Evaluation of Effect of Carisolv, EDTA-S and EDTA on Periodontally Diseased Root Surfaces: An In-vitro Scanning Electron Microscopic Study

Introduction: Periodontal disease results in recession and bone loss which causes morphological changes in the root surface. Traditional treatment like scaling and root planing successfully remove plaque and calculus and necrosed cementum but leaves smear layer which may interfere with normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. However, there were certain drawbacks with respect to the conventional root conditioning agents such as the acidic pH which can damage the root surface. Hence, there has been a search for more efficient biocompatible root conditioning agents. The newer insight in the area of root conditioning agents was introduction of Carisolv. However, the evidence with respect to Carisolv as an effective root conditioning agent is scarce. Aim: To evaluate the effectiveness of Carisolv, EDTA-S and EDTA on periodontally diseased root surface and ability to remove smear layer. Materials and Methods: The study constituted of sixty single rooted teeth which were extracted due to periodontal disease. These teeth were randomly allocated into 4 groups (n=15)- Group I: Scaling and Root Planing (SRP) alone, Group II: Carisolv+SRP, Group III: SRP+15% EDTA gel, Group IV: SRP+EDTA-S (EDTA+Texapon/Soft soap mixed in 1:1 ratio) gel. These teeth were treated with the root conditioning agents and evaluated with scanning electronic microscope. The teeth were evaluated for surface morphology, presence of smear layer, Patency of dentinal tubules, Roughness loss of tooth substance index and Sampaio's Index for root surface modification. These values were statistically analysed using Mann-Whitney U Test. Results: The results demonstrated a highly statistical significance (p<0.01) for removal of smear layer and patency of dentinal tubules in favour of Group II (Carisolv) at both 1000X and 1500X as compared to Group I, III and IV. Conclusion: Carisolv showed better root biomodification properties as compared to Ethylene Diamine Tetraacetic Acid (EDTA) and Ethylene Diamine Tetraacetic acid-S (EDTA-S). It was also concluded that EDTA and EDTA-S did not show any significant differences when compared to scaling and root planing alone as a root biomodification agents. The use of Carisolv as a root biomodification agent showed promising results and hence it can be recommended for in-vivo use.