Objectives: Root surface biomodification is a mainstay of surgical periodontics. Historically, citric acid (CA) has been the gold standard to which all other agents have been compared. Ethylenediaminetetraacetic acid (EDTA) has been proposed as an alternative to citric acid and it possesses numerous admirable properties including being a more neutral buffer. The purpose of this study was to compare the ability of root surface preparation with EDTA to CA to provide a biologically acceptable root surface for human gingival fibroblast attachment via an in vitro fibroblast attachment system. Methods: Eighteen uniform human root samples were obtained (9 diseased and 9 healthy). All specimens were root planed, then conditioned with either CA, EDTA or saline (SA) for 1 minute. Root samples were then individually cultured with 30,000 human gingival fibroblasts (HGF) for 72 hours at 37°C / well then processed for SEM evaluation. An additional 6 samples were treated with RGD peptides prior to culturing to block the binding of HGF via collagen receptors. The number of attached HGF cells per root sample was then determined. Results: The use of either CA or EDTA in conjunction with root planing significantly enhanced fibroblast attachment. In healthy root samples, both CA and EDTA produced significant increases in HGF attachment over SA controls (13 and 12-fold respectively). The difference between CA and EDTA was not statistically significant. In diseased root samples the degree in HGF attachment was more substantial for both CA and EDTA (24 and 21-fold respectively), the difference was significant (p < .10). Application of RGD peptides selectively blocked binding of HGF to below control levels for both CA and EDTA treatment groups, suggesting that collagen binding participates in the binding mechanism. Conclusions: EDTA can detoxify a previously diseased root sample in vitro but less effectively than citric acid.

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