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Since endotoxin may be absorbed only in the superficial layer of cementum leaving the deep cementum unchanged morphologically, the cementum of teeth with periodontal involvement was examined. The author considered that the application of citric acid after curetting of only the superficial cementum was better root treatment than complete removal of the cementum. The aim of this study was to examine histological events during the formation of new fibrous attachment to demineralized cementum after flap surgery following citric acid treatment in fifteen dogs. The demineralized cementum prevented the apical proliferation of junctional epithelium. The fibroblasts apposed to the exposed cemental collagen produced numerous new fibrils. Furthermore, the newly-formed collagen fibrils appeared to link with the exposed ones. These findings suggest that this root treatment would facilitate the formation of new fibrous attachment.

nihon shishubyo gakkai kaishi (journal of the japanese society of periodontology)

Study on new gingival tissue attachment following flap surgery - Gingival attachment to cementum in curettage of the superficial layer following the use of citric acid.