Healing Responses of Human Intraosseous Lesions Following the Use of Debridement, Grafting and Citric Acid Root Treatment: I. Clinical and Histologic Observations Six Months Postsurgery

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Abstract
Three block sections of treated human intraosseous lesions within one individual are presented. These lesions were debrided, filled with autogenous grafts and at two sites the root was treated with citric acid. The treated sites were lightly root planed once a month and the blocks were removed 6 months after surgery. In addition, the root accretions within two lesions were notched with a bur prior to root planing in order to positively identify the position of these root accretions in the histologic sections. Clinically, the lesions closed by marginal shrinkage and limited pocket closure. Histologically, regeneration of new cementum, osteogenesis at bone and graft spicule seams and reformation of functionally oriented ligament fibers were present at sites within lesions where accretions had covered the root. Such a healing phenomenon was observed close to the base of the lesions and seemed to be related to this spatial configuration rather than to the notching of the root itself. No specific increased healing responses could be attributed to citric acid root treatment. Thus, “regeneration” of new attachment is possible within human intraosseous lesions even at root sites previously covered by accretions. However, such responses seem to be limited to areas near the base of the intraosseous lesion.