ROOT CONDITIONING BEFORE PERIO SURGERIES

[Drsumitra]

Materials used for root conditioning include
FIBRONECTIN
TETACYCLINE
CITRIC ACID

Of these most widely used is citric acid
CItric acid have the following actions
Accelerated healing and new cementum formation after surgical detachment of gingival tissues and demineralisation of root surface by means of citric acid
It has no effect on non planed roots however when applied on planed roots, it leads to producing a 4micromm deep demineralised zone with exposed collagen
Removes debris as also smear layer and makes the exposed dentinal tubules appear wider and funnel shaped orifices
Eliminates bacteria and endotoxins from the root surface
Early fibrin linkage to collagen fibres exposed by the citric acid prevents epithelium migration over treated roots

REcommended technique is as follows::
Raise mucoperiosteal flap
Thoroughly plane the root surface
Apply cotton pledgets soaked in saturated citric acid pH 1 for 2-5 mins
Remove pledgets and irrigate thoroughly
REplace flap and suture

        

[sushantpatel_doc]

The effect of citric acid conditioning of the root surface in conjunction with gingival flap surgery including barrier membranes (expanded polytetrafluoroethylene) was clinically evaluated in 26 intrabony periodontal defects in 23 patients. Control treatment included gingival flap surgery with barrier membranes alone. Twelve defects were treated with the experimental and 14 with the control protocol. Healing was evaluated 12 months after surgery. Initial probing depths approximated 6.9 mm and defect depths measured during surgery exceeded 4 mm. The patients exhibited good oral hygiene over the study interval as substantiated by low plaque and bleeding scores. Acid conditioning of the root surface did not enhance periodontal healing in this study, similar amounts of defect resolution were observed following either treatment protocol. Probing depth reduction generally approximated 1.8 mm; gain of clinical attachment, 0.8 mm; and defect bone fill, 1.2 mm. Under the prevailing conditions, the barrier membrane procedure apparently gave a healing result beyond which further improvement could not be achieved by root surface conditioning.

        

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