The effect on healing of the application of citric acid during replaced flap surgery.

The aim of this double-blind controlled clinical trial was to assess the effect on healing following conditioning the root surface with citric acid during replaced flap surgery. Healing was assessed in 18 pairs of sites in 12 patients before surgery and after 3 months; healing was also assessed in 13 pairs of these sites in 10 of the patients after 9 months. During surgery, the root surface at 1 site from each pair was treated with citric acid pH 0.6 for 3 min and the contralateral site was exposed to sterile saline. Healing was assessed by measuring attachment levels, probing depths and recession; in addition, gingival crevicular fluid flow was measured, as was the degree of bleeding on probing. The mean gain of attachment (mm) in the acid and control groups were 1.0 and 1.2, respectively, at 3 months and 1.1 and 0.9 respectively, at 9 months. The results of this study indicate, both clinically and statistically, that the difference in healing between the acid and the non-acid sites is not significant. Thus no additional benefit is shown by using citric acid in conjunction with replaced flap surgery on anterior teeth.