Effects of EDTA gel preconditioning of periodontally affected human root surfaces on chlorhexidine substantivity - an SEM study.
BACKGROUND
Infection control is an important requirement during the early stages of periodontal healing. This study was performed to assess the preconditioning effect of EDTA gel on chlorhexidine (CHX) substantivity to periodontally involved root surfaces.


METHODS
Eighty patients with severe chronic periodontitis were enrolled in this study. Following cause-related therapy, patients were divided randomly into four groups. Each group consisted of 20 subjects with one tooth that was diagnosed as hopeless and designated for extraction. In group 1 (G1), selected periodontal pockets were filled with a placebo gel in a silica base for 2 minutes. Exposed roots in group 2 (G2) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the placebo gel. Pockets in group 3 (G3) were filled with 0.12% CHX digluconate gel in a silica base. Exposed roots in group 4 (G4) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the CHX gel. Four teeth from each group were extracted immediately and at 3, 12, 24, and 48 hours for SEM evaluation.


RESULTS
G1 and G2 specimens showed no evidence of silica adherent to any of the examined root surfaces. At 3 hours following CHX gel application, G3 specimens showed marked reduction in CHX-coated silica. At 24 and 48 hours following EDTA and CHX gel application, G4 specimens demonstrated adherent CHX-coated silica particles despite the reclogging of the tubule orifices.


CONCLUSIONS
EDTA and CHX gel root conditioning is a valuable regimen that improves CHX substantivity to periodontally involved root surfaces.
Gamal
Ahmed Y
AY
Faculty of Dental Medicine, El Azhar University, Cairo, Egypt.
Mailhot
Jason M
JM
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002614:Chelating Agents / Q000494:pharmacology*; D002710:Chlorhexidine / Q000008:administration & dosage*; D002908:Chronic Disease; D004311:Double-Blind Method; D016503:Drug Delivery Systems; D004492:Edetic Acid / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010518:Periodontitis / Q000188:drug therapy*; D058428:Silica Gel; D012822:Silicon Dioxide / Q000494:pharmacology; D016369:Smear Layer; D013499:Surface Properties / Q000187:drug effects; D014092:Tooth Root / Q000187:drug effects* / Q000648:ultrastructure
D000891:Anti-Infective Agents, Local; D002614:Chelating Agents; D058428:Silica Gel; D012822:Silicon Dioxide; D004492:Edetic Acid; D002710:Chlorhexidine