An in vitro scanning electron microscopic study comparing MTAD (intracanal irrigant) and various root biomodifiers on periodontally involved human teeth

Background: Smear layer removal and collagen fiber exposure may improve regeneration outcome, which can be accomplished by use of root biomodifiers. These enhance the degree of connective tissue attachment to denuded roots. The objective of this in vitro scanning electron microscopic study was to comparatively evaluate mixture of tetracycline (TTC) and acid and detergent (MTAD) and other root biomodifiers for smear layer removal on periodontally involved human teeth. Materials and Methods: Forty human teeth were collected and stored in saline. After scaling and root planning, two samples were obtained from each tooth. A total of 80 dentin blocks were randomly divided into four groups: MTAD, TTC hydrochloride (TTC HCl), citric acid (CA), and normal saline. The agents were applied for 3 min by active burnishing. Immediately following treatment, the specimens were rinsed, dehydrated, fixed and prepared for scanning electron microscope and was examined at Χ3500 magnification. Previously trained blind examiners evaluated photomicrographs using Sampaio′s index (2005). Statistical analysis was performed. Results: MTAD is most efficacious in removing smear layer and showed statistically significant dentinal tubules opening, followed by TTC HCl and CA. Conclusion: MTAD and conventional root biomodifiers used in the study alters the dentin surface by smear layer removal and exposure of dentinal tubules. Hence, MTAD as a root biomodifier may have a significant role in periodontal regeneration