A Comparative Evaluation of the Efficacy of Citric Acid, Ethylene Diamine Tetra Acetic Acid (EDTA) and Tetracycline Hydrochloride as Root Biomodification Agents: An In Vitro SEM Study

Background and aims. Root conditioning is recommended as an adjunct to mechanical root surface debridement to remove smear layer and root associated endotoxins. The aim of this study was to compare the efficacy of citric acid, ethylenediaminetetraacetic acid (EDTA), and tetracycline hydrochloride as root biomodification agents. Materials and methods. Fifteen freshly extracted teeth were root planed and specimens obtained from the cervical two-thirds of the root. Each tooth root provided four specimens to be treated by saline (used as control, citric acid, EDTA and tetracycline hydrochloride for a total of three minutes using the passive burnishing technique. The specimens were then observed under a scanning electron microscope (SEM). The specimens were evaluated for presence or absence of smear layer, total number of tubules visible, number of patent tubules and diameter of patent tubules. Statistical analysis was performed using paired-test. Results. All three test groups effectively removed the smear layer in comparison to the control. The number of patent tubules present in the citric acid and EDTA test groups was significantly higher than those in the tetracycline hydrochloride test group. However, the average diameter of the patent tubules was greater in the tetracycline hydrochloride group compared with citric acid and EDTA groups. Conclusion. All three agents are equally effective root biomodification agents. In clinical practice, EDTA might be more useful owing to its neutral pH.