Salgado M
Rev Dent Chile. 1989 Apr;80(1):19-22.
The optimal result of periodontal therapy is the regeneration of tissues previously destroyed by periodontal disease. In order for regeneration to occur, it is believed necessary to eliminate all root surface alterations. Preparation of the root surface include scaling and root planning, use of acids and other chemical and biological agents. Citric acid has been studied by several authors, but still remains in controversy the biological nature of its effects. In spite of this, the findings of some studies indicate that citric acid used on root surfaces results in: elimination of endotoxins; chemical, exposure of dentin collagen fibers; induction of cementogenesis by the exposed dentin; demineralization of root cementum; enhancement of fibroblast attachment when a plasma factor is used in addition to citric acid demineralization and influence on direction in which the epithelium initially starts to migrate. By the other hand root surface preparation by mean of scaling and root planning is an unpredictable procedure due to variables such as failure to remove the cementum on calculus debris in a clinical situation. New research is needed in order to obtain a predictable root conditioning procedure for a biological surface.
牙周治疗的最佳结果是使先前被牙周病破坏的组织再生。为了实现组织再生,人们认为有必要消除所有牙根表面的改变。牙根表面处理包括龈上洁治和根面平整、使用酸以及其他化学和生物制剂。几位作者对柠檬酸进行了研究,但其作用的生物学性质仍存在争议。尽管如此,一些研究结果表明,在牙根表面使用柠檬酸会导致:内毒素的消除;牙本质胶原纤维的化学性暴露;暴露的牙本质诱导牙骨质生成;牙根牙骨质脱矿;在柠檬酸脱矿的基础上添加血浆因子时,成纤维细胞附着增强;以及对上皮最初开始迁移方向的影响。另一方面,由于临床情况下未能去除牙石碎片上的牙骨质等变量,通过龈上洁治和根面平整进行牙根表面处理是一个不可预测的过程。为了获得可预测的生物表面牙根预处理程序,需要开展新的研究。