at different tetracycline HCl concentrations, at 0, 10, 25, 50, 75, 100, 125, and 150 mg/ml. Application times for each group were 1, 3, and 5 minutes. Immediately following treatment procedures, the specimens were rinsed, fixed in GTA-PBF, dehydrated, and prepared for SEM. Each specimen was examined at 2 magnification values, representative fields photographed, and data tested by one-way ANOVA and paired t test statistical analysis.. Our results indicate that the use of tetracycline HCl solution between 50 mg/ml and 150 mg/ml showed a statistically significant opening of dentin tubules. All tetracycline HCl groups at 1, 3, and 5 minutes show smear layer removal from the dentin surface.. Dentin demineralization is not time dependent at all concentrations of tetracycline HCI.

Topics: Anti-Bacterial Agents; Decalcification Technique; Dentin; Dentin Permeability; Humans; Microscopy, Electron, Scanning; Molar; Random Allocation; Smear Layer; Statistics, Nonparametric; Tetracycline; Tooth Root

This study aimed to evaluate quantitatively the migrated, attached, and oriented human periodontal ligament cells (HPLC) to periodontally diseased cementum and dentin after demineralization with low and neutral pH etching solution.. Human teeth, extracted due to periodontal diseases, were scaled and root planed so that cementum remained on one longitudinal half of the root and dentin was exposed on the other half. Forty root slices of 200 microm thickness, obtained from the mid-third of these roots, were divided into four groups: group 1, demineralized with a saturated solution of citric acid (pH 1.20); group 2, with 24% EDTA (pH 7.04); group 3, with tetracycline HCl 100 mg/ml (pH 2.00); and group 4, only scaled and root planed (control). Root slices were placed over the confluent HPLC in 35 mm culture dishes and incubated. Phase contrast microscopic photographs of attached and oriented refractile HPLC to root surfaces were taken at days 1, 3, and 7. Quantitative analysis of attached and oriented HPLC from these photographs was done using special software.. The results showed no significant difference in the attachment and orientation index of HPLC to cementum compared to dentin in any method of demineralization at each time point (P >0.05), although there was a significantly higher cell attachment and orientation index to demineralized dentin with EDTA and citric acid than to non-etched dentin and to all 3 demineralized cementum surfaces compared to non-etched cementum (P<0.05).. EDTA and citric acid demineralization may enhance HPLC attachment and orientation to the root surface, and it is not always necessary to remove excessive cementum when the demineralizing procedure is used.

Topics: Cell Adhesion; Cells, Cultured; Citric Acid; Decalcification Technique; Dental Cementum; Dentin; Edetic Acid; Humans; Periodontal Attachment Loss; Periodontal Ligament; Regeneration; Root Planing; Smear Layer; Statistics, Nonparametric; Surface Properties; Tetracycline; Tooth Root

Scanning electron microscopy of root surfaces that had been ultrasonically scaled and subjected to various conditioning regimens revealed the presence of two distinct types of cracks: extensive cracks, presumed to have been caused by drying before and during sputter-coating procedures; and smaller cracks that reflected the pattern of the irregular underlying dentin. Both etching and chelating agents appear to cause demineralization of the interfacial layer between cementum and dentin, causing a "peeling off" of cementum and exposure of the underlying dentin. The results suggest that burnishing the scaled root surface with either saline or any of the etching or chelating agents for at least 10 seconds, followed by soaking the cementum in 8% ethylenediaminetetraacetic acid for about 40 seconds, achieved a root surface that might be regarded as optimal for regeneration of periodontal tissues.

Topics: Acid Etching, Dental; Chelating Agents; Citric Acid; Collagen; Dental Cementum; Dentin; Edetic Acid; Guided Tissue Regeneration, Periodontal; Humans; Microscopy, Electron, Scanning; Patient Care Planning; Smear Layer; Sodium Chloride; Surface Properties; Tetracycline; Time Factors; Tooth Root

This in vitro study compares, by scanning electron microscope (SEM) examination, the surface effects of various topical applications of tetracycline on the instrumented dentin root surface of human teeth. Eighty-two (82) dentin samples were prepared from periodontally-compromised teeth planned for extraction. Solutions of tetracycline HCl, doxycycline, minocycline, sumycin, and a saline control were prepared and applied to the dentin samples for 0.5, 1, 3, 5, and 10 minutes. Each solution pH was measured: tetracycline HCI (pH 1.6), doxycycline (pH 2.2), minocycline (pH 3.8), sumycin (pH 4.4), and saline (pH 5.1). A tetracycline periodontal fiber was also evaluated at 1, 4, 7, and 10 days of exposure for dentin surface effects. Tetracycline HCI removed the dentin smear layer leaving clean and open tubules significantly better than other solutions tested in as little as 30 seconds. Doxycycline and minocycline produced similar results to each other, which were significantly better than sumycin and saline, but not as effective as tetracycline HCl. Smear layer removal was attained by doxycycline and minocycline in five to ten minutes; however, sumycin and the saline control ineffectively removed the surface smear layer and dentinal tubules remained partially to totally occluded by debris. The periodontal fiber did not significantly alter the surface smear layer. Results of this study suggest that tetracycline HCl is the best current tetracycline form for root surface conditioning as measured by its ability to affect both dentin smear layer removal and dentin tubule exposure.

