Effects of citric acid on diseased root surfaces

The effect of topically applied citric acid on periodontally diseased root surfaces was evaluated using the scanning (SEM) and transmission (TEM) electron microscopes. Results with the SEM indicate that acid application had no effect on specimens that had not been root planed. After application to root planed surfaces, however, the acid priduced a fiber-like surface with frequent depressions. TEM observations showed that the acid application produced a four micron wide demineralized zone, which was characterized by exposed collagen fibrils. These fibrils seemed to be continuous between the mineralized and demineralized zones of the root.
It appears that the relative success of the citric acid application in periodontal reattachment procedures is realted to the fact that the acid causes exposure of collagen fibrils in the dentin matrix, thus providing a suitable nidus for splicing with new fibrils during the healing process.