Enhancing attachment of human gingival fibroblasts to periodontally compromised teeth: A comparative analysis of hyaluronic acid, EDTA, enamel matrix derivatives

Background: Gingival recession is a characteristic indicator of periodontitis and one of the factors that contributes to increased tooth clinical crown length. Patients with root exposure fre-quently undergo periodontal surgical procedures in addition to adjunctive therapy to increase root coverage area and soft tissue stability. Purpose: This study aimed to evaluate fibroblast-root surface adhesion and determine whether periodontitis-damaged root surface microstructure can be restored using ethylenediaminetetraacetic acid (EDTA) and an enamel matrix derivative (EMD), individually or in combination.Material and methods: Teeth extracted from patients with periodontal disease were used to cre-ate 60 samples, with each group containing six specimens. The test groups were provided root plan-ing or root condition-specific materials (hyaluronic acid [HA], 24% EDTA, EMD, or EDTA/ EMD) for varying treatment time periods. In contrast, the control group did not undergo any sur-face modifications. The samples and fibroblast cells were incubated for 72 h. The number of living cells on the root surface in each group was calculated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphe nyltetrazolium bromide (MTT) assay (cell viability assessment). Results: The control, root planing, and EMD groups showed that the root surfaces treated with EDTA for 4 min had significantly better cell adhesion. Surface EDTA treatment for 2 min signif-icantly promoted cell attachment compared to root planing treatment. The root surfaces modified with EDTA/EMD for 2 and 4 min showed significantly improved cellular migration and adhesion compared to the root surface treated with root planing.Conclusion: EDTA and EDTA/EMD substantially affected the root surface, which was related to the length of the treatment process. This effect shifts the surface properties, alters fibroblast inter-actions with the root surface, and recruits more cells to cover a larger area.& COPY; 2023 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).