A Scanning Electron Microscope Evaluation of the Adhesion of Fibrin Clot to the Periodontally Compromised Teeth after Exposed to Different Root-conditioning Agents: An In Vitro Study
Citation Information :
Verma A, Raj K, Satyanarayan A, Archana D, Anand K, Nath B. A Scanning Electron Microscope Evaluation of the Adhesion of Fibrin Clot to the Periodontally Compromised Teeth after Exposed to Different Root-conditioning Agents: An In Vitro Study. J Contemp Dent Pract 2022; 23 (9):895-899.
Aim: 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.
Materials and methods: 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 (p < 0.001).
Conclusion: 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.
Clinical significance: 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.
Minocha T, Rahul A. Comparison of fibrin clot adhesion to dentine conditioned with citric acid, tetracycline, and ethylene diamine tetra acetic acid: An in vitro scanning electron microscopic study. J Indian Soc Periodontol 2012;16(3):333–341. DOI: 10.4103/0972-124X.100907.
Baker PJ, Rotch HA, Trombelli L, et al. An in vitro screening model to evaluate root conditioning protocols for periodontal regenerative procedures. J Periodontol 2000;71(7):1139–1143. DOI: 10.1902/jop.2000.71.7.1139.
Nascimento GG, Leite AA, Leite ER, et al. Blood clot stabilization on root dentin conditioned by the combination of tetracycline and EDTA. Braz J Oral Sci 2014;13(2):83–88. DOI: 10.1590/1677-3225v13n2a01.
Tandon C, Govila V, Pant VA, et al. Comparative in vitro SEM study of a novel root canal irrigant-MTAD and conventional root biomodifiers on periodontally involved human teeth. J Indian SocPeriodontol 2015;19(3):268–272. DOI: 10.4103/0972-124X.154192.
Preeja C, Janam P, Nayar BR. Fibrin clot adhesion to root surface treated with tetracycline hydrochloride and ethylenediaminetetraacetic acid: A scanning electron microscopic study. Dent Res J 2013;10(3):382–388. PMID: 24019809.
Polson AM, Frederick GT, Ladenheim S, et al. The production of a root surface smear layer by instrumentation and its removal by citric acid. J Periodontol 1984;55:443–446. https://pubmed.ncbi.nlm.nih.gov/6384464/.
Didhra G, Upadhyay S, Sharma A, et al. Fibrin clot adhesion to instrumented conditioned root surfaces by MTAD and normal saline: A scanning electron microscopy study. Arch Med Health Sci 2020;8(1):57–61. DOI: 10.4103/amhs.amhs_149_19.
Theodoro LH, Sampaio JE, Haypek P, et al. Effect of Er: YAG and Diode lasers on the adhesion of blood components and on the morphology of irradiated root surfaces. J Periodontal Res 2006;41:381–390. https://pubmed.ncbi.nlm.nih.gov/16953814/.
Zandim DL, Leite FR, Silva VC, et al. Wound healing of dehiscence defects following different root conditioning modalities: An experimental study in dogs. Clin Oral Investig 2013;17(6):1585–1593. DOI: 10.1007/s00784-012-0848-4.
Isik AG, Tarim B, Hafez AA, et al. A comparative scanning electron microscopic study on the characteristics of demineralized dentin root surface using different tetracycline HCl concentrations and application times. J Periodontol 2000;71(2):219–225. DOI: 10.1902/jop.2000.71.2.219.
Cavassim R, Leite FR, Zandim DL, et al. Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning. J Appl Oral Sci 2012;20(3):376–383. DOI: 10.1590/s1678-77572012000300014.
Amaral NG, Rezende ML, Hirata F, et al. Comparison among four commonly used demineralizing agents for root conditioning: A scanning electron microscopy. J Appl Oral Sci 2011;19:469–475. DOI: 10.1590/s1678-77572011000500006.
Silva AC, Moura CC, Ferreira JA, et al. Biological effects of a root conditioning treatment on periodontally affected teeth: An in vitro analysis. Braz Dent J 2016;27(2):160–168. DOI: 10.1590/0103-6440201600427.
Blomlof J, Lindskog S. Root surface texture and early cell and tissue colonization after different etching modalities. Eur J Oral Sci 1995;103(1):17–24. DOI: 10.1111/j.1600-0722.1995.tb00005.x.
Gamal AY. Enhanced β-tricalcium phosphate blended clot adhesion to EDTA biomodulated periodontally affected root surfaces: In vivo scanning electron microscopy evaluation. J Periodontol. 2011;82(11):1587–1595. DOI: 10.1902/jop.2011.110023.
Leite F, Moreira C, Theodoro L. Blood cell attachment to root surfaces treated with EDTA gel. Braz Oral Res 2005;19(2):88–92. DOI: 10.1590/s1806-83242005000200003.
Zia A, Andrabi SM, Bey A, et al. Endodontic irrigant as a root conditioning agent: An in vitro scanning electron microscopic study evaluating the ability of MTAD to remove smear layer from periodontally affected root surfaces. Singapore Dent J 2014;35:47–52. DOI: 10.1016/j.sdj.2014.04.002.