Root Conditioning Agents in Periodontal Therapy

Root Conditioning Agents

It is a process which aims at obtaining new attachment by conditioning the root surface with the help of agents known as root conditioners or root surface conditioners or root biomodifiers.

Root Conditioning can be Done with Help of Following

• Chemical treatment of root surfaces
  • Acid etching by citric acid and tetracycline
  • Detergents, i.e. Cetylpyridinium chloride and sodium N-lauroylsarcosine
  • Chelating agents, i.e. EDTA
  • Enzymes
  • Attachment proteins, i.e. Fibronectin and growth factors.
• Mechanical
• LASER.

“Understanding The Role Of Root Conditioning Agents In Periodontal Therapy”

Citric acid

• It is used at pH of 1 for 2–3 minutes on root surface, after surgical debridement it produces a surface demineralization, which in turn induces cementogenesis and attachment of collagen fibers.
• It removes the smear layer, and may open dentinal tubules, thus allowing cementum to form within these tubules and produces cementum pins. This could be associated with accelerated cementogenesis.
• Epithelium does not migrate apically because of the accelerated healing either by connective tissue attachment or a collagen adhesion may occur before epithelium migrates.
• Citric acid may demineralize small bits of residual calculus, disinfect the root surface and aid in removing endotoxins.

“Types Of Root Conditioning Agents Used In Dentistry”

Tetracycline

• It removes the smear layer and exposes the dentinal tubules.
• It enhances the attachment and spreading of fibroblast on the root surfaces.
• It decreases the epithelial cell attachment.

EDTA

• It is used at a concentration of 24% and at pH 7.
• It exposes the collagen fibers of the dentine matrix, which facilitates the adhesion of blood clot to the root surface, and thereby favors the migration of fibroblasts.
• It improves clot organization, retards epithelium downgrowth and enhances clinical attachment gain.

“Comprehensive Overview Of Root Conditioning Benefits In Periodontics”

Growth Factors

• Naturally occurring polypeptide molecules secreted by macrophages, endothelial cells. fibroblasts, and platelets that regulate events in periodontal wound healing.
• They regulate connective tissue cells migration and proliferation of periodontal ligament cells, differentiation of osteoblasts and cementoblasts and production of extracellular matrix proteins for periodontal regeneration.

“Risk Factors For Improper Use Of Root Conditioning Agents”

Enamel Matrix Proteins

• Enamel matrix proteins are isolated from developing porcine teeth.
• Promote periodontal regeneration by mimicking events that take place during development of the periodontal tissues.
• Enhance PDL cell attachment

Fibronectin

• Acts as adhesive for the attachment of fibroblast on the root surfaces.
• It promotes the connective tissue attachment and helps in bone regeneration.
• Prevents the separation of flap and favors the hemostasis.