Topics: Administration, Topical; Anti-Bacterial Agents; Dentin; Doxycycline; Drug Carriers; Follow-Up Studies; Humans; Microscopy, Electron, Scanning; Minocycline; Periodontal Diseases; Placebos; Root Planing; Smear Layer; Subgingival Curettage; Tetracycline; Time Factors; Tooth Root

The scanning electron microscope was used to evaluate the effects of ultrasonic irrigation before and after root conditioning. Six groups of five specimens each received saline irrigation; ultrasonic irrigation; saline irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride; or ultrasonic irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride. After immersion in citric acid or tetracycline hydrochloride solutions, root dentin was rinsed again with saline or irrigated ultrasonically. Control specimens exhibited an amorphous, irregular surface smear layer. Ultrasonic irrigation, citric acid, and tetracycline hydrochloride were effective in removing the smear layer. Use of ultrasonic irrigation before and after acid application improved the exposure of dentinal fibrils.

Topics: Acid Etching, Dental; Analysis of Variance; Anti-Bacterial Agents; Citric Acid; Dentin; Humans; Microscopy, Electron, Scanning; Root Canal Irrigants; Root Canal Preparation; Smear Layer; Statistics, Nonparametric; Tetracycline; Tooth Root; Ultrasonic Therapy

The purpose of this investigation was to compare by scanning electron microscopy (SEM) the surfaces of roots treated with a dentin conditioning agent and other materials that have been used routinely in periodontal therapy for root surface demineralization, namely, citric acid and tetracycline hydrochloride.. Sixteen freshly extracted human teeth were randomly divided into four equal groups; each tooth was hand scaled and planed prior to root surface conditioning with citric acid, tetracycline hydrochloride, and a dentin bonding conditioner; Tenure Dentin Conditioner (DenMat Corporation, Santa Maria, CA). The last has been used previously in conjunction with a resin-ionomer barrier in cases involving guided tissue regeneration. Root specimens were prepared for scanning electron microscopy and representative micrographs were taken at 1000x and 2000x.. The results of this study indicate that there are morphological similarities between surfaces obtained with the dentin conditioning agent and the other acidic materials that are used routinely in periodontal regenerative therapy.. Root surface demineralization has been shown to remove the smear layer, and provides a surface which is conductive to mechanical adhesion and cellular mechanisms for growth and attachment.

Topics: Acid Etching, Dental; Anti-Bacterial Agents; Citric Acid; Dentin; Humans; Nitric Acid; Oxalates; Root Planing; Smear Layer; Tetracycline; Tooth Root

Tetracycline hydrochloride treatment of cementum and dentin surfaces derived from human teeth not affected by periodontitis resulted in the removal of the smear layer and uncovered a fibrillar collagen substrate. In cementum specimens, the amount of exposure of the organic matrix appeared to be more related to morphologic structure of the cementum and mechanical instrumentation of the root surface rather than to concentration and time of application of tetracycline solution. Time-dependent changes were observed in dentin surfaces, the intertubular "matted" collagen matrix being evident only in the 4-minute specimens.

Topics: Dental Cementum; Dentin; Dose-Response Relationship, Drug; Humans; Microscopy, Electron, Scanning; Root Planing; Smear Layer; Surface Properties; Tetracycline; Time Factors; Tooth Root

This study compared the surface characteristics of periodontally diseased single-rooted human teeth extracted after treatment with either tetracycline HCl or citric acid solutions. The study group was comprised of 30 teeth from 22 patients with advanced periodontal disease extracted before the start of periodontal therapy. Diseased surfaces were identified, outlined, and root planed by hand curet or finishing bur. The teeth were sectioned and solutions of tetracycline HCl or citric acid (pH 1) were applied to the surfaces with cotton pellets for 5 minutes. Extracted teeth were processed and root surface samples then examined by scanning electron microscope. The surfaces of both acid-treated sets of specimens differed considerably from specimens treated with root planing alone, regardless of root planing method. Acid-treated specimens exhibited dentinal tubules exposed by the removal of the smear layer, surfaces devoid of the debris normally present in root planed-only specimens, and the dense network of collagen fibers that make up the dentin structure. Although differences were seen in surface depressions and fiber-like structures among some specimens, the tetracycline HCl and citric acid solutions produced comparable morphologic characteristics.

Topics: Acid Etching, Dental; Adult; Citrates; Citric Acid; Cuspid; Dental Scaling; Dentin; Humans; Microscopy, Electron, Scanning; Periodontitis; Root Planing; Smear Layer; Surface Properties; Tetracycline; Tooth Root