title: Effect of the association between citric acid and EDTA on root surface etching.
abstract: OBJECTIVE
  This study aims to compare the clot stabilization on root surfaces conditioned with citric acid and ethylenediamine-tetraacetic acid (EDTA).
  
  
  METHODS
  Scaled root samples (n = 100) were set in fve groups: group I-control group (saline solution); group II (24% EDTA); group III (25% citric acid); group IV (EDTA + citric acid); group V (citric acid + EDTA). Fifty samples were assessed using the root surface modifcation index (RSMI). The other 50 received a blood drop after conditioning. Clot formation was assessed using blood elements adhesion index (BEAI). A blind examiner evaluated photomicrographs. Statistical analysis considered p < 0.05.
  
  
  RESULTS
  Groups-III and G-V attained the best results for RSMI and BEAI in comparison to control. The worst results for clot stabilization were seen in group-II. EDTA employment before citric acid (group-IV) reduced clot formation in comparison to citric acid use alone (group-III).
  
  
  CONCLUSIONS
  Root conditioning with citric acid alone and before EDTA had the best results for smear layer removal and clot stabilization. EDTA inhibited clot stabilization on root surface and must have a residual activity once it has diminished clot adhesion to root even after citric acid conditioning. Thus, EDTA can be used to neutralize citric acid effects on periodontal cells without affecting clot stabilization. Clinical signifcance: To demonstrate that citric acid use on root surfaces previously affected by periodontal disease may favor clot stabilization and may have a benefcial effect on surgical outcomes. Also, EDTA can be used to neutralize citric acid effects on periodontal cells.
authors.affiliation: Adjunct Professor, Department of Semiology and Clinics, Federal University of Pelotas, Rio Grande do Sul, Brazil, Phone: 555332256741 e-mail: leite.fabio@gmail.com.
authors.forename: Fabio Renato
authors.initials: FR
authors.lastname: Manzolli Leite
authors.affiliation: Graduate Student, Department of Restorative Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil.
authors.forename: Gustavo Giacomelli
authors.initials: GG
authors.lastname: Nascimento
authors.affiliation: Professor, Department of Clinical Analysis, State University of São Paulo, São Paulo, Brazil.
authors.forename: Elza Regina
authors.initials: ER
authors.lastname: Manzolli Leite
authors.affiliation: Adjunct Professor, Department of Clinical Analysis, State University of São Paulo, São Paulo, Brazil.
authors.forename: Amauri Antiquera
authors.initials: AA
authors.lastname: Leite
authors.affiliation: Adjunct Professor, Department of Diagnosis and Surgery, State University of São Paulo, São Paulo, Brazil.
authors.forename: Josá Eduardo
authors.initials: JE
authors.lastname: Cezar Sampaio
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods*; D000327:Adsorption; D001773:Blood Cells / Q000187:drug effects / Q000648:ultrastructure; D001777:Blood Coagulation / Q000187:drug effects*; D002448:Cell Adhesion / Q000187:drug effects; D019343:Citric Acid / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D003094:Collagen / Q000187:drug effects / Q000648:ultrastructure; D003739:Dental Cementum / Q000187:drug effects / Q000648:ultrastructure; D012534:Dental Scaling / Q000379:methods; D003804:Dentin / Q000187:drug effects / Q000648:ultrastructure; D004492:Edetic Acid / Q000494:pharmacology*; D005337:Fibrin / Q000648:ultrastructure; D006801:Humans; D008855:Microscopy, Electron, Scanning; D010513:Periodontal Ligament / Q000166:cytology / Q000187:drug effects; D016369:Smear Layer; D014092:Tooth Root / Q000187:drug effects / Q000648:ultrastructure*
chemical_list: D019343:Citric Acid; D005337:Fibrin; D003094:Collagen; D004492:Edetic Acid