The clinical effects of citric acid and laterally positioned pedicle grafts in the treatment of denuded root surfaces. A pilot study.

A new technique of a combined mechanical-chemical root preparation to enhance reattachment of pedicle grafts to previously denuded root surfaces is described. The clinical results of two documented cases are presented. The findings of this pilot study indicate that the technique is well tolerated by the patients, yielding a normal postoperative healing pattern and a clinical gain in the attachment level. These preliminary results may be attributed to: (1) Total elimination of bacterial endotoxin from the root surfaces by instrumentation and topical application of saturated citric acid at pH 1.0 for 3 minutes; (2) chemical exposure of dentin collagen fibrils, into which the graft may reattach; and (3) induction of cementogenesis by the exposed dentin.