The effect of citric acid treatment on periodontal healing after replantation of permanent teeth.

The aim of this study was to evaluate the effect of surface demineralization on the healing of 120 replanted teeth in fifteen 8- to 16-month-old dogs. Replanted teeth were divided into two groups (A and B). In group A, teeth were replanted following planing of the entire root surface. In group B, teeth were replanted following planing and surface demineralization with citric acid. Replanted teeth were splinted for 7 days, and observation periods were 3, 14 and 56 days. A total of 95 teeth and their surrounding tissues were examined histologically under a light microscope. Histological examination of specimens 3 days after replantation revealed that initial reunion between the root and the alveolar periodontal ligament fibres was via a fibrin-like network in both groups. Fourteen days after replantation histological observations showed superior healing in group B with regard to epithelial condition, periodontal ligament fibre reattachment to the root surface, resorption and functional arrangement of the periodontal ligament fibres. By 56 days after replantation, healing was superior in group A; group B was characterized by severe inflammatory and replacement resorption. These results indicated that surface demineralization had an initial positive effect, but later led to impaired healing.