Dimensional evaluation of blood clot gap distances within intrabony defects following grafting and EDTA root surface treatment—experimental study in dogs

• Published in: Journal of periodontology (1970) 2018-06, Vol.89 (6), p.691-698
• Main Authors: Gamal, Ahmed Y., Abdel‐Ghaffar, Khaled A., Zouair, Mohamed G., Salama, Mohamed H., El Destawy, Mahmoud T.
• Format: Article
• Language: English
• Subjects: clot retraction; Dentistry; ethylenediaminetetraacetic acid; periodontal diseases; periodontal regeneration; surgical flaps; wound healing
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1002/JPER.17-0361

Background Because it is important to establish and maintain a firm blood clot to the surrounding tissues within the intrabony lesion; we have to investigate the potentials of different materials in resisting clot retraction that disrupt clot adhesion to the root surface. This study was designed to measure the gap distance created by clot retraction within the defect following intrabony defects grafting with and without root surface EDTA etching. Methods Eight mongrel dogs with surgically created acute‐chronic bilateral mandibular interproximal intrabony defects in the premolar‐molar areas were enrolled in this study (total 8 defects per dog). Intrabony defects were divided into four groups, the first group (OFD): control open flap debridement, the second group, (EDTA treated defects) in which debridement of the defects was followed by two minute root surface etching with a neutral 24% EDTA gel followed by two minute copious saline irrigation, the third group (only grafted defects): defects received closely packed β‐TCP of a particle size ranged from 150 to 500 mm, and the fourth group, (Graft + EDTA treated defects): defects were etched for 2 minutes with a neutral 24% EDTA gel and saline irrigation followed by intrabony defect fill of β‐TCP. Twenty four hours post treatment, animal euthanasia was carried out for histomorphometric analysis of the tooth and root side gap distances. Results EDTA treated group and EDTA + graft group showed statistically significant lower degree of clot shrinkage compared to both the control and only grafted group. Clot shrinkage in EDTA treated group showed no significant difference from that of the EDTA + graft group (p = 0.197). OFD and only grafted groups were found to show statistically higher clot retraction percnetage compared to both EDTA and EDTA+graft groups. Conclusion following intrabony defect debridement, blood clot undergoes clot retraction creating a micro gap with the root surface. EDTA root surface etching before graft application into the defect area significantly reduced the amount of gap distance.