The pulpal response to citric acid in cats

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Abstract
Citric acid conditioning of dentine has been proposed as an efficacious treatment for promoting re-attachment after periodontal surgery. This study investigated the pulpal reactions to periodontal surgery combined with citric acid (pH 1) demineralization of exposed dentine for 3 min. 9 cats were used as the experimental animals, with each cat providing 1 negative and 1 positive control and 2 experimental canine teeth. Evaluation was over 3 observation periods, with 3 cats in each period being sacrificed at 4, 21 and 83 days. Positive control teeth, which underwent periodontal surgery combining the removal of approximately 3 mm2 of labial bone and vigorous root planning of the exposed root surfaces, displayed mild to moderate pulpal reactions during the short- and intermediate-term periods and only mild to no reactions in the long-term period. The addition of citric acid demineralization, however, resulted in 5 experimental teeth (28%) becoming abscessed or totally necrotic in the intermediate- and long-term periods. At 21 days, the frequency of adverse pulpal responses to surgery and citric acid conditioning was significantly (p<0.05) greater than to surgery alone. Although 4 experimental teeth were relatively uninflamed at the long-term period of observation, all showed irritational dentine formation. Penetration of exposed dentinal tubules by plaque bacteria was observed only in the citric acid treated teeth